Primary care priorities in addressing health equity: summary of the WONCA 2013 health equity workshop.
BACKGROUND
Research consistently shows that gaps in health and health care persist, and are even widening. While the strength of a country's primary health care system and its primary care attributes significantly improves populations' health and reduces inequity (differences in health and health care that are unfair and unjust), many areas, such as inequity reduction through the provision of health promotion and preventive services, are not explicitly addressed by general practice. Substantiating the role of primary care in reducing inequity as well as establishing educational training programs geared towards health inequity reduction and improvement of the health and health care of underserved populations are needed.


METHODS
This paper summarizes the work performed at the World WONCA (World Organization of National Colleges and Academies of Family Medicine) 2013 Meetings' Health Equity Workshop which aimed to explore how a better understanding of health inequities could enable primary care providers (PCPs)/general practitioners (GPs) to adopt strategies that could improve health outcomes through the delivery of primary health care. It explored the development of a health equity curriculum and opened a discussion on the future and potential impact of health equity training among GPs.


RESULTS
A survey completed by workshop participants on the current and expected levels of primary care participation in various inequity reduction activities showed that promoting access (availability and coverage) to primary care services was the most important priority. Assessment of the gaps between current and preferred priorities showed that to bridge expectations and actual performance, the following should be the focus of governments and health care systems: forming cross-national collaborations; incorporating health equity and cultural competency training in medical education; and, engaging in initiation of advocacy programs that involve major stakeholders in equity promotion policy making as well as promoting research on health equity.


CONCLUSIONS
This workshop formed the basis for the establishment of WONCA's Health Equity Special Interest Group, set up in early 2014, aiming to bring the essential experience, skills and perspective of interested GPs around the world to address differences in health that are unfair, unjust, unnecessary but avoidable.
Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel. eshadmi@univ.haifa.ac.il.
Efrat
E
Shadmi
Department of Family Medicine and Primary Care, The University of Hong Kong, Pokfulam, Hong Kong. wongwcw@hku.hk.
William C W
WC
Wong
ACG International, Johns Hopkins University, Baltimore, MD, 21218, USA. kkinder@jhsph.edu.
Karen
K
Kinder
Royal College of General Practitioners, London, UK. iona.heath22@yahoo.co.uk.
Iona
I
Heath
WONCA, Flinders Medical School, Flinders Dr, Bedford Park, SA, 5042, Australia. michael.kidd@flinders.edu.au.
Michael
M
Kidd
D014943:Global Health; D006293:Health Promotion / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D054624:Health Status Disparities; D006801:Humans; D011320:Primary Health Care / Q000458:organization & administration*; D015980:Public Health Practice; D012959:Socioeconomic Factors; D035862:Vulnerable Populations