Table 3 ICON macro level – attributes, attribute definitions and sample features

Community influences

“Community influences” refers to influences from the general public or other organizations on the decision-making and behaviour of organizations and the individuals (as an aggregated group) within these organizations

• Public influences

• Peer organizational pressure

• Does the organization promote open dialogue with the communities or populations it serves?

• Does the organization build and maintain trusting relationships with the communities or populations it serves?

• Are the community influences representative of diverse populations?

Intercommunity/

interorganizational/

intersectoral relationships

“Intercommunity/interorganizational/intersectoral relationships” refers to the interactions or partnerships between different communities, organizations or sectors

• Intersectoral collaboration

• Community health outreach

• Coordinated action

• Do stakeholders from other sectors (for example, city planners) partner with the organization to impact the health of individuals, especially equity-deprived populations?

• Do community organizations or communities collaborate with the organization to improve health equity and well-being?

• Do the actions and goals of the organization align with their community partners?

Political influences

“Political Influences” refers to influences relating to government or public affairs and their effect on organizations and individuals (as an aggregated group) within these organizations

• Politics

• Political climate

• Complexity of the broader sociopolitical environment

• Are there laws and policies requiring consideration of equity?

• Does the organization lobby for reform of laws and policies that impact health equity?

Regulatory influences

“Regulatory influences” refers to influences relating to regulatory bodies, created on the basis of a legal mandate or legislation (for example, providing and enforcing on adequate standards for health and safety in an organization) [49]

• Laws and legislation

• External policies, directives, mandates and regulations

• Industrial influences

• Accreditation standards

• Are there laws and policies requiring consideration of equity?

• Does the organization lobby for reform of laws and policies that impact health equity?

• Do accreditation standards include criteria relevant to equity?

Regional/national/global influences on health

“Regional/national/global influences on health” refers to regional, national and worldwide influences on organizations and individuals (as an aggregated group) within these organizations. For example, epidemics, pandemics, endemics, outbreaks, natural disasters, climate change and war

• Epidemics/pandemics/endemics/outbreaks

• Natural disasters

• Climate change

• Is there a process for determining which groups are more vulnerable to health inequities caused by epidemics, pandemics, endemics, outbreaks, natural disasters and/or climate change?

• Do organizational processes for distributing relief or support in response to regional/national/global health influences consider equity?

• Does the organization fulfil its role and responsibilities in decreasing its impact on climate change?