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Background and Framework


In 2017, IHI launched the first iteration of IHI Pursuing Equity and partnered with eight pioneer US health care systems to accelerate the role of health care in improving equity. During the two-year initiative, the eight teams made strides to embed a culture of equity by making health equity a strategic priority, facilitating conversations and actions to address structural racism, and testing numerous changes to improve equity in their systems and communities. 

In 2020, IHI launched the second iteration of Pursuing Equity, an 18-month initiative with teams from 22 health care organizations working to advance equity and racial justice in two project areas: one clinically focused, closing specific equity gaps, and one strategically focused, impacting culture or infrastructure. The next iteration of Pursuing Equity (January 2023 – June 2024) will challenge and support a small cohort of teams to take bold strides through deep work, while a larger community will build the foundation for radical equity work.


The Centers for Disease Control and Prevention defines health equity as: when all people have “the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstance.”

The Pursuing Equity initiative seeks to activate health care systems, using a framework developed by IHI and our partners, to remediate health care differences that are systematic, avoidable, and unjust.

Health care has a critical role in advancing health and equity. While health care organizations alone do not have the power to improve all of the multiple determinants of health for all of society, they do have the power to address disparities directly at the point of care, and to impact many of the determinants that create these disparities.

Health care organizations can make an impact by providing equitable, high-quality, and high-value care, and also through their role as employers and partners in  communities.

The theory of change for Pursuing Equity is set forth in the IHI White Paper, Achieving Health Equity: A Guide for Health Care Organizations. The white paper offers a consolidated framework for how health systems can advance health equity in five key areas:

  • Make Health Equity a Strategic Priority

  • Build Infrastructure to Support Health Equity

  • Address the Multiple Determinants of Health

  • Eliminate Racism and Other Forms of Oppression

  • Partner with the Community