Centering Equity in the Nation's Public Health System

The Robert Wood Johnson Foundation offers five considerations to support the CDC and its state and local partners as they seek to bring equity to the nation’s public health systems.

During the COVID-19 pandemic, public health professionals across the country worked tirelessly and heroically to save lives and reduce suffering. They contended not only with a vexing global health threat, but also with rampant health misinformation and outright attacks on their integrity, independence, and safety. 

However, the pandemic also revealed critical weaknesses in our domestic and global public health systems, stemming from historical and ongoing disinvestment in public health infrastructure, political interference in public health decisionmaking, and poor coordination among and strategic miscalculations by public health agencies. These manifested in testing delays, inconsistent and untimely communications to the public, and inadequate strategies to prevent racial/ethnic and rural/geographic disparities in COVID-related health outcomes.

In August 2022, CDC released findings from CDC Moving Forward, an effort to refine and modernize its structures, systems, and processes in the wake of COVID-19.

Five Considerations

In the issue brief, Centering Equity in the Nation’s Public Health System, the Robert Wood Johnson Foundation offers the following five considerations to complement the equity component that the CDC raised in its Moving Forward initiative:

• Vision, leadership, and governance: Take a holistic approach to equity across the organization, and position and resource equity efforts for success.
  
• Partnerships and trust: Earn the trust of communities directly impacted by health injustice and support community-based health infrastructure.
• Data and accountability: Measure progress and hone strategy based on the experiences and outcomes of people most affected by structural discrimination.
• Communications and narrative: Communicate accessibly and strategically with attention to messages, mindsets, and misinformation. And remember to listen.
• People and culture: Value equity when recruiting, training, and evaluating staff and when conceptualizing public health expertise.
  

Achieving equity in America means that every person—irrespective of ZIP code, income, race, ethnicity, or occupation—has a fair and just opportunity to not just survive, but thrive.

The pandemic shows how we are all interconnected. Persistent health disparities affect all of us.

A top-to-bottom review of, and recommitment to, public health and its needs is long overdue. We believe these recommendations will help CDC as it begins a sustained effort to rebuild trust in the public health system.