By Alexandra Piatkowski

Let's be honest: most strategic plans end up collecting dust on a shelf somewhere. They're beautifully formatted documents with impressive language that ultimately change nothing. And when we're talking about health equity, the kind of work that directly impacts whether people live or die, thrive or struggle, that's not just disappointing. It's unacceptable.

So what separates strategic plans that actually drive lasting change from the ones that become expensive paperweights? After working with many public health, healthcare, community-based organizations, and coalitions, we've learned that the difference comes down to how you build the plan in the first place.

Here's the framework that actually works.

Why Traditional Strategic Planning Falls Short

Traditional strategic planning often starts with leadership sitting in a boardroom, identifying priorities based on what they think communities need. Data gets pulled, goals get set, and everyone pats themselves on the back for a job well done.

The problem? Communities weren't meaningfully involved. The data only tells part of the story. And the plan exists separately from the day-to-day operations that would actually make it real.

Health equity work demands something different. It requires us to centre the voices of those most impacted by health inequities, blend quantitative data with lived experience, and embed equity into organizational DNA, not just a standalone initiative.

The Five Components That Actually Drive Change

Research from the Institute for Healthcare Improvement shows that organizations achieving real results in health equity work across five interconnected components. There's no magic sequence, you need comprehensive coverage of all of them.

Here's how we approach each one at Piat Public Health:

1. Leadership Commitment That Goes Beyond Lip Service

You've probably seen it before: an organization announces health equity as a priority, creates a committee, and then... nothing changes. That's because genuine leadership commitment looks different than a press release.

Real commitment means:

Senior leaders taking explicit ownership for improving health equity outcomes
Equity appearing as a priority in the organization's strategic plan and department-level goals
Resources allocated to match the stated priorities
Leaders modelling the behaviours they expect from others

This isn't about checking a box. It's about creating alignment across all levels and departments, building relationships between health equity teams and quality departments, and making sure everyone understands their role in the work.

2. Community Engagement That Shares Power

Here's where many organizations stumble. They confuse informing communities with engaging them. True community engagement means power-sharing and community-led decision-making.

We've written extensively about common community engagement mistakes because getting this right is so critical. The communities most affected by health inequities have expertise that no dataset can capture. They know what barriers exist, what solutions might actually work, and what's been tried before.

Effective engagement includes:

Allocating resources to community-led organizations
Conducting thorough community needs assessments
Creating feedback loops so communities see how their input shaped decisions
Building long-term relationships, not one-time consultations

If you're new to community needs assessments, our ultimate guide breaks down the process step by step.

3. Mixed-Methods Research That Tells the Whole Story

Numbers matter. Rates, trends, demographic breakdowns, this quantitative data reveals patterns and disparities that demand attention. But numbers alone don't explain why those patterns exist or how to address them.

That's where mixed-methods research becomes essential. We combine:

Quantitative data that identifies where disparities exist, tracks outcomes over time, and measures progress toward goals.

Qualitative insights from community members, frontline workers, and other stakeholders that explain the context behind the numbers and surface solutions.

This approach ensures your strategic plan is grounded in both evidence and lived experience. It's not enough to know that a particular community has higher rates of chronic disease, you need to understand the systemic factors driving those outcomes to develop strategies that will actually work.

4. Organizational Integration (Not a Side Project)

One of the most common mistakes we see? Treating health equity as an add-on rather than embedding it into organizational policies, procedures, and decision-making processes.

Lasting change requires:

Comprehensive training for staff at all levels
Reviewing contracting and procurement practices through an equity lens
Establishing equitable data practices that prioritize equity in collection and analysis
Connecting system resources to regional and mission-based programming

The goal is for equity considerations to become automatic, part of how your organization operates, not a separate checklist to complete.

5. Measurement and Accountability That's Realistic

Here's something important: you won't see immediate results. Health equity work operates along a continuum, and expecting quick wins often leads to abandoning strategies before they've had a chance to work.

Effective measurement includes:

Documented success metrics and goals
Regular reporting to leadership and the public
Clear accountability structures with explicit responsibility for results
Tracking progress over time, not just at a single point

This doesn't mean accepting slow progress indefinitely. It means setting realistic benchmarks, celebrating incremental wins, and adjusting course based on what you're learning.

Turning Data Into Action

So you've gathered your data, engaged your community, and built leadership buy-in. Now what?

This is where strategic planning becomes operational planning. Every insight needs to translate into specific actions with clear owners, timelines, and resources.

We help organizations:

Prioritize strategically. You can't fix everything at once. Identify where you can have the greatest impact given available resources.

Develop focused action plans. Each priority needs concrete steps, responsible parties, and measurable outcomes.

Build in flexibility. Conditions change. Your plan needs mechanisms for adaptation without losing sight of core goals.

Create accountability. Who reviews progress? How often? What happens when things aren't working?

The organizations that succeed at this work understand that a strategic plan is a living document, not a finished product.

What Lasting Change Actually Looks Like

When health equity strategic planning works, you see changes that persist beyond any single initiative or leader:

Equity considerations are embedded in budget decisions
Community partners have genuine influence over priorities
Staff understand their role in advancing health equity
Data systems track disparities and improvements systematically
Policies get reviewed and revised through an equity lens

This doesn't happen overnight. But it does happen when organizations commit to the comprehensive framework we've outlined here.

Getting Started

If your organization is ready to move beyond surface-level commitments to health equity, here are some first steps:

Assess where you are. What equity work is already happening? Where are the gaps?
Engage leadership. Without senior buy-in, this work won't get the resources it needs.
Centre community voices. Before setting priorities, understand what communities are experiencing.
Build your evidence base. Combine quantitative data with qualitative insights for a complete picture.
Embed, don't add on. Look for ways to integrate equity into existing processes rather than creating parallel structures.

We've helped many organizations navigate this process, from community needs assessments to full strategic planning engagements. The work isn't easy, but it's some of the most important work there is.

Because at the end of the day, strategic plans should improve lives. And when equity is truly at the centre, they can.

Ready to build a health equity strategy that drives real change? View our services to learn more about our approach to equity-centred strategic planning and contact us today.

Health Equity Strategic Planning: The Framework That Actually Drives Lasting Change