For communities working to improve community health outcomes and ultimately advance health equity, the past year has presented countless challenges. The intersection of the pandemic, demonstrations in support of racial injustice, and amplified economic inequality left our communities reeling from profound losses and demanding change. It is a relief to see resources being directed back into communities with the passage of the American Rescue Plan (ARP) by Congress in March of 2021.
The ARP offers the promise of $1.9 trillion in meaningful investments in community health at the local, state, and federal levels. (See the Association of State and Territorial Health Officials American Rescue Plan summary.) It approves funding to support COVID-19 related vaccines, testing, and tracing; investment in public health and its workforce; support for mental health and substance use disorders; unemployment relief; Medicaid expansion; and more. Funds are available until expended, and for city and county recipients must be used by December 31, 2024.
Perhaps most exciting is the statement the plan makes in terms of efforts to advance health equity by addressing a variety of social, economic, and policy-related issues, such as childhood poverty, gaps in access to medical care related to insurance coverage and affordability, and addressing social determinants of health. It is in the pursuit of health equity that collaboratives participating in programs such as The BUILD Health Challenge® (BUILD) and Invest Health may be uniquely suited to partner with their local government leaders, Centers for Disease Control and Population, Health and Human Services, and other conduits for the funding to help deploy the needed services. For as we witnessed during the pandemic, groups that prioritize cross-sector collaboration and community leadership and development, have a history of working together, trust with the community, and relationships across sectors are often much more successful in their COVID-19 responses than others.
In considering what and how to center your program to align with the ARP, or longer-term efforts related to health equity, I invite you to consider five key community-focused strategies for advancing equity developed by the Michigan Public Health Institute (MPHI), in partnership with BUILD. We looked at participating community collaboratives to understand how they centered equity and developed an approach that was responsive to the history, culture, strengths, and experience of each participating community and their region. While there is no one road map to advancing equity, we offer this as a starting point to consider.
5 Key Strategies to Practicing Health Equity
- Building a Shared Vocabulary: A critical first step to “doing equity” is to help partners develop a shared vocabulary and core concepts to engage while embarking on this work. Starting from this basic level assures that all partners have a common language and framework for discussing deeper issues, examining institutional processes, and for developing future policies to promote equity.
- Organizational Readiness and Capacity Building: Organizational readiness is a critical conduit for engaging and enacting equitable practices. Readiness evaluations can provide a critical assessment of where an organization sits in the continuum of equity-framed efforts and help those engaged in these efforts identify shared values around equity while illuminating gaps and pathways for better alignment.
- Facilitated Dialogue: Naming root causes—racism, classism, gender exploitation, and discrimination—is critical to advancing equity-based initiatives. However, the reality is that for many communities this element is often a significant barrier to successfully advancing this work, given the inherent discomfort associated with these topics and limited opportunity to practice engaging them.
- Action Planning – From Concept to Practice: To move from concept to practice, technical assistance providers engaged BUILD sites using case studies and partners’ lived experiences to explore social identity, oppression, power, and the benefits and limits of organizational authority. After reflecting on these concepts, strategies were introduced to analyze identified project foci and for action planning. Action planning involved using a health equity frame to reimagine work plans and more adequately address root causes.
- Building a Community of Practice: MPHI’s experience has found that identifying partners in this work is critical to long-term sustainability, innovation, resource-sharing, implementation, and accountability. Health equity work can be difficult, and becoming part of a supportive community of practice can mitigate day-to-day challenges. Having the work supported by knowledgeable and encouraging facilitators and content experts helps ensure that the work is done with intentionality.
To see the complete list of strategies, check out BUILD’s “Community Approaches to System Change.”
At BUILD, we are waiting to see if and how ARP funding will impact participating collaboratives and their communities for both the short- and long-term. We have already seen how injections of funding through the CARES Act, which was intended to provide relief to various sectors of the U.S. economy, as well as individuals and businesses earlier in the pandemic, has been put to use in several BUILD communities: two collaboratives received funding to help build local infrastructure to secure the continuation of community hunger relief efforts and another helped distribute small business grants to support dozens of local businesses with a focus on Black, Indigenous, people of color, and women owners, all of which have been significantly impacted by the pandemic.
When it comes to how the ARP can and should be used, one thing is clear: communities already hold the critical wisdom, bonds, creativity, and drive necessary to help people achieve better health. What they need are resources, funding, and infrastructure to help dismantle the broken systems and policies that have failed them. This infusion of resources will not last indefinitely and we can’t count on another injection when the next crisis occurs. Recognizing the insufficient investment in community health over the past several decades, it is up to all of us—with communities in the lead, working alongside local, state, and federal officials—to maximize the impact of these funds to ensure our public health infrastructure is a priority moving forward.
For a deeper dive on health equity, check out this session on “Health Equity: Laying the Groundwork,” with ChangeLabSolutions as they explore what equity is and why it matters with BUILD awardees.
For more information about the ARP, watch “What the American Rescue Plan Means for Public Health” webinar, featuring leaders from the Johns Hopkins Center for Health Equity, Association of State and Territorial Health Officials, Association of Schools and Programs of Public Health, and the Big Cities Health Coalition.
About the Author
Emily Yu, Executive Director of The BUILD Health Challenge, is helping to change the future of health in America and leading the charge to cultivate cross-sector collaborations that are working to give everyone a fair chance to be healthy. With two decades of experience in program development and social marketing strategy implementation, for both the public and private sectors, Emily brings together a unique perspective that fuels her passion for both identifying and proving sustainable models for social change.