This equity toolkit provides guidance and structure for the development of new, and examination of existing, policies to ensure a systemic approach for equitable outcomes.
We recognize our history as a community with institutional racism, colonization, misogyny, xenophobia, the litany of “ism’s” and various types of intentional or unintentional structural outcomes and oppression of individuals and groups that can occur as products or by-products of policy creation and implementation. Lack of awareness, ignorance or an unwillingness to look deeper into ourselves is no longer acceptable. We must embrace and live our values of diversity, equity, and inclusion at SMPH. Policies should reinforce and exemplify these values and mission.
In the spirit of “you can’t fix what you can’t see,” this equity toolkit offers a lens for assessing policies for a better tomorrow, starting today.
Embarking on reviewing and making policy through an equity lens requires self-reflection and education. The buttons below will introduce you to this toolkit and to creating a policy review team, and then guide you through a series of learnings that will position you to do this important work.
Introduction and Getting Started
1. Tools and Exercises 2. Policy Proposal, Development, and Review
Introduction
This is an accordion element with a series of buttons that open and close related content panels.
The purpose of this toolkit is to facilitate:
- Standardization and consistency of policy creation, review and implementation across SMPH using an equity lens
- Ensuring an equitable, inclusive workforce, learner population, training opportunity, experience and environment for all
- Recognizing historic patterns of exclusion based on racial, gender, ability, socioeconomic status and all marginalized identities and social categories and intersections, and allocating the exact resources and opportunities needed to reach an equitable, just outcome
This toolkit should be used to review:
- New policy during creation, implementation and evaluation
- Existing policy when deemed to: constrict opportunity for individuals and groups; no longer meet legal or ethical standards for funding and governing bodies; have unclear outcomes; etc.
- Policy/ies that fit within the purview of the policy review team
The goals of this toolkit are to:
- Ensure equitable, inclusive policies are developed and implemented to build a true culture of belonging for all.
- Ensure inequitable policies are consciously addressed, revised and evaluated so that inequitable policies and practices are not perpetuated and continue to do harm.
- Empower individuals and groups to review policy even if they do not have jurisdiction to change which can bring to the attention of those with power to enact changes.
- Ensure we are not just speaking about our values, mission etc. but actively working to live in an inclusive, equitable policy environment by regularly reviewing our policies and making changes that are warranted.
The intended impact from using this toolkit is:
- Cultural transformation so that all identities and intersections are welcomed, celebrated and feel a sense of belonging here
- Examine what we know today and do better.
- Further the SMPH Building Community mission:
- INTEGRITY AND ACCOUNTABILITY – Every person, every action, every time.
- COMPASSION – Treat all with kindness, understanding, and empathy.
- DIVERSITY, EQUITY, INCLUSIVITY – Advance health and health equity by respecting the rights, dignity, and differences of all.
- EXCELLENCE – Strive for the very best in all we do.
Getting started
This is an accordion element with a series of buttons that open and close related content panels.
Who should use this toolkit and be at “the table” with it?
- Any interested party from UW SMPH — staff, faculty, leadership, students and learners
- A person in a position of power/chain of command at SMPH who can address/implement changes
- One or more people who are currently, or could be in the future, impacted by the policy
- Multiple stakeholders from diverse backgrounds with a variety of perspectives — not just those who write the policy, benefit or are impacted
Setting team expectations — things to consider:
- Timing
- Confidentiality of discussion
- Impact assessment
- Intention
- Distribution
- Editing
- Commitment to equity
- Accountability of everyone on the team
- Recognition not everyone is in the same place or had the same journey
Roles and responsibilities of policy review team:
- To review newly proposed and existing policies alongside this toolkit to ensure equity is at the fore
- The team is responsible for:
- Acknowledgement of any known group biases
- Use of respectful language and defining any new terms
- Thoughtful assessment of policy impact
- Communicating policy changes and justifications to stakeholders
1. Equip Yourself for this Work with Tools and Exercises
You have reached a vital part of this toolkit. This step will begin a journey of self-reflection and expectation setting that equips you to review and craft policy through an equity lens. These tools and exercises will guide you through a series of learnings about diversity, equity, and inclusion, and where these issues intersect with policy.
Some tools contain lists of many valuable resources. In these instances, it can be helpful to divide up a resource per team member to read or listen to and each team member can present their learnings to the group for discussion. Teams of individuals will always be at different stages of their personal growth and learning. These resources will allow your group to establish shared language and understanding.
