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“No project has unlimited funds and time for implementation…It is important to prioritize and concentrate on a limited number of issues. It may not be possible to work in all aspects of inequity at the same time. Decisions about which interventions to focus on should be related to the magnitude of the inequity and the possibility of taking action to improve the situation.”

—USAID/MCHIP

(Citation: Prioritizing, #1)

1. What is prioritization? Why prioritize?  Why use a health equity lens when conducting prioritization?

  • Prioritization is a process to rank items (i.e. health issues, strategies, interventions, etc) based on their perceived or measured importance or significance.

  • Prioritization serves as a transition from focusing on the findings collected during your assessment and of the review of the scientific literature to developing an action plan or determining a strategy, program, policy, or intervention.

  • Prioritizing allows the team, partnerships, and communities to direct resources, time, and energy to those issues that are deemed most critical to address with limited available resources (Citation: Prioritizing, #2).

There is no “one best way” to set public health priorities. What is essential, however, is that a process or method be adopted that is systematic, objective, and allows for standardized comparison of problems or alternatives that incorporate the scrutiny of science and the realities of the environment.

--Vilnius & Dandoy, 1990

(Citation: Prioritizing, #2)

Agencies, teams, organizations and partnerships are faced with an unlimited number of competing health issues to address. When faced with these tough decisions, using prioritization can provide a structured approach for ranking issues and making decisions, while also allowing groups to include community input and taking into consideration all facets of the competing health issues (Citation: Prioritizing, #3). Including a health equity lens in the prioritization process offers a comprehensive view of the health issues being compared, including carefully considering the impact (urgency and severity) on different populations as well as feasible solutions.

2. How can the health equity lens be used when determining who is involved in prioritization process?

Members of your agency, team, organization, or partnership should have input into the prioritization process. Members need to be mindful that their own beliefs may be different from those around them. Priorities should reflect the community (e.g. based on changes in the community or with changes in people’s concerns or knowledge). Priorities are often selected using criteria relevant to the community and based on those involved in the priority selection.  Involving impacted stakeholders in this process is critical.

3. How are priorities determined using a health equity lens?

Criteria to Identify Priority Problem

  • Cost and/or return on investment

  • Availability of solutions

  • Impact of problem

  • Availability of resources (staff, time, money, equipment) to solve problem

  • Urgency of solving problem (H1N1 or air pollution)

  • Size of problem (e.g. # of individuals affected)

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Criteria to Identify Intervention for Problem

  • Expertise to implement solution

  • Return on investment

  • Effectiveness of solution

  • Ease of implementation/maintenance

  • Potential negative consequences

  • Legal considerations

  • Impact on systems or health

  • Feasibility of intervention

“No determination of public health priorities should be reduced solely to numbers; values, social justice, and the political climate all play roles.”

---Brownson et al., 2011

(Citation: Prioritizing, #2)

There are multiple methods and criteria to use when conducting prioritization. Some methods rely heavily on group participation, whereas others are less hands-on and are more focused on data.  Depending on your agency, team, organization, or partnership, prioritization criteria may look at different criteria such as: conditions that are in place at the time of the decision and the needs and concerns of the people making the decision. NACCHO’s Common Methods of Prioritization provides a useful table (Table 1.14) for determining criteria for prioritizing health problems or health interventions. Also, resources listed below will assist in shaping methods and criteria to use in prioritization. 

4. How to implement an action plan using a health equity lens?

While conducting prioritization, it is important to keep in mind that prioritization should include input from all groups. Recognize how the priorities (i.e. health issues, strategies, or interventions) selected may impact negatively or positively different populations.

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5. How do you communicate prioritization results using a health equity lens?

Once you have conducted your prioritization process, this information should be shared with the larger community in many ways (website, social media, public forum, public announcement, press release, local libraries, and more).  It is important that the information remain available to partners and community members.

Learn More about

Prioritizing Program and Policy Options for Health Equity

Go back to Prioritizing Program and Policy Options for Health Equity Core Questions

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