INTRODUCTION: Equity and social justice have long been key tenets of health promotion practice, policy and research . Health promotion foregrounds the pertinence of social, economic, cultural, political and spiritual life in creating and maintaining health . This necessitates a critical structural determinants of health perspective that actively engages with the experiences of health and wellbeing among diverse peoples . The inequitable impacts of pandemics are well documented, as are calls for improved pandemic responses . Yet, current pandemic and emergency preparedness plans do not adequately account for the social and structural determinants of health and health equity .
METHODS: Through five one-hour online conversations held in April 2020, we engaged 13 practice, policy, research and community leaders on the intersections of COVID-19 and gender, racism, homelessness, Indigenous health and knowledge, household food insecurity, disability, ethics and equitable futures post-COVID-19 . We conducted a thematic analysis of speaker and participant contributions to investigate the impacts and influence of COVID-19 related to the structural and social determinants of health . We analyzed which policies, practices and responses amplified or undermined equity and social justice and identified opportunities for improved action . FINDINGS: Analysis of the COVID-19 pandemic revealed four broad themes: • oppressive, unjust systems and existing health and social inequities; • health and social systems under duress and non-responsive to equity; • disproportionate impacts of COVID-19 driven by underlying structural and socioeconomic inequity; and• enhanced momentum for collective mobilization, policy innovations and social transformation .
DISCUSSION: There was a strong desire for a more just and equitable society in a post-COVID-19 world, going 'back to better' rather than 'back to normal .' Our analysis demonstrates that equity has not been well integrated into pandemic planning and responses . Social movement and systems theories provide insight on ways to build on existing community mobilization and policy openings for sustained social transformation.
Index: community action, determinants of health, equity / social justice, policy / politics, systems