A) My Multicultural Identity
Take a moment to create your own multicultural identity puzzle and take part in a group discussion.
B) Implicit Bias and Reflection Worksheet
Complete this guided worksheet to uncover and recognize implicit bias that you, as an individual and you, as a group, may hold.
C) Embedding Equity Tools
This series of modules offers the necessary education, resources, and tools to set leaders, stakeholder groups, and teams up for success in learning how to embed a systematic application of a DEI lens across clinical and non-clinical policies, processes, and business decisions.
D) DEI Resources and Action Items
Although by no means comprehensive, this wealth of resources will begin to help you understand privilege, avoid common missteps, and identify ways in which you can intentionally be anti-racist in your work.
E) Advancing Health Equity: A Guide to Language, Narrative and Concepts
The Association of American Medical Colleges and American Medical Association have put together a guide to provide learners, staff, faculty, and others with a valuable foundational toolkit for health equity.
2. Now Embark on Policy Proposal, Development, and Review
Step 2 provides you with resources for how formal policy development and review processes function at the University of Wisconsin School of Medicine and Public Health. This will help you complete the revised SMPH Policy Proposal and Review Plan.
SMPH Policy Development and Approval Process Flowchart
The policy author(s) and review team should familiarize themselves with the policy development and approval process.
SMPH Policy Proposal and Review Plan
The policy author(s) and review team should complete the below form prior to drafting or revising an existing SMPH policy. Submit completed forms or request consultative services by contacting Carrie Brinkmeier at cbrinkmeier@wisc.edu.
Have a question?
Have a question about this toolkit? Get in touch with us by emailing ntakahashi@uwhealth.org or hitting the button below and someone will get back to you.
Supplementary Information
Glossary
This is an accordion element with a series of buttons that open and close related content panels.
Ableism
The discrimination of and social prejudice against people with disabilities based on the belief that typical abilities are superior. At its heart, ableism is rooted in the assumption that disabled people require ‘fixing’ and defines people by their disability.
Acceptance
Acceptance of others’ opinions; acceptance and self-awareness of our own personal biases.
Ageism
The discrimination, prejudice and negative stereotyping against people based on age.
Anti-racism
Actively opposing racism by conscious and deliberate advocacy to provide equal opportunities for all people on an individual and systemic level.
Assumptions
An idea that is assumed to be the true, even without proof, and from which a conclusion can be drawn.
Black, Indigenous, People of Color (BIPOC)
Black generally describes a person of African or Caribbean descent. Many in the U.S. use the term African American; however, this is not always accurate as some Black people are not American and some do not trace their roots to Africa. Indigenous describes the native inhabitants of North America that encompasses all tribes of the original residents of the content. Specific terms might include American Indians or Native Americans, First Nations, Native Alaskans or Alaska Natives. People of Color is an umbrella term that refers to all of color – anyone who is not white and broadly includes, among others, people from India, East Asia, Mexico, Hawaii and other Pacific Islands, the Philippines.
Cisgender
When one’s sense of gender and personal identity corresponds with one’s birth sex.
Classism
Differential treatment based on social class or perceived social class, particularly a belief that a person’s social or economic station in society determines their value in that society. In the SMPH setting, classism can unintentionally manifest itself in policies and practices that presume all have equal access to personal financial resources. For instance, a policy that has the expectation that an employee will pay upfront an expense such as for the purchase of a personal computer or tuition that will be reimbursed by SMPH after the fact reinforces a classist environment for those who do not have access to that type of flexible income.
Culture
Refers to a group or community which shares common experiences that shape the way its members understand the world by influencing their views, their values, their loyalties, and their worries and fears. It includes groups joined via birth, such as race, national origin, gender, class, or religion. It can also include a group joined by moving to a new country or region, by a change in economic status, or by becoming disabled.
Diversity
Embodies acceptance, mutual respect, and multiple perspectives and serves as a catalyst for change resulting in equity. In this context, we are mindful of all aspects of human likeness and differences, such as race, ethnicity, sex, gender identity, sexual orientation, socioeconomic status, religion, language, nationality, geography, disability, and age.
Engagement
The personal and/or professional commitment of each SMPH community member to actively promote and facilitate the organization’s pursuit and achievement of its goals.
