Tacoma’s Journey to Promote Health, Well-Being, and Equity
Five years into the Sentinel Communities Surveillance Project, capacity has been grounded in the efforts of the public health and healthcare sectors, local government, education, and community-based stakeholders.
Efforts in Tacoma focused on equity, youth development, and healthcare coordination have grown over the past five years, and new activities have been initiated targeting homelessness, workforce development, and community diversity. With regard to the health narrative in Tacoma, a long-standing focus on the social determinants of health has only deepened over the past five years, with additional stakeholders seeing the connection between factors like housing, education, and physical and mental health. With regard to health equity, Tacoma’s approach has evolved over the past five years, from established structures dedicated to equity to implementing policies explicitly intended to have equity impacts and establishing anti-racist commitments and actions.
Health Priorities and Narrative
Leaders for health in Tacoma have been the public health and healthcare sectors, with new players emerging to support population health.
The City of Tacoma and TPCHD have led a set of equity-focused initiatives that have grown over time and influenced other sectors to become involved.
Collaborative efforts were established to address inequities in educational attainment and continue to provide wraparound and out-of-school support for students.
Health Priorities and Narrative
Health priorities across sectors have shifted from focusing on individual behaviors to reduce tobacco use and obesity to address more upstream causes of poor health, including housing, transportation, and mental health.
In 2020, the city and TPCHD established commitments to being anti-racist and philanthropic, private-sector, and nonprofit organizations have followed suit, adding language to their websites and undergoing organizational assessments to determine their next steps.
Lessons Learned: Where is Tacoma Five Years Later?
Tacoma’s journey to promote health, well-being, and equity is one that illustrates the deepening of prior commitments, and the role of shared values in making those changes. Commitments to health and equity that were in place for several years prior to 2017 laid the groundwork—such as through strategic frameworks, staff capacity, data, and informal collaborative networks—for the community to transition from conversation to action around equity and systems change; from healthcare access to the SDOH; and from service provision to representative decision-making, a process that’s still ongoing. Other communities can learn from Tacoma’s approaches to make these changes, as well as the challenges they encountered, to inform their own journeys. And as COVID-19 recovery continues, with historic funding flowing to local communities, future research could consider the ways in which momentum around health, equity, and well-being influences community health narratives and decisions moving forward.
Tacoma has leveraged facilitators like strong leadership and capacity for health and equity to make progress on health and well-being outcomes. Yet, remaining data and governance barriers have stymied progress, many of which are expected to continue to persist.
History of prioritizing health equity
Legacy of environmental activism
Public health leaders in new sectors
Strong use of data
State-level Medicaid demonstration focused on prevention
Navigating diverse stakeholder perspectives
Misalignment between city and county
Independent health department results in inefficiencies
Lack of comprehensive understanding of systems
Data integration challenges
Lack of authority to address homelessness