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Embracing Advocacy as a Fundamental Commitment for Healthcare Professionals

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Advocacy is an essential aspect of professional responsibility in healthcare, extending beyond individual patient interactions to influence systemic change and promote health equity. Recognizing the importance of advocating for vulnerable populations, equitable access, and improved health outcomes is crucial for pharmacists and other health practitioners committed to social justice and professional integrity. This article explores the multifaceted nature of advocacy, its integration into pharmacy practice, and how professionals can actively engage at both personal and systemic levels to advance health equity.

Background

Health disparities in Canada persist and are increasingly recognized as urgent issues requiring deliberate action. These disparities manifest as differences in disease predisposition, severity, complications, mortality rates, preventive screening, treatment adherence, and overall access to care. Rooted in social, political, and economic inequalities, these gaps disproportionately affect populations based on race, ethnicity, immigrant status, ability, sexual orientation, gender identity, rurality, and socioeconomic standing. As public awareness of policy impacts on health grows, addressing these inequalities becomes a shared responsibility across the healthcare sector.

Historically, social advocacy in medicine was championed by Rudolf Virchow in the 19th century, emphasizing the social origins of disease and the importance of political engagement for public health reform. He famously stated, “Physicians are natural attorneys of the poor and social problems should largely be solved by them,” highlighting the moral obligation of health professionals to advocate for social change. Today, pharmacists are increasingly recognizing their role in this ongoing effort, extending advocacy responsibilities into their evolving scope of practice.

Advocacy involves speaking on behalf of others to promote their interests and seek justice. The American Pharmacists Association emphasizes that pharmacists must advocate for improvements in patient care and equitable distribution of health resources. Similarly, the American Society of Hospital Pharmacists underscores advocacy as both a moral and ethical duty, asserting that clinical excellence alone is insufficient without active engagement in advocacy efforts. In Canada, the National Association of Pharmacy Regulatory Authorities (NAPRA) has incorporated advocacy into professional standards, urging pharmacists to promote safe, effective medication use and assist patients in navigating complex health systems. This commitment to advocacy is embedded in pharmacy education, with the Association of Faculties of Pharmacy of Canada (AFPC) designating it as a key competency for graduates. AFPC encourages future pharmacists to demonstrate care, understand community health needs, and champion social accountability through system-level initiatives.

Health advocacy encompasses a wide array of activities and approaches. Hubinette et al. developed a comprehensive Health Advocacy Framework to delineate different advocacy types and strategies, serving as a guide across health disciplines and as an educational tool. They classify advocacy efforts primarily as agency or activism.

Agency focuses on supporting individuals directly, helping patients navigate healthcare systems by providing information, connecting them to resources, or making referrals. Activism operates at broader levels—systemic, community, or policy—aiming to raise awareness, mobilize resources, and implement changes that benefit populations.

Within these categories, two main approaches are distinguished: shared and directed. Shared advocacy involves collaboration between healthcare providers and communities, where expertise supports existing community-led initiatives. Conversely, directed advocacy entails healthcare professionals leading efforts based on identified needs, advocating on behalf of individuals or groups. This framework creates four quadrants, each representing different advocacy activities, as illustrated in Table 1.

Table 1. Health Advocacy Framework and Examples

| | Shared Advocacy | Directed Advocacy |
|—|—|—|
| Community-led | – Support community organizations through donations, awareness campaigns, volunteer work, or board membership.
– Participate in events highlighting social justice issues.
– Amplify voices of those experiencing health disparities.
– Collect feedback via patient advisory committees.
– Make practice environments inclusive. | – Assess healthcare services for disparities in access and outcomes.
– Initiate quality improvement projects.
– Implement organizational or systemic changes.
– Organize patient advisory groups.
– Communicate policy concerns to policymakers.
– Raise awareness through media and social platforms.
– Share personal stories to influence change. |
| Community-supported | – Recognize community strengths, needs, and opportunities with community input.
– Collaborate with community members in action. | – Identify systemic issues affecting patient populations.
– Develop and implement strategies to improve care quality.
– Advocate for policy reforms at organizational or governmental levels.
– Engage in professional advocacy groups. |

