Considering equity

It is important to actively consider equity when planning and implementing suicide prevention approaches. This page provides an overview of equity and how an equity lens can be applied when implementing suicide prevention approaches.

What is equity?

Equity is the idea that everyone should have a fair opportunity to reach their full health and wellbeing potential. It is the absence of unfair or avoidable differences between groups of people.

Equity (and inequity) is shaped by the conditions under which people grow, live, work, and play—the social determinants of health.

Why consider equity in implementation?

Considering equity during implementation is essential to ensure suicide prevention efforts meet everyone's needs and do not unfairly affect certain groups more than others.

Historically, equity considerations in research and implementation are often overlooked:

  • Research can often be removed from the ‘real world’
  • Innovations may not be developed in collaboration with diverse people and communities, and;
  • Structural determinants often not acknowledged as part of the setting in which an innovation is being implemented. Structural determinants include political, economic and social systems that impact the social determinants (the conditions in which people grow, work, live and play).
Some implementation theories, models and frameworks do include equity considerations.

What is equitable implementation?

Equitable implementation explicitly and intentionally considers equity. It is reflecting on what is being delivered, who the audience is, and in what context or setting.

Actively involving people with a lived experience is an example of a step that can be taken to make implementation more equitable. Engaging people with lived experience is a matter of social justice because it ensures that people who have experienced a particular issue are involved in decision-making processes that affect them. Co-designing projects with diverse lived experience voices can help address systemic inequalities and improve policies, programs or services that directly impact people's lives.

The equity iceberg

The Centre for Implementation created the equity iceberg to help guide thoughts and conversations around equity in implementation.

It includes four levels:

Level 1 – Our actions

  • The specific actions we perform to make our intervention more equitable.

Level 2 – Our relationships

  • How equitable are our relationships and social processes?

Level 3 – Our systems and structures

  • How equitable are our systems and structures?

Level 4 – Our values and beliefs

  • Do our worldviews and beliefs promote equity?
Figure concept and development by Drs. Sobia Khan & Julia E. Moore. Figure design by Valentina Gastaldo. Khan, S., & Moore, J. E. (2023). Embedding Equity into Implementation: The Equity Iceberg. Implementation in Action Bulletin. Retrieved from https://thecenterforimplementation.com/toolbox/embedding-equity.
Figure concept and development by Drs. Sobia Khan & Julia E. Moore. Figure design by Valentina Gastaldo. Khan, S., & Moore, J. E. (2023). Embedding Equity into Implementation: The Equity Iceberg. Implementation in Action Bulletin. Retrieved from https://thecenterforimplementation.com/toolbox/embedding-equity.

There are many different elements to consider at each level of the iceberg. The worksheet below has been developed to help you consider how actions, relationships, systems and structures, and values and beliefs impact equitable implementation.

Considering equity in implementation worksheet