State Health and Value Strategies (SHVS), in partnership with Manatt Health, Health Equity Solutions, Georgetown’s Center on Health Insurance Reforms (CHIR), the State Health Access Data Assistance Center (SHADAC), Bailit Health, and GMMB, developed this resource page to serve as an accessible “one-stop” source of health equity information for states. This resource is designed to support states seeking to make coverage and essential services available to all of their residents, regardless of where they live, how much money they make, or discrimination they face. SHVS will update this page frequently with new resources as they become available.
Governor Tony Evers and the Wisconsin Department of Health Services (DHS) announced the hiring of Dr. Michelle Robinson as the Director of the newly formed Office of Health Equity. The Office of Health Equity and its team is attached to the Office of the Secretary and will lead work to advance diversity, equity, and inclusion within the department while also coordinating the development and implementation of policies and programs to address root causes of health inequities.
To bolster local organizations supporting health equity in communities across Kansas, Governor Laura Kelly announced the “Increase the Reach” Grant Initiative. The program specifically aims to reach groups that have been socially marginalized and those experiencing low vaccination rates, including both racial and ethnic minority populations as well as rural communities, and empower community organizations promoting equitable access to the COVID-19 vaccine for all Kansans. The grants will enable these organizations to expand access to vaccines and increase vaccine uptake among those who are unvaccinated.
Many states are looking to fill gaps in race and ethnicity data for Medicaid and related agencies. Working with the State Health Access Data Assistance Center (SHADAC) at the University of Minnesota, with support from the State Health and Value Strategies (SHVS) program, New York tested multiple strategies aimed at encouraging applicants to answer the optional race and ethnicity questions. This expert perspective highlights an effort by New York’s official state-based marketplace, NY State of Health, to improve the completeness of race and ethnicity data that applicants share when applying for Medicaid; Child Health Plus, the state’s Children’s Health Insurance Program (CHIP); the Essential Plan, New York’s Basic Health Program (BHP); or Qualified Health Plan (QHP) coverage through its Marketplace.
The DC Health Benefit Exchange Authority (DCHBX) Executive Board voted to adopt recommendations from its Social Justice and Health Disparities Working Group, in an effort to stop racism in health care. These recommendations are focused on three crucial areas in order to establish practices, structures, and policies that can be implemented by DCHBX and DC Health Link health plans to (1) expand access to providers and health systems for communities of color, (2) eliminate health outcome disparities for communities of color, and (3) ensure equitable treatment for patients of color in health care settings and in the delivery of health care services.
The plan is a set of strategies and actions for all partners to align efforts to address the selected high priorities for reducing inequities.
This document promotes a set of uniform data collection standards for race and ethnicity information conducted by, sponsored by, or reported to the Utah Department of Health (UDOH).
This report includes five perspectives of a health equity mindset: why these perspectives are important to advance health equity, ideas for how to put the perspectives into action, and examples of how they were used to shape the CCP project.
A snapshot of the perception of Utah’s community health workers in considering the state’s racial and ethnic minority communities’ attitudes and hesitancy toward the COVID-19 vaccine. Analysis of local data compared with national narratives around vaccine hesitancy may inform strategic approaches to respond to barriers and improve timely vaccine uptake.
The goal of this report is to highlight how factors like race, gender, and class intersect with historical injustices and forces in our institutions and systems to drive health inequities for many individuals and families in Rhode Island.
This State Health Assessment is organized to provide information on social determinants of health, health equity, and health factors, and then focus specifically on eight health themes, as well as the populations impacted in each theme.
The North Dakota COVID Special Populations Strategic Plan will address the concerns found in the data presented at this moment in time and address the specific concerns expressed by North Dakota’s Special Populations related to COVID-19. As a living document, this plan and associated target dates may be modified to reflect community needs.
Longstanding racial and ethnic injustices contribute to disparities in vaccination rates among historically marginalized populations. We are building equity into every aspect of vaccine distribution in order to close the vaccination gap between white populations and Black/African American, Hispanic/Latinx, and American Indian populations in North Carolina.
The Office of Health Equity seeks to acknowledge systemic racism and the social determinants of health to eliminate disparities by addressing and promoting health equity among all people in every community in New Mexico. The Office of Health Equity strives to provide equitable health opportunities by building relationships with communities, establishing collaborations with care providers and forging partnerships with stakeholders to provide quality service in a culturally and linguistically appropriate manner. These measures focus on ensuring all New Mexicans, especially in rural and under-served areas and borderlands, have increased opportunities to be healthy and promote the public health mission of the New Mexico Department of Health.