Equality
Ensuring that all have an equal opportunity and access to the same resources to make the most of their lives and talents.
Equity
Just and fair inclusion into a society in which all can participate, prosper, and reach their full potential. Both equity and equality promote fairness, but equity promotes a fair and just shot at life by recognizing individual circumstances such as historic patterns of racial, gender, and socioeconomic exclusion, and allocating the exact resources and opportunities needed to reach an equal outcome. This is done through ongoing evaluation of systems and institutions to identify and remove biases in the distribution of opportunities and resources.
Equity Lens
Systematic examination of how different groups, including but not limited to racial and ethnic groups, will likely be affected by a proposed action or decision.
Ethnocentrism
The use of a cultural or ethnic bias lens in which one views one’s own group as superior to all other groups.
Hispanic, Latino/a, Latinx
Demographic categories ascribed to people groups from Latin America including the three largest populaces of the Latin-American diaspora: Puerto Rico, Mexico, and Cuba. The categorization label arose from the U.S. census count practices leading up to 1970 and the addition of the question “Are you of Spanish origin?” on the 1970 long-form census; the long-form survey was only administered to a limited number of households. The question became a formal part of the census form in 1980.
Historically Excluded Groups
Although there will be diversity within any group, there are specific groups or identities who have been historically excluded in an ablest, white, male-dominated, heterosexual society that favors urbanism. These include: Native and Indigenous people, People Living in Poverty, People of Color, People with Disabilities, LGBT2SQIA+ people, Immigrants & Refugees, Minority Religious Groups, Older Adults, Women, Youth, Other groups.
Homophobia
Refers to various negative attitudes for those who have an aversion to homosexual people or their lifestyle or culture that may be expressed at the individual, cultural, and institutional level. It can be directed towards gay, lesbian, bisexual, transgender and transsexual groups.
Inclusion
A core element for successfully achieving diversity. It is the intentional process of creating an environment (climate and culture of the institution) that acknowledges, welcomes, fosters belonging, respects, values, and supports all individuals and the unique qualities of their true and whole self. This is done through ongoing professional development, education, policy, and practice. The objective is to encourage engagement and connection throughout the institution.
Institutional Racism
Organizational programs, policies or procedures that work to the benefit of white people and to the detriment of people of color, usually unintentionally or inadvertently.
LGBT2SQIA+
This acronym refers to identity, sexuality and relationships. It evolves, and the current version expanded to be more inclusive. Lesbian (women attracted to women), Gay (men attracted to men), Bisexual (sexually attracted to both men and women), Transgender/Transsexual (gender identity different than what they were thought to be at birth), Two Spirited (having both a masculine and feminine spirit), Queer/Questioning (Queer is an umbrella term; Questioning describes someone who is questioning their gender identity or sexual preferences), Intersex (having biological traits which do not match what is typically identified as male or female), Asexual (individuals who do not experience or experience a low level of sexual desire), + other forms of sexual expression (people who have non-normative gender identity or sexual orientation).
Microaggression
A behavior such as an insulting remark, insensitive question or action that has to do with another person’s membership in a group that is discriminated against or subject to stereotypes. They can happen casually, frequently and without any harm intended.
Participation
All stakeholders have an opportunity to be involved in policy development and assessment. These activities should be encouraged and freely accessible to all.
Privilege
The experience of unearned freedoms, rights, benefits, advantages, access, and/or opportunities afford to members of a particular dominant group in society or in a specific context
Pronouns
Pronouns are what we use when speaking of a singular person in the third person. Pronouns often assume the gender of the individual, which can often be incorrect. In order to respect others’ identity and create inclusive environments, it is important to use correct pronouns.
Racism
The belief that one group of humans has the power to carry out systematic discrimination through the institutional policies and practices of the society against another group based on perceived racial or ethnic superiority.
Transphobia
The intense dislike of or prejudice against transsexual or transgender people.
Under-represented Minority or Under-represented in Medicine (URM)
The acronym can be used to refer to the low participation rates of racial and ethnic groups in fields such as science, technology, engineering, math and medicine as compared to their representation in the U.S. population. African Americans/Blacks, Hispanics/Latino(a), and Native Americans/Alaskan Natives are most commonly defined as URMs, which aligns with the National Science Foundation’s definition. In some contexts within the University of Wisconsin School of Medicine and Public Health, URM is also used to refer to Under-represented in Medicine.