Advocacy is central to Canadian pharmacy practice, requiring professionals to recognize opportunities at both individual and systemic levels to foster equitable health outcomes. By working collaboratively across sectors, pharmacists can elevate underserved voices and address health disparities more effectively. This article aims to reflect critically on pharmacists’ roles and responsibilities in advocacy, offering guidance on integrating shared and directed agency and activism into everyday practice.

Advocacy in Practice

Understanding the practical application of advocacy involves reflecting on personal and professional experiences. As frontline providers and educators, we observe firsthand how advocacy manifests in daily activities. For example, Caitlin Olatunbosun’s work with HIV patients exemplifies how advocacy extends beyond clinical interventions to addressing stigma, intergenerational trauma, and social determinants of health. She emphasizes that supporting patient agency—helping individuals access resources—can be complemented by shared activism, such as participating in community events or policy advocacy, to amplify marginalized voices.

Her involvement illustrates that advocacy is a collective effort, where community-based organizations serve as vital allies. Supporting initiatives like World AIDS Day or local health campaigns fosters broader awareness and social change. Such activities demonstrate that advocacy is not a solitary act; rather, it thrives through collaboration and shared purpose.

Similarly, Kyle Wilby reflects on his international experiences, recognizing that systemic issues such as healthcare access and cultural safety transcend borders. His research into 2SLGBTQ+ health disparities highlights opportunities for pharmacists to influence policy and practice through community engagement, staff training, and direct support. Incorporating systemic awareness into pharmacy education prepares future practitioners to identify and address structural barriers, ultimately fostering more inclusive and equitable care environments.

Supporting advocacy at higher system levels involves understanding the complex interplay of policies, organizational structures, and societal norms. Strategies include engaging with professional organizations, influencing policy, and participating in public discourse. Practical steps for pharmacists to become effective advocates are outlined in this guide, which discusses how understanding healthcare systems can empower professionals to advocate more effectively. Moreover, engaging in data-driven advocacy—such as analyzing care disparities through data mining techniques—can inform targeted interventions and policy reforms. Learn more about how data analytics can transform healthcare delivery in this resource.

Advocacy efforts should also consider the broader context of healthcare models, such as the structure of financing and access systems. Understanding models like the single-payer system can help pharmacists advocate for policies that promote universality and equity. For detailed insights into this model, refer to this explanation.

Call to Action

Pharmacists occupy a strategic position to influence health outcomes and reduce disparities through active advocacy. There are numerous avenues to engage, as outlined in Table 1. To begin, select a healthcare issue that resonates personally, stay informed about relevant policies and evidence, and collaborate with stakeholders across sectors.

Joining local, provincial, or national organizations amplifies your voice and provides platforms for advocacy. Sharing success stories, both triumphs and setbacks, fosters collective learning and drives continuous improvement. Whether through direct patient engagement, community outreach, or policy dialogue, pharmacists can enact meaningful change by practicing both shared and directed advocacy approaches.

As health advocates, our responsibilities extend beyond individual patient care to shaping equitable health systems. Embedding advocacy into practice, education, and organizational culture ensures that all populations receive the quality care they deserve. Active engagement at multiple levels—personal, community, and systemic—can create sustainable improvements in health equity and social justice.

Footnotes

Author Contributions: C. Olatunbosun conceptualized the manuscript; both authors collaborated on drafting, revising, and final approval.

The authors declare no conflicts of interest related to this work.

Funding: No funding was received for this project.

ORCID iD: Caitlin Olatunbosun

Contributor Information

Caitlin Olatunbosun, Alberta Health Services, Edmonton, Alberta.

Kyle John Wilby, College of Pharmacy, Dalhousie University, Halifax, Nova Scotia.

References

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