Integrating equity into environmental health practice: findings of a pilot study

The existence of health inequities is a priority public health issue in Canada, but it is not clear how—or how well—equity is embedded into environmental health practice. To assess how health equity and the social determinants of health intersect with their practice, we conducted two focus groups with public health inspectors in British Columbia and Nova Scotia. We explored where social barriers affect compliance, how practitioners respond, and where there are resource or knowledge gaps that limit practitioner response. Participants identified barriers related to socioeconomic status, culture, education, and geography. They responded to these barriers largely in ad hoc ways, using makeshift or borrowed tools, personal collaboration networks, and communication strategies, and by exercising discretion and progressive enforcement. Public health inspectors indicated they were motivated to take action but felt uncertain of their scope and role in doing so. Findings indicate that health equity does relate to environmental health practice and that there is a need for additional resources, organizational supports from management, and further research to identify and evaluate best practices.