Frequently Asked Questions
This is an accordion element with a series of buttons that open and close related content panels.
Why assess and review SMPH policies and practices with a lens on equity, diversity, and inclusion?
It is possible, if not likely, that some long standing policies within SMPH were developed and implemented by a homogenous group of individuals at a moment in time in which the value of diversity, equity, and inclusion in our community was not as evident as it is today. We also continue to learn about ways in which individual biases can subconsciously permeate policies and result in systemic exclusionary and/or unwelcoming signals. This Toolkit was developed by a diverse group of SMPH faculty, academic staff, and students as a way to evaluate SMPH policies in order to identify within them gaps, address disparities, and mitigate barriers that may be present or conveyed in written or spoken language.
What is the goal of the EIE Policy Assessment Toolkit?
The goal of this Toolkit is to provide a framework by which to reassess SMPH policies through a lens of diversity, equity, and inclusion. By providing a basis of knowledge and a clearly outlined process for reviewing policies, this Toolkit aims to identify areas for improvement and amendment that will result in policies that unambiguously reflect an inclusive and engaging environment that values diversity and a variety of backgrounds, abilities, and experiences in our community.
How do we use the EIE Policy Assessment Toolkit?
The committee or group involved in performing policy assessment using the Toolkit should include a diverse collection of perspectives from stakeholders representing all groups affected by the policies being reviewed. For further instruction, please refer to the section “Using This Toolkit” that is located above.
What happens after the Toolkit Assessment determines that an SMPH policy requires amendment?
If the Policy Review Team determines that an SMPH policy does not meet the standards of diversity, equity, and inclusion as outlined in the toolkit, any requested amendments and/or revisions will be routed through the SMPH Policy Proposal and Approval Process. The policy will undergo review at least every 3 years.
Where can I find examples of other institutions that performed policy assessments with a focus on equity, diversity, and inclusion?
Several other institutions have recently reevaluated their policies using processes similar to the EIE Policy Toolkit. We have curated a list of links to these institutions and the tools used in their policy assessment as an educational reference.
Where can I find more information about specific SMPH policies and their development?
An overview of SMPH policies, including policy development, approval, and review, as well as a searchable policy library, can be found at https://intranet.med.wisc.edu/policies/.
UW-Madison policies can be found at www.policy.wisc.edu.
An overview of the Policy Life Cycle at UW-Madison can be found at https://development.policy.wisc.edu/wp-content/uploads/sites/1600/2021/03/UW-Madison-Policy-Life-Cycle-01-20-21.pdf.
To contact the UW-Madison Policy Library Coordinator, please email policylibrarycoordinator@wisc.edu.
Best Practices for Difficult Conversations
This is an accordion element with a series of buttons that open and close related content panels.
Starting point
Have the group accept a set of ground rules for the conversation. These rules should encourage everyone to participate, everyone to listen in an understanding way, and everyone to feel safe in expressing their feelings without fear of negative consequences. Participants should use “I” sentences and talk about their own experiences and ideas and should avoid “you”, “we”, and “they” sentences that may lead to characterizing other’s ideas inaccurately.
Positive goal
The group should focus on the common goal and assume that each member is trying to help reach that goal.
Dialogue
The best understanding and resolution of conflicts will be achieved if everyone participates and expresses their honest opinions. The group should lean into discomfort to best address the issue. Individuals need to admit they do not have the same lived experiences as other members. Thus they should actively listen to the experiences of the group members and empathize with those telling their stories. Fear of negative consequences will prevent any meaningful dialogue, i.e., if people are afraid of being labeled as too sensitive or of overreacting or of being racist or sexist, they will not speak openly and honestly. Where possible, the conversation should be made explicitly confidential to avoid these negative consequences. Asking others to share their ideas and feelings may bring about an honest and useful conversation.
Summary
Meetings should end with a summary of decisions and policy changes agreed upon in an effort to make sure all members are comfortable with these conclusions. The summary increases transparency and allows all members of the group to voice any remaining concerns.
More Tools and Examples
This is an accordion element with a series of buttons that open and close related content panels.
