Health Equity Audit or Assessment


What is a health equity audit?

A health equity audit (HEA) is a tool used to identify and address inequalities, focusing on how fairly resources are distributed in relation to the health needs of different groups. HEA enables a systematic review of inequities in ill-health or in access to effective services. Equities refer to situations where level of access is truly related to level of need. HEA specifically investigates issues around access to healthcare according to epidemiology and demographic group.

HEA identifies how fairly services or other resources are distributed in relation to the health needs of different groups and areas and the priority action to provide services relative to need. The overall aim is not to distribute resources equally but rather, relative to health need. This process assists the planning and decision-making processes of organisations. It determines whether the distribution of health outcomes, healthcare or the determinants of health are inequitable or unrelated to need and action is then taken to remedy and monitor progress.

An important advantage is that HEA uses data on health inequalities to support decisions at all levels by utilizing comparisons by area, ethnicity, socio-economic group, gender and age. in doing so, it also considers the whole population and not just service users.

What is the difference between Inequality and Inequity?

Health inequality describes the differences in health experience and health outcomes between different population groups - according to socio-economic status, geographical area, age, disability, gender or ethnic group.

Health inequity describes differences in opportunity for different population groups which result in unequal life chances, access to health services, nutritious food, adequate housing and so on. These can lead to health inequalities.


  1. Inform commissioning to make services more accessible and appropriate.
  2. Provide evidence to show whether local health needs are being met.
  3. Encourage community involvement by providing information on inequities in services that allows groups to lobby for improved resource allocation.

Stages of a Health Equity Audit

  1. Agree priorities and partners
  2. Do an equity profile - identify the gaps (a health needs assessment can help with this)
  3. Identify effective local action to tackle inequalities
  4. Agree local targets/priorities with partners
  5. Secure changes in investment and local service delivery
  6. Review progress and impacts against targets

Further Resources

Health Equity Audits: Guide for the NHS (2003)