Equity

2 Equity

Equity is a principle, condition, process, and outcome rooted in human rights and the inviolability of human dignity. It is integral to the legal principle of justice and the ethical practice of fairness, requiring intentional transformation of systems to enable full participation and potential for all.^[1]

Equity is committed to uncovering and addressing systemic patterns of inequity embedded in structures, cultures, and processes that obstruct opportunity and participation.
A proactive orientation toward removing structural, systemic, and cultural barriers through deliberate measures and reasonable accommodations.
Substantive equity recognizes that different groups face different barriers and therefore require tailored measures to achieve fair and just outcomes. A pathway to equitable structures and opportunities that center and uplift equity-deserving groups—including but not limited to women, Indigenous peoples, racialized communities, persons with disabilities, and LGBTQ2S+—with explicit attention to their intersections.

Examples of Equity in Research Design

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Framing research questions to explicitly name equity-deserving groups to address differential impacts of health interventions. Example: “How do virtual mental health services impact Indigenous youth, Black youth, and LGBTQ2S+ youth differently across urban and rural contacts?”
- Did you know? 8 of 10 drugs were withdrawn from the U.S. market between 1997 and 2000 since these posed greater health risks for women than for men, illustrating the consequences of not accounting for Gender-based analysis plus (GBA+) in research design.
  - Reference: U.S. General Accounting Office [GAO], 2001. Drug Safety: Most Drugs Withdrawn in Recent Years Had Greater Health Risks for Women. Government Publishing Office, Washington, DC.
Designing inclusive sampling strategies to avoid biased “evidence”: e.g., ensuring recruitment targets reflect the demographic makeup of patients most affected by diabetes, including Indigenous peoples and racialized communities, rather than relying solely on convenience samples.
- Did you know? Indigenous peoples are diagnosed with diabetes at a younger age, have more severe symptoms when diagnosed, face higher rates of complications, and experience poorer treatment outcomes.
  - Reference: Diabetes Canada. Indigenous communities and diabetes: snapshot of age-standardized prevalence rates (2023). Diabetes – Canada – Indigenous communities & diabetes
Embedding community partnership principles in protocol development to ensure the research reflects lived experiences and local priorities: e.g., co-developing research questions on perinatal care with Indigenous midwives and patient partners to ensure the study reflects cultural safety priorities
- Did you know? Community-led perinatal programs have been shown to improve health outcomes and trust among Indigenous families.
  - Reference: Restoring Midwifery and Birth Workbook by the National Counsil of Indigenous Midwives.
Disaggregating health data by gender, race, disability, and other social identity factors: e.g., analyzing disease outcomes separately for women, men, and non-binary people, and for racialized and non-racialized groups, to detect differential treatment efficacy.
- Did you know?
  
  Disaggregated COVID-19 data revealed disproportionately higher infection and mortality rates among racialized communities, which were initially obscured by aggregate reporting.
  - Reference: Lessons learned from the collection of sociodemographic data during the COVID-19 pandemic by Public Health Ontario
  - Check out this resource to learn more: Centering Racial Equity Throughout Data Integrationhttps://aisp.upenn.edu/centering-equity/
Budgeting for equitable research design participation: e.g., including funds for translation of consent forms, accessible survey formats for participants with disabilities, and honoraria for patient/community advisors.
- Did you know? Lack of funding for accessibility and engagement is one of the top reasons marginalized populations are excluded from health research participation.
  - Reference: Le, D., Almaw, R. D., Rinaldi, D., Ivanochko, N. K., Harris, S., Benjamin, A., & Maly, M. R. (2023). Barriers and strategies for recruiting participants who identify as racial minorities in musculoskeletal health research: a scoping review. Frontiers in public health, 11, 1211520. https://doi.org/10.3389/fpubh.2023.1211520
Acknowledging researcher positionality in the proposal to make visible how background and perspectives shape research framing.
- Did you know?
  
  Reflexivity and positionality statements can strengthen the credibility and ethical grounding of health research, particularly when working with equity-deserving communities.
  - Reference: Wilson, C., Janes, G., & Williams, J. (2022). Identity, positionality and reflexivity: relevance and application to research paramedics. British paramedic journal, 7(2), 43–49. https://doi.org/10.29045/14784726.2022.09.7.2.43

Examples of Equity in Research Practice

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Providing accessibility supports for students or trainees with disabilities to ensure meaningful participation:
e.g., offering ASL interpretation, extended time for deliverables, or adaptive lab equipment.
- Did you know? Ensuring accessibility is not preferential treatment—it is an equity measure that enables full participation and aligns with human rights legislation.
  - Reference: Canadian Human Rights Commission. Duty to Accommodate
Recruiting participants through channels that reach equity-deserving groups to ensure diverse representation in research teams and participant pools: e.g., outreach through Indigenous community organizations, disability networks, and LGBTQ2S+ advocacy groups.
- Did you know? A 2018 report showed persistent lack of diversity in Canada’s academic workforce and wage gaps between men and women, and between white, Indigenous, and racialized staff.
  - Reference: Canadian Association of University Teachers. (2018). Underrepresented and Underpaid: Diversity & Equity Among Canada’s Postsecondary Education Teachers.
Addressing bias in evaluation processes in recruitment and selection: e.g., bias training for grant reviewers, using structured rubrics for scoring applications.
- Did you know? Structured evaluation tools reduce the impact of unconscious bias in academic hiring and awards.
  - Reference: Cumming School of Medicine — Bias in Hiring: EDIA Resources
  - Key resource: https://360.articulate.com/review/content/f634642b-c273-43ba-822f-839c8379ca67/review
Protecting students’ development opportunities after leave (e.g., caregiving, parental, bereavement, illness): e.g., maintaining access to co-authorship, conference participation, and research activities upon return.
- Did you know? Career interruptions disproportionately affect women and caregivers, widening equity gaps in academic progression.
  - Reference: Moors, A.C., Stewart, A.J. & Malley, J.E. Gendered Impact of Caregiving Responsibilities on Tenure Track Faculty Parents’ Professional Lives. Sex Roles87, 498–514 (2022). https://doi.org/10.1007/s11199-022-01324-y
Making flexible work and travel accommodations to support diverse needs: e.g., broadening vacation allowances for international students visiting family, or adjusting fieldwork schedules for religious observances and accessibility requirements.
- Did you know? Flexible arrangements can improve retention and well-being of underrepresented trainees and faculty.
  - Reference: Kaplan, S. (2022). Flexible work agreements: Here to stay but uneven in equity and promoting success. Evidence Based Library and Information Practice, 17(4), 4–7.
    https://doi.org/10.18438/eblip30200