Skip to main content
Evaluation 2023 Main banner
Icon Legend
Presentation Icons
PD Workshop
PD Workshop
Virtual Offering
Virtual Offering
Presidential Strand
Presidential Strand
Plenary Session
Plenary Session
BOF
BOF
Ignite
Ignite

Health Evaluation

An Approach to Measuring Health Inequities: Building the Health Equity Indicators for Cardiovascular Disease Toolkit

Wednesday, October 11, 2023
4:15 PM - 5:15 PM ET
Location: Grand Ballroom 9

Location: Grand Ballroom 9

Abstract Information: In the U.S., historical and current unequal policies and systems, as well as intentional disenfranchisement of Black, Hispanic, and Indigenous communities, contribute to health inequities in cardiovascular disease (CVD). To better understand and address these inequities, evaluators and public health practitioners need tools and resources for health equity measurement. This presentation shares the Centers for Disease Control and Prevention (CDC) Division for Heart Disease and Stroke Prevention multistage design process to develop health equity indicators (HEI) for CVD interventions and create a web-based toolkit with HEI measurement options for evaluators, public health practitioners and health care professionals. As an initial step, we used social justice and equity frameworks and literature scans to identify HEIs and to develop a conceptual framework that depicts how HEIs influence CVD inequities through multiple structural and socioenvironmental factors. Next, we interviewed researcher and practitioner subject matter experts (SME) to determine the utility and feasibility of the HEI conceptual framework and identified indicators. SMEs identified gaps in the framework and provided measurement considerations for HEIs. Lastly, we conducted an exploratory pilot among eight U.S. healthcare organizations to field test the HEIs, identify measurement gaps, develop case examples to showcase real-world applications of HEIs for program evaluation, and share patient perspectives. This presentation tells the story of the approach and the evaluation methodologies used for toolkit development and demonstrates how to use the toolkit.

Relevance Statement: Despite advances in treating CVD and its risk factors, inequities in cardiovascular outcomes persist by race and ethnicity, socioeconomic status, geography, and other factors. The recognition that health disparities persist among groups that have been marginalized fuels the need for evaluation indicators that address the root causes of inequity. This presentation will discuss a multistage design that used various evaluation methodologies to develop an online toolkit for public health practitioners and healthcare professionals to collect health equity data to inform programming and address inequities affecting the cardiovascular health of their patient populations. The HEI for CVD Toolkit includes the following components to support HEI measurement: a conceptual framework to provide a model for understanding health inequities in CVD, indicator profiles to provide an overview of HEIs and measurement guidance, case examples and field notes to describe healthcare organizations’ experience and lessons learned with gathering data for specific indicators, actionable resources, and glossary of terms. Although these indicators focus on CVD, the approach and methods used to develop HEIs can be translated across various sectors and will inform the field of evaluation. This presentation shares how to develop a comprehensive set of indicators that spans multiple sectors addressing the social determinants of health that ultimately contribute advancing of health equity. The presentation provides a real-world example of how evaluators can develop a measurement tool and framework and will inform audiences on the following: 1) the importance of creating tools to strengthen capacity for health equity data collection; 2) the methodologies (literature reviews, subject matter expert engagements, quantitative and qualitative methods) used to develop a measurement toolkit; and 3) how to use data related to social determinants of health and identify potential drivers of health disparities while assessing the progress and outcomes of interventions.