Establishing a Health Equity Office: The Importance of Recentering Equity

Objectives: The Pediatric Health Equity Collaborative (PHEC) set out to describe the best practices for establishing a health equity-focused office within a clinical setting.Study Design: Survey and in-depth interviews of the members of the PHEC comprised pediatric care delivery systems in the United States and Canada.Methods: Human-centered design methods were utilized in an iterative fashion to develop and agree on survey and interview domains. The final seven domains were as follows: (1) history of the office, (2) general description of the office, (3) position of the office in the organization, (4) budget and finance, (5) stakeholders, (6) community engagement, and (7) measuring outcomes. Interviews were analyzed using an applied thematic approach to inductively identify themes until saturation was achieved.Results: PHEC participants articulated several key implementation factors in the development of a health equity office. First, the history of the office is important and has the potential to determine the office's scope of work and sphere of influence. Second, a health equity office can provide crosscutting organizational direction, stability, and execution of equity efforts, reducing the effects of siloing. Third, high-level leadership buy-in provides time and financial resources. Finally, a health equity office should be centrally involved in the collection, analysis, and reporting of equity-focused metrics.Conclusions: A health equity-focused office can play an integral and sustaining role in representing and focusing equity efforts across an organization, measuring processes and outcomes, and helping to develop the equity mission and vision.