Embedding Equity into the Hospital Incident Command System: A Narrative Review

Area of Science:

• Public Health
• Health Systems Management
• Disaster Preparedness

Background:

• Disasters disproportionately affect marginalized populations, worsening health inequities.
• The Hospital Incident Command System (HICS) is standard for disaster response but lacks built-in equity considerations.
• Current HICS structures do not address the unique needs of vulnerable groups during health crises.

Purpose of the Study:

• To identify and summarize methods for embedding health equity into the HICS.
• To provide actionable strategies for health systems to enhance disaster response equity.

Main Methods:

• A narrative review of peer-reviewed and gray literature from high-income countries.
• Searched databases (PubMed, SCOPUS) and gray literature for HICS/ICS and equity-related terms.
• Employed inductive thematic analysis to identify common themes.

Main Results:

• Identified three key themes for embedding equity into HICS: including equity specialists, modifying systems for equity, and community sensitivity.
• Found several initiatives aimed at integrating equity into disaster preparedness and response.
• Extracted practical strategies for health system leaders.

Conclusions:

• Embedding equity into the HICS is feasible and necessary for effective disaster response.
• The findings offer practical guidance for health systems to promote equity during emergencies.
• Further integration of equity principles into disaster management frameworks is recommended.