How to measure health equity

But how do you measure health equity? For public health professionals and healthcare organizations, the answer starts with identifying health disparities, tracking them with metrics and using data to help drive meaningful interventions.

This article explores the difference between health equity and health equality, why measuring health equity is important for advancing population health and a four‑step framework that public health agencies and health systems can use to track progress.

Health equity vs. health equality

While the terms are often used interchangeably, health equity and health equality are distinct concepts that lead to very different results in care delivery.

Health equity means providing resources and support tailored to an individual’s need so people can achieve their highest possible health outcome. This approach recognizes that historical, social and economic factors, such as socioeconomic status, race, language or geography, can influence health and be addressed through customized solutions.

Health equality, on the other hand, means giving individuals the same resources, regardless of need. While well-intentioned, equality doesn’t consider that some groups face more barriers than others, resulting in persistent health disparities and health inequity even when access to resources appears uniform.

This distinction highlights an important truth: equal inputs don’t create equal outcomes. To advance community health and reduce gaps in care, organizations must focus on equity, designing care models, policies and interventions that meet people where they are and provide the support they need.

Why measuring health equity is essential for quality care

Measuring health equity is critical for identifying and addressing health inequalities. Without clear health equity metrics, disparities in care access and outcomes can remain hidden.

Tracking these metrics helps healthcare organizations:

• Uncover gaps in healthcare access and quality
• Support compliance, accreditation and quality assurance programs
• Align with health policy and value‑based care initiatives
• Improve public health management through targeted interventions

This type of health equity measurement also strengthens disease prevention and health promotion strategies by showing where investments and resources can make the greatest impact

A four-step framework to measure health equity

For organizations wondering how to measure health equity, adopting a structured, repeatable approach is a good place to start. Without a clear framework, health equity measurement can become inconsistent and difficult to scale across departments or programs.¹

Public health professionals often use this type of health equity assessment toolkit to gather actionable insights:

Select indicators

Identify the most meaningful data points to track. These often include social determinants of health (SDOH) such as income, education, housing stability, transportation access and neighborhood safety. These indicators can help uncover root causes of health disparities beyond clinical care.

Define reference groups

Equity measurement requires comparison. Determine which populations to analyze, such as by race, ethnicity, language preference, insurance type or ZIP code, to identify where gaps in care or health outcomes exist.

Choose quality metrics

Select metrics that connect directly to your organization’s priorities. Examples include preventive screening rates, chronic disease management outcomes, medication adherence, patient experience scores and emergency department utilization. These quality measures can be helpful in revealing patterns that might otherwise go unnoticed.

Set benchmarks

Establish clear targets to measure progress over time. Use national standards like Healthy People objectives², state measures or your organization’s own historical data as reference points. This helps to ensure continuous improvement and keeps efforts aligned with broader public health and health policy goals.

When implemented together, these four steps help create a consistent approach to advancing health equity that is data-driven, measurable and scalable across health systems.

Using social determinants of health as key indicators

Addressing health inequity starts with understanding social determinants of health — the non‑clinical factors that shape well‑being and drive health outcomes.

Common indicators include:

• Income and employment status
• Housing stability and neighborhood safety
• Access to healthy food and transportation
• Language and literacy barriers
• Educational attainment

By collecting and classifying SDOH data, public health agencies and healthcare organizations can develop health equity efforts that address root causes of health disparities. These efforts align with World Health Organization recommendations³ for disease control, health promotion and advancing racial equity.

Standardizing metrics with IHI’s seven domains

To help maintain consistency across organizations, many health systems rely on the Institute for Healthcare Improvement (IHI) framework for advancing equity. This approach combines strategic priorities with measurable domains to help organizations create lasting change.

The IHI Framework for Achieving Health Equity⁴ outlines five key components:

• Make health equity a strategic priority: Embed equity into organizational goals, leadership agendas and resource allocation.
• Develop structure and processes: Establish dedicated teams, workflows and reporting systems to support equity initiatives.
• Deploy targeted strategies: Address the social and structural determinants of health that healthcare organizations can directly influence.
• Decrease institutional racism: Identify and dismantle policies and practices that perpetuate inequities.
• Build community partnerships: Collaborate with local organizations to extend the impact of equity initiatives beyond the clinical setting.

To operationalize these priorities, the framework also uses seven domains of health equity measurement, which provide a standardized way to track progress:

• Access to care
• Quality and health outcomes
• Workforce diversity
• Patient experience
• Community engagement
• Leadership commitment
• Data infrastructure

Together, these components and domains support health equity measurement⁵ approaches that are actionable, comparable and scalable, aiding health systems to track, report and help improve equity at any level.

Examples of equity metrics in practice

Organizations nationwide are using health equity measures to make measurable improvements:

• Language access: Tracking patient language preferences and providing multilingual support to help improve patient experience.
• Community outreach: Stratifying cancer screening rates by ZIP code and offering mobile screenings in underserved areas.
• Transportation assistance: Measuring missed appointment rates and adding transportation benefits to help improve follow‑up care.

These examples show how public health agencies and healthcare organizations can use health equity data to design targeted interventions that advance equitable care.

How to use equity metrics to drive improvement

Collecting data is the start. Health equity measurement should drive action by linking data to clinical pathways, community programs and quality measures.

Healthcare leaders can:

• Incorporate equity into strategic planning and public health management.
• Adjust care models to close identified gaps.
• Hold teams accountable for measurable progress.

When measurement informs interventions, organizations can create a culture of continuous improvement and advance health equity efforts across systems.

Start measuring what matters

Achieving equity requires data‑driven action⁵. By adopting a structured, metrics-driven approach, healthcare organizations and public health agencies can close gaps, help improve health outcomes and build more equitable systems of care.

Connect with McKesson today to access tools, resources and strategies for advancing health equity in your organization.