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Making the connection between health equity and sustainability

Sustainability and health inequities are key challenges in public health and healthcare. Research suggests that only about half of evidence-based interventions (EBIs) are sustained over time, and settings and populations experiencing systemic and structural barriers to health (e.g., poverty, racism,...

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Autores principales: Shelton, Rachel C., Hailemariam, Maji, Iwelunmor, Juliet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562623/
https://www.ncbi.nlm.nih.gov/pubmed/37822544
http://dx.doi.org/10.3389/fpubh.2023.1226175
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author Shelton, Rachel C.
Hailemariam, Maji
Iwelunmor, Juliet
author_facet Shelton, Rachel C.
Hailemariam, Maji
Iwelunmor, Juliet
author_sort Shelton, Rachel C.
collection PubMed
description Sustainability and health inequities are key challenges in public health and healthcare. Research suggests that only about half of evidence-based interventions (EBIs) are sustained over time, and settings and populations experiencing systemic and structural barriers to health (e.g., poverty, racism, stigma, and discrimination) experience even greater challenges to sustainability. In this article, we argue that an enhanced focus on sustainability in the field of implementation science is critical in order to maximize the long-term health benefits and broader societal impacts of EBIs for all populations and settings. From an equity perspective, a focus on sustainability is particularly critical to prioritize among population sub-groups that have not historically received the benefits of health-related EBIs. We discuss how a health equity framing is essential to sustaining EBIs in under-resourced communities, and requires moving away from a deficit mindset that focuses on why EBIs are challenging to sustain, to one that focuses more on identifying and nurturing existing assets within individuals and communities to increase the likelihood that EBIs are sustained. We conclude with a discussion of future directions as well as recommendations and resources (e.g., frameworks, tools) to advance and make progress toward sustainability from a health equity mindset, including: (1) Actively planning early for sustainability alongside key partners; (2) Tracking progress toward enhancing sustainability and being accountable in doing so equitably for all settings and populations; and (3) Focusing on both equity and engagement early and often throughout the research process and all implementation phases.
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spelling pubmed-105626232023-10-11 Making the connection between health equity and sustainability Shelton, Rachel C. Hailemariam, Maji Iwelunmor, Juliet Front Public Health Public Health Sustainability and health inequities are key challenges in public health and healthcare. Research suggests that only about half of evidence-based interventions (EBIs) are sustained over time, and settings and populations experiencing systemic and structural barriers to health (e.g., poverty, racism, stigma, and discrimination) experience even greater challenges to sustainability. In this article, we argue that an enhanced focus on sustainability in the field of implementation science is critical in order to maximize the long-term health benefits and broader societal impacts of EBIs for all populations and settings. From an equity perspective, a focus on sustainability is particularly critical to prioritize among population sub-groups that have not historically received the benefits of health-related EBIs. We discuss how a health equity framing is essential to sustaining EBIs in under-resourced communities, and requires moving away from a deficit mindset that focuses on why EBIs are challenging to sustain, to one that focuses more on identifying and nurturing existing assets within individuals and communities to increase the likelihood that EBIs are sustained. We conclude with a discussion of future directions as well as recommendations and resources (e.g., frameworks, tools) to advance and make progress toward sustainability from a health equity mindset, including: (1) Actively planning early for sustainability alongside key partners; (2) Tracking progress toward enhancing sustainability and being accountable in doing so equitably for all settings and populations; and (3) Focusing on both equity and engagement early and often throughout the research process and all implementation phases. Frontiers Media S.A. 2023-09-26 /pmc/articles/PMC10562623/ /pubmed/37822544 http://dx.doi.org/10.3389/fpubh.2023.1226175 Text en Copyright © 2023 Shelton, Hailemariam and Iwelunmor. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Shelton, Rachel C.
Hailemariam, Maji
Iwelunmor, Juliet
Making the connection between health equity and sustainability
title Making the connection between health equity and sustainability
title_full Making the connection between health equity and sustainability
title_fullStr Making the connection between health equity and sustainability
title_full_unstemmed Making the connection between health equity and sustainability
title_short Making the connection between health equity and sustainability
title_sort making the connection between health equity and sustainability
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562623/
https://www.ncbi.nlm.nih.gov/pubmed/37822544
http://dx.doi.org/10.3389/fpubh.2023.1226175
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