health equity; health disparities; mission alignment; social determinants of health


Eliminating health disparities is a priority across national agenda and initiatives such as the National Partnership for Action to End Health Disparities (NPA), the National Prevention Strategy, and Healthy People 2020. To advance this priority under the NPA, the Federal Interagency Health Equity Team (FIHET), which is an NPA federal cross-sector and collaborative platform, initiated a voluntary pilot “health equity mapping” exercise in 2014. This exercise served as a strategy to clarify the strategic alignment between participant federal partner program missions, goals, and activities, and the goal to end health disparities and promote health equity. The mapping process included an examination of how participant programs applied the “equity lens” within the context of executing their missions. It also included identification of opportunities within participant programs to enhance the existing equity lens, or include one where it did not exist. In this paper, we exemplify this strategy and its outcomes using a case study approach conducted in collaboration with the “Children, Youth, and Families at Risk Sustainable Communities Program” (CYFAR SCP) in the Division for Youth and 4-H, at the National Institute of Food and Agriculture, within the US Department of Agriculture (USDA). Overall, we deduced that the CYFAR SCP program though not driven by an explicitly stated health equity mandate promotes health equity through existing programming. Specifically, we found evidence of the use of an equity lens in how the program targets resources and specific programs to benefit youth that are socially and economically disadvantaged. We also noted alignment between CYFAR SCP’s mission and promoting health equity in the program’s emphasis on improving the social determinants of health for its beneficiaries. Given these initial findings, we conclude that health equity mapping is a potentially insightful first line of inquiry into the tangible connections between a program’s mission, functions and implementation, and the promotion of health equity.