Bringing Light & Heat: An Equity Guide for Healthcare Transformation and Accountability

July 2021

Health Equity Guide created in partnership with HealthBegins, Health Leads, JSI, SIREN at UCSF, and HIP to provide healthcare leaders with guidance for how to deepen, broaden, and elevate their organization’s health equity work, via a framework and process for transformation and accountability.


In response to the public health crises and community-led movements for racial justice in 2020, healthcare leaders are increasingly seeking to place health equity at the forefront of their organizations’ work. To ensure this commitment is translated into meaningful, sustainable action, institutions need practical guidance. Developed by national organizations with experience at the forefront of healthcare transformation and health equity initiatives, this guidebook provides this needed framework. 

The Guide outlines a strategic process for leaders and managers of healthcare institutions to commit to, own, and advance health equity and racial justice (bringing light) and outlines key questions stakeholders can use to help hold these systems accountable for this critical work (bringing heat). The aim is to drive radical transformation to achieve equity. 

In the Guide, you will find:
  • An overarching framework for how your healthcare institution can pursue health and racial equity
  • A proposed process and approach to organize your action and ongoing improvement
  • Ideas about the kinds of strategic goals and sample practices you might adopt – at the patient, organizational, community, and societal levels – to operationalize health and racial equity

This guide is intended as a catalyzing instrument and resource for healthcare institutions and leaders to achieve health and racial equity. Health equity will not be achieved by completing a checklist, through a short-term effort, or by focusing exclusively on healthcare service delivery. It is intended to support a long-term commitment while also providing structure and intermediate steps necessary to maintain momentum. Our proposed framework, goals, and strategic practices are geared towards systematically transforming how healthcare institutions function at the patient, organization, community, and societal levels.

This resource was envisioned with leaders at medium to large nonprofit hospitals and integrated delivery systems as the primary audience. However, the initiative and urgency to substantively focus on equity, and the imperative for accountability, can come from many sources within and outside of healthcare institutions. We hope it can be useful for any healthcare stakeholder who is committed to participating in an equity journey whether they are affiliated with a provider, payer, government agency, community-based organization, or patient advocacy group.

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