Assessing Civic Health Equity in Health Professions Education: Development of a Novel Metric Within the Planetary Health Report Card

Abstract

Civic health equity is the principle that all people deserve a fair and just opportunity to participate in their communities and to have a voice in the systems that shape their lives. Yet despite its importance to population health, civic engagement remains inconsistently addressed in health professions education. Inequities in civic participation contribute to unequal political representation and policy responsiveness, disproportionately affecting historically marginalized communities, and limit the ability of future health professionals to engage with the structural and policy drivers of health. This paper describes the development and implementation of a civic health equity metric within the Planetary Health Report Card (PHRC), an international, student-led, faculty-supported initiative that evaluates how health professional schools integrate planetary health and social accountability into educational practice. First introduced in the 2026 PHRC assessment cycle, the metric was developed through iterative leadership discussions informed by existing frameworks. It assesses whether health professional curricula prepare students to understand civic participation and advocacy as mechanisms for addressing environmental and structural determinants of health. The metric is part of the PHRC curriculum domain and uses a standardized scoring system ranging from 0 to 3 points, with required qualitative justification from participating institutions. To promote feasibility and broad adoption, it is explicitly nonpartisan and educational in nature, aligning with 501(c)(3) requirements. By embedding civic health equity within an established assessment framework, this metric provides educators with a practical tool to identify curricular gaps, support equitable access to civic learning, and strengthen health promotion–oriented training.