University of Minnesota's “Applying an Equity Lens To Policy Development” Policy
- Equity lens “is a process for analyzing or diagnosing the impact of the design and implementation of policies on under-served and marginalized individuals and groups, and to identify and potentially eliminate barriers. This includes: race/ethnicity, religious expression, veteran status, people of color, including underrepresented groups and new immigrant populations, people who identify as women, age, socio-economic people with both apparent and non-apparent disabilities, people of various gender and sexual identities and expressions, American Indians and other indigenous populations.”
- Policy specifies that a “good policy” must:
- identify the key purpose of the policy, in as few words as possible (language that helps preventing barriers)
- prevent barriers with understanding or interpreting policy or procedure language
- sets direction and defines the intended audience
- Who does the policy impact?
- What forces are driving this policy?
- Are there individuals and/or communities that will be disproportionately (and negatively) affected by this policy?
- Does this policy perpetuate or help to dismantle historical, legal, or other barriers set in the past?
- If disparities are identified, how can they be mitigated or eliminated?
- provides a series of consecutive action steps related to a policy that specifies how a particular process should be completed
- includes individual roles or units who are responsible for some portion of the policy and process
- Are there individuals and/or communities that will be disproportionately (and negatively) affected by serving in this role and fulfilling the responsibilities identified?
- Applies an equity lens to Frequently Asked Questions and/or Appendices
- identify the key purpose of the policy, in as few words as possible (language that helps preventing barriers)
- Policies best practices:
- Pay attention also to these areas throughout your policy documents:
- Contacts – consider contacts listed within the context of the needs of the intended audiences
- Definitions – review or add definitions that would add to the reader’s understanding of the basic policy or procedures.
- Use of pronouns – avoid use of gendered pronouns (her/she).
- Recognize bias and assumptions
- Spend sufficient time and attention evaluating your policy and looking for disparate impact
- Consider whom have you consulted while creating/revising your policies
- Use campus resources such as the Diversity Community of Practice to help evaluate your policy
- Stop periodically to evaluate your policy and its implementation.
- Pay attention also to these areas throughout your policy documents:
The Non-Profit Association of Oregon (NAO) Equity and Inclusion Guide
The Non-Profit Association of Oregon (NAO) Equity and Inclusion Guide (1st edition 2010; 3rd ed 2018)
An interactive tool that helps learn about equity and inclusion and how to apply it to your work.
- Step 1: Consider Your Diversity
Recognizing diversity within ourselves and others can help us understand how multiple factors influence the way we provide services, design policies and programs, or interact with staff and community members or stakeholders.
Diversity Wheel:
Life experiences
Social factors
Organizational factors
Overarching systems of power
- Step 2: Check Assumptions
When we question our own ideas and biases, we can open up to new ways of understanding. Keep in mind that each of us could identify with more than one group, and that individual personalities make each person unique.
What are the assumptions taking place here?
Does this happen in our workplace?
Does this happen in the services we provide?
- Step 3: Ask About Inclusion
By always asking some intentional questions, we can thread equity and inclusion throughout our work.
Are the people most impacted and informed meaningfully included in discussions and decisions?
What policies or practices contribute to the exclusion?
Who is accountable for making changes that ensure inclusion?
- Step 4: Apply to Your Work
To help us apply equity and inclusion to a specific area of work, we can ask some practical questions and learn from examples of how others have applied the lens.
Are the people most impacted and informed meaningfully included in discussions and decisions?
What policies or practices contribute to the exclusion?
Who is accountable for making changes that ensure inclusion?
- Step 5: Be a Change Agent – Take Action
When we become a change agent and take action, we commit ourselves to using the information we learn in this work. It is not a one-time action. Being a change agent is a lifelong learning process of asking questions so we can apply (and re-apply) insights to action.
When I am a change agent or take action…
- I listen.
- I am aware of my own advantages and disadvantages and how I can use them to make a difference. I check my assumptions to unlearn biases and stereotypes.
- I stand beside and walk with others.
- I speak up against hurtful comments or insulting action, rather than wait for others to point out.
- I take steps to make the workplace and services inclusive, safe, and welcoming.
- I help others to understand discrimination and exclusion.
- I avoid the trap of “knowing what is good” for someone else.
- I share power and promote the leadership of others.
- I realize that being an agent of change requires ongoing learning.
- I listen some more.
- I am an agent of change when I take the initiative to join with others in creating change in the organization and ensure that our programs are equitable and inclusive of the wider community.