The image illustrates key difference between inequality, equality, equity, and justice. In this panel, the apples can represent resources, opportunities, or even outcomes and the ladders represent tools to access them.

• Inequality - Each person has access to the tree, but only one is receiving apples.

• Equality - In the top, right panel, both people receive the same ladder, however still, only one person can reach the apples.

• Equity - Each person gets an appropriate ladder that allows them to access the apples, but one person has less apples available to them due to the way the tree is growing.

• Justice - We see that the tree (which here represents institutions, policies, and systems) has been structurally altered so that each person can both access the apples and have access to the same number of apples.

Image Credit: Tony Ruth, Giving Tree, 2019

• Equity¹ – The process of identifying and removing the barriers that create disparities in the access to resources and means, and the achievement of fair treatment and equal opportunities to thrive.
• Health Equity¹ – Means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.
• Social Determinants of Health² – Social Determinants of Health (SDOH) are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
• Cultural Humility¹– The notion that while one cannot be competent in another's culture, one can engage in self-reflection, learning of biases, and being open to others' cultures.
• Inclusion¹ – Is creating environments in which any individual or group can be and feel welcomed, respected, supported and valued to participate fully.
• Diversity¹ – The presence of different and multiple characteristics that make up individual and collective identities, including race, gender, age, religion, sexual orientation, ethnicity, national origin, socioeconomic status, language, and physical ability.
• Microaggression¹ – Commonplace daily verbal, behavioral or environmental indignities, whether intentional or unintentional, which communicate hostile, derogatory slights toward culturally marginalized groups.
• Implicit Bias¹ (Hidden or Unconscious Bias) – The unconscious attitudes or stereotypes that affect a person's understanding, actions or decisions as they relate to people from different groups.
• Individual Racism³ – Negative interactions between individuals based on their individual characteristics (i.e. race, gender, ability). It can have a physiological effect compounded overtime, and can occur through daily, ongoing events or a major event.   
• Structural Racism^1,3– A combination of public policies, institutional practices, social forces, ideologies, and processes that limit “opportunities resources, and well-being” based on the discriminated group’s identity. It is reinforced in cultural norms and institutions. Examples can include the racial gap in wealth, homeownership, education, historical redlining practices among other factors.

References

1. National Association of Counties, 2019
2. Centers for Disease Control and Prevention, 2021
3. Healthy People 2030

The Equity Committee is part of the Oakland County Health Division (OCHD) Strategic Plan and demonstrates OCHD’s commitment to creating a healthier and more equitable community. In 2023, the committee was expanded to included all of Oakland County's Health and Human Services Department (HHS).  This committee demonstrates HHS' commitment to creating a healthier and more equitable community. The committee uses a collaborative approach to empower individuals and create change within HHS including the following:

• Create a culture of inclusion at HHS
• Engrain health equity and cultural humility in all HHS practices
• Improve the cultural and linguistic humility of the HHS workforce

Vision Statement

Improve diversity, equity, and inclusion for Oakland County employees and residents by working to eliminate barriers and improve health and well-being outcomes.

Current Initiatives

• Ongoing training for all HHS staff to enhance knowledge of equity and cultural humility and these concepts relevance to HHS' mission.
• Review and enhancement of HHS policies and procedures related to hiring, staffing, and workforce development to create a more diverse and inclusive workplace.
• Increasing culturally and linguistically tailored materials available to clients.

Equity Committee Members

Committee members are from the following Health & Human Services' Divisions and Units:

• Administrative Services
• Central Support Unit
• Clinic
• Community Nursing
• Community Nursing, Outreach Services
• Communicable Disease/Epidemiology
• Emergency Preparedness Environmental Health, Food, Shelter, & Prevention
• Environmental Health, Land and Water
• Environmental Health, Special Programs
• Harm Reduction
• Neighborhood & Housing Development
• Nutrition
• Nurse Family Partnership
• Planning and Evaluation
• Women's, Infant, and Children's Program (WIC)

• American Public Health Association - Creating health equity is a guiding priority and core value of APHA.
• Human Impact Partners Health Equity Guide - This website is structured around a set of strategic practices that health departments can apply to more meaningfully and comprehensively advance health equity.
• Michigan Department of Civil Rights Toolkit - This toolkit is designed to assist communities, government agencies and other organizations looking to incorporate racial equity into their decision-making and policy development in order to build stronger, more prosperous communities for all.
• National Standards for Culturally and Linguistically Appropriate Services (CLAS) - Guidelines for providing health services that are respectful of, and responsive to, the health beliefs, practices, and needs of diverse patients to help reduce health inequities.
• Racial Equity Tools – A toolkit designed to support individuals and groups working to achieve racial equity.
• Robert Wood Johnson Foundation - A deep dive into the meaning of health equity.

If you have any questions about equity or the Equity Committee, contact Lindsay TerHaar at terhaarl@oakgov.com.

For more information on Oakland County's Equity Initiatives and Equity Council, visit Oakland County’s commitment to Equity.