Shared Language to Advance Health Equity

Words matter. Being intentional with language and developing shared understanding can help ensure that we center care around the lived experience of patients and communities without reinforcing oppression and marginalization. The definitions below inform the way MSHIELD approaches our work. Given that language is dynamic, they are living definitions, last updated by MSHIELD in December 2023.

Scroll down for a complete glossary of frequently used terms.

Social Drivers of Health v. Social Needs

We intentionally use social drivers of health (SDOH) rather than social determinants of health. Both terms refer to the same thing—the conditions in which people are born, grow, live, work and age, which are shaped by the distribution of money, power and resources. SDOH include income, education, employment, housing, neighborhood conditions, transportation systems, social connections, and other social factors. However, determinants can have a sense of finality, as if access to food or housing are predetermined and not changeable. Using drivers more accurately represents the ability for policy-makers, communities, and individuals to affect change on these factors that influence health outcomes.
Social needs result from SDOH and are the individual-level needs people experience such as lack of access to healthy foods, inability to pay for utilities, and housing instability. Patients should be able to self-identify and prioritize their social needs.
Resource(s) for a deeper dive: https://www.milbank.org/quarterly/articles/meanings-and-misunderstandings-a-social-determinants-of-health-lexicon-for-health-care-systems/ and https://prapare.org/using-clear-terms-to-advance-health-equity-social-drivers-vs-social-determinants/

Racism

Racism is different from prejudice, hatred, or discrimination. Racism is when the power elite of one group, the white group, has the power to carry out systematic discrimination through the institutional policies and practices of the society while shaping the cultural beliefs and values that support those racist policies and practices. Simplified, Racism = race prejudice + (the misuse of) social and institutional power.
Racism can be understood on different, interrelated levels. For example, interpersonal racism is race-based discrimination between individuals, and structural racism is the compounding impacts of cultural norms, policies, laws, and practices that produce racial inequity.
Resource(s) for a deeper dive: ERACCE (https://www.eracce.org/) and https://www.dismantlingracism.org/racism-defined.html

Anti-racism

Active, ongoing commitment to identifying and eliminating racism by changing systems, organizational structures, policies, practices, and attitudes, so that power is redistributed and shared equitably.
Resource(s) for a deeper dive: National Museum of African American History & Culture (https://nmaahc.si.edu/learn/talking-about-race/topics/being-antiracist) and White Supremacy Culture Characteristics & Antidotes (https://drive.google.com/file/d/1XR_7M_9qa64zZ00_JyFVTAjmjVU-uSz8/view)

Health equity

Assurance of the conditions for optimal health for all people. Achieving health equity requires valuing all individuals and populations equally, recognizing and rectifying historical injustice, and providing resources according to need. – Dr. Camara Jones
Resource(s) for a deeper dive: https://www.ama-assn.org/delivering-care/health-equity/what-health-equity

Community engagement

Intentional collaboration with communities to achieve sustainable outcomes and equitable decision-making processes, deepen relationships and trust, and ensure communities have a direct say over what is needed to survive and thrive.
Resource(s) for a deeper dive: Spectrum of Community Engagement to Ownership (https://movementstrategy.org/wp-content/uploads/2021/08/The-Spectrum-of-Community-Engagement-to-Ownership.pdf)

Additional Resources

SIREN’s Guide to Implementing Social Risk Screening and Referral-making: https://sirenetwork.ucsf.edu/guide-implementing-social-risk-screening-and-referral-making

Oregon Primary Care Association’s Principles for Patient-Centered Approaches to Social Determinants of Health Screening: https://orpca.org/wp-content/uploads/2023/08/OPCA-Principles-for-Patient-Centered-Social-Needs-Screening.pdf

Anti-Racism Accountability

Glossary

Collaborative Quality Initiatives (CQIs): Collaborative Quality Initiatives address many of the most common and costly areas of surgical and medical care in Michigan. In each CQI, hospitals and physicians across the state collect, share and analyze data on patient risk factors, processes of care and outcomes of care, then design and implement changes to improve patient care.

Community-Based Organizations (CBOs): A public or private nonprofit organization that is representative of a community or a significant segment of a community and works to meet community needs.

Community Hub: A public space that brings several community agencies and neighborhood groups together to offer a range of activities, programs and services.

Community Information Exchange (CIE): Care coordination tools that bring together providers and data from the health and social services sector.

Electronic Health Record (EHR): A digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.

Federally Qualified Health Centers (FQHCs): Safety-net providers that offer outpatient services. FQHCs include community health centers, migrant health centers, health care for the homeless centers, public housing primary care centers, and health center service “lookalikes.”

Health Equity Champions (HECs): Staff from CQI coordinating centers who participated in a sequence of educational modules aimed at growing their knowledge of health equity and antiracism and identifying opportunities to incorporate a health equity and antiracist approach into their work.

Health Information Exchange (HIE): Allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically—improving the speed, quality, safety and cost of patient care.

LOINC: LOINC, which stands for Logical Observation Identifiers Names and Codes, is a system used to electronically transmit a vast amount of health data, including clinical laboratory test orders and results. Currently, there are over 179 countries that have adopted LOINC, and it is translated into 20 different languages. LOINC is a common language (set of identifiers, names, and codes) for identifying health measurements, observations, and documents.

Michigan Health Information Network Shared Services (MiHIN): Michigan’s non-profit statewide entity legally, technically, and privately providing critical and comprehensive patient information to doctors, clinics, federally qualified health centers, hospitals, pharmacies, health insurance providers, and public health.

Pay-for-Performance (P4P): A performance-based compensation plan that can impact how health care providers are rewarded.

Plan-Do-Study-Act (PDSA): A systematic series of steps for gaining valuable learning and knowledge for the continual improvement of a product, process, or service.

Z-codes: Part of the International Classification of Disease (ICD) which is a widely recognized international system for recording diagnoses. It is developed, monitored, and copyrighted by the World Health Organization (WHO). Applied to any diagnosis, symptom, or cause of death, ICD consists of alphanumeric codes that follow an international standard, making sure that the diagnosis will be interpreted in the same way by every medical professional both in the U.S. and internationally.

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