The purpose of this report is to highlight existing health disparities by race/ethnicity in Nevada, with a focus upon the most current data available. The race/ethnic groups represented in this report are White-non-Hispanic, Black-non-Hispanic, American Indian/Alaskan Native (AI/AN) -non-Hispanic, Asian/Pacific Islander (API) -non-Hispanic, and Hispanic. Racial and ethnic minorities are disproportionately affected by health problems and disease in Nevada and throughout the nation. This report is intended to present current and available data, from the state of Nevada, broken down by race/ethnicity and region, in order to inform health professionals, policy makers, community members, and researchers about existing disparities among Nevada’s population.
This report assesses the current state of Nebraska’s racial and ethnic minority populations and the changes, both positive and negative, which occurred over the 15-year period from 2000-2015. The report focuses primarily on health disparities between Nebraska’s racial and ethnic populations, including diseases, health status, and health behaviors. However, various disparities by gender, immigrant status, language ability, income, and education are also included.
To ensure the positive health trends are not reversed and to create a healthier Montana, the Public Health and Safety Division (PHSD) of the Montana Department of Public Health and Human Services (DPHHS) initiated a strategic planning process in 2017. Twenty-four members, representing healthcare and public health agencies across the state, served on the steering committee for this process. This steering committee is called the State Health Improvement Coalition and it developed the five-year State Health Improvement Plan (SHIP) contained in this report.
To assess Mississippians’ COVID-19 Vaccine confidence, the Mississippi Community Engagement Alliance Against COVID-19 Disparities (CEAL) Team and the Mississippi State Department of Health (MSDH) Office of Preventive Health and Health Equity (OPHHE) disseminated a statewide vaccine confidence survey beginning end of December 2020 and collecting data until March 2021. The survey is intended to be representative of Mississippians, with intentional efforts invested to reach lower income and rural Mississippi populations, as well as the state’s Black, Hispanic (Latino/ Latinx), Asian (including the Vietnamese population of the Gulf Coast), and Native American/Choctaw communities.
Presentation at the July 22, 2020 meeting at the Health Policy Commission Board of Commissioners
We encourage dissemination of these strategies to improve health outcomes for racial and ethnic minorities. Our goal is to share material included in the literature and promote effective interventions. We hope you will review the findings included in this report and consider them when you are developing programs, issuing request for proposals, and determining the types of endeavors to fund. We are committed to sharing research findings and evaluation results as it pertains to improving health and social outcomes for racial and ethnic populations and encourage dissemination of this information widely.
As part of the Health Policy Commission’s (HPC) work to apply an equity lens to all of its workstreams, it is important to develop a shared understanding of the context of racism and inequities affecting health and a common vocabulary for communicating about equity that avoids bias, encourages inclusion, and prompts reflection in all of our work. The purpose of this guide is to be a practical resource for all HPC staff: (1) to promote intentional and consistent use of language and terminology across the agency when possible and practical; (2) to encourage reflection among staff as they communicate about equity within their workstreams; and (3) to provide resources, tools (including preferred terms), and HPC-specific use cases that can support staff.
The Racial Equity Data Road Map is not a toolkit or one-size-fits all approach. Instead, it is a living document that outlines a number of steps for using data that have been piloted and tested within MDPH as one part of our journey towards achieving racial equity. As such, while the sections are presented in a way that is hopefully easy to follow, there is no set order in which they should be followed. Instead, users of the Road Map can move through the document at the pace and in the manner that makes the most sense for the program or issue being addressed, taking into consideration funding requirements, approval processes, and decision-making structures as needed.
Tackling inequity at its source is a complex challenge that must start with addressing barriers to economic participation, education, and health care that are holding families of color—and the state’s economy—back from their fullest potential. This report will explore the social determinants of health that lead to such inequities, defined here as the conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of liferisks and outcomes.1 The social determinants of health fall into five domains: (1) economic stability; (2) education access and quality; (3) health care access and quality; (4) neighborhood and built environment; and (5) social and community context.2 The first section of the report provides Recommendations By Subject that impact these domains, while the second section outlines Subjects For Future Study.
Leading health improvement and tackling health equity is the mission of the public health system. In the state of Illinois, one initiative to fulfill this mission is a coordinated project titled Healthy Illinois 2021. This initiative is composed of three statewide efforts: the State Health Assessment (SHA), the State Health Improvement Plan (SHIP), and the plans for state health system innovation that started under the State Innovation Model (SIM). Collectively, these components work together to align and coordinate plans, processes, and resources to drive health improvement and work toward health equity.
