What is measured, matters: advancing the measurement of reproductive health equity-What is measured, matters: advancing the measurement of reproductive health equity

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The plenary session on health equity measurement, moderated by Asha Hassan and colleagues, delves into the complex interplay between defining, measuring, and advancing health equity, especially in reproductive health research. The discussion emphasizes that health equity entails fair opportunities for all to achieve optimal health by addressing systemic barriers rooted in poverty, discrimination, and power imbalances. Traditional health disparities differ from inequities, which inherently involve unjust social structures and are avoidable through systemic change.<br /><br />The session traces health equity research evolution from documenting disparities, to understanding causes via social determinants and power dynamics, to implementing interventions targeting systemic roots. Crucial attention is given to the pitfalls of health equity "tourism," where researchers superficially engage with equity work without deep commitment, complicating resource allocation amidst recent funding cutbacks and political shifts.<br /><br />Focusing on racial health equity, the presenters stress integrating anti-racist frameworks, explicitly naming racism, carefully defining race variables, and involving impacted communities and scholars of color to improve research validity and relevance. Heidi Moseson highlights challenges in inclusive measurement of transgender and gender diverse (TGD) populations in family planning, underscoring the harms of binary, cisnormative data collection and clinical systems, and advocating for nuanced gender and sex measures that capture diverse experiences to reduce invisibility and health risks.<br /><br />May Siddhanaraseth discusses immigration-related measurement barriers, emphasizing the need to move beyond simplistic categorizations toward recognizing legal status, language access, and structural determinants rather than individual deficits. Mindful, culturally responsive measurement that builds trust and shares power with communities is paramount.<br /><br />Sara Daniel brings an intersectional lens, rooted in Black feminist activism, urging research to focus on systems of power rather than isolated identities, incorporating multidimensional structural discrimination measures, and employing interdisciplinary, mixed methods approaches to capture complex realities.<br /><br />Clara Lerma shares applied survey research lessons, advocating for inclusive, precise language to build trust and visibility among marginalized groups (e.g., intersex, neurodivergent, Middle Eastern and North African populations), and measures that go beyond identity to capture systemic discrimination experiences.<br /><br />Panelists acknowledge current barriers, including political hostility, funding cuts, and widespread mistrust among vulnerable groups, while underscoring the imperative to persist with community-engaged, equity-centered measurement to transform reproductive health research and practice fundamentally. Overall, the session calls for continuous reflection, accountability, and innovation to ensure health equity research not only documents disparities but actively dismantles oppressive structures.

Keywords

health equity

reproductive health research

systemic barriers

health disparities

social determinants of health

racial health equity

anti-racist frameworks

transgender and gender diverse measurement

immigration-related measurement

intersectionality

community-engaged research