This report represents a collaborative effort between the Hawaiʻi State Department of Health and a diverse group of academic and community partners. As the magnitude of the COVID-19 pandemic grew over time, it became clear that public health authorities could not adequately address the threats posed by this disease alone. Partnerships with the Native Hawaiian and Pacific Islander COVID-19 Response, Recovery, and Resilience Team and other community-based organizations serving the Native Hawaiian, Pacific Islander, and Filipino communities as well as the input from the Office of Public Health Studies and Department of Native Hawaiian Health at University of Hawaiʻi at Mānoa were instrumental to mounting an effective response. Their perspectives are included through the voices of the authors and contributors to this report who represent these organizations as well as through feedback provided by reviewers.
Healthy Connecticut 2025 is designed to provide an even more focused framework for agencies, coalitions, organizations, groups, and individuals to use in leveraging resources, coordinating and aligning efforts, eliminating redundancies and duplicative efforts, and sharing data and best practices to improve the health of Connecticut residents in a purposeful and measurably impactful way.
This document is intended to support local communities in achieving their Health Equity Measure as part of the California’s Blueprint for a Safer Economy and building an equitable recovery. More specifically, counties can use this document to inform Targeted Investment Plans that will be leveraging Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (Strategy 5: Use Laboratory Data to Enhance Investigation, Response, and Prevention) grant funds throughout implementation. This living document will continue to be updated as the pandemic progresses and as more is learned about what strategies are working on the ground.
The AzHIP provides a structure and a venue bringing together a networked system of partners to improve the health of communities and individuals across Arizona. Driven by data and community participation, the AzHIP includes input from individuals and organizations who comprise the public health system. The plan aligns the state on common goals by enhancing non-traditional partnerships, focusing work on priority areas, breaking silos, and leveraging community health improvement plans (CHIPs) statewide. By identifying priorities specific to Arizona’s needs, the plan can make the greatest impact on health promotion and disease prevention.
Governor Laura Kelly announced that her Commission on Racial Equity and Justice has released its second report, which makes recommendations on ways that Kansas can improve racial equity around the social determinants of health, focusing on economic systems, education access, and health care. The recommendations address topics including teacher diversity, tax policy, early childhood education, and maternal and child health.
The University at Albany published a new report that researches why communities of color in New York have been disproportionately impacted by COVID-19. The research, carried out in partnership with the New York State Department of Health and other partners, adds to the existing well of knowledge about health disparities in New York by identifying the environmental, socioeconomic and occupational factors that explain why COVID-19 has disproportionately harmed Black and Hispanic New Yorkers and proposes practical intervention strategies to eliminate these disparities and save lives. Additionally, the work suggests important differences exist in the way different minority groups experience the progression of the disease. This project is an important initial step toward filling some of these gaps and identifying interventions that, by necessity, must be informed by and rooted in community experiences and insight.
The COVID-19 pandemic has highlighted health inequities across the nation and in Wisconsin. COVID-19 has been hard on everyone, but data shows that Wisconsin’s Black, Indigenous, and people of color (BIPOC) have been disproportionately affected by COVID-19. Inequities are reflected in COVID-19 vaccination rates. Many of the factors that contribute to health disparities may also be barriers that prevent people from getting vaccinated, as the data shows that white populations have higher vaccination rates.
The state House gave final passage Tuesday to a sweeping measure that declares racism a public health crisis in Connecticut and would trigger a deeper exploration of the effects racism has on public health.
DELTA (Developing Equity Leadership through Training & Action) is a health equity and inclusion leadership program that includes training, capacity building, and networking to health, community, and policy leaders in Oregon. The purpose of this program is to build and strengthen the capacity of Oregon’s public health and health systems, and community based leaders to promote equity and diversity. This nine-month program trains 25 members committed to advancing health equity and diversity throughout Oregon.
The National Governors Association released a case study highlighting Nurture NJ, an initiative of First Lady Tammy Murphy to address significant disparities and curb the rate of preventable maternal deaths in the state. Nurture NJ is an umbrella that breaks down silos between stakeholders, bringing them together to tackle issues related to maternal and child health (MCH). Seated in the First Lady’s office, the program facilitates collaborative partnerships with the Governor’s office, 18 state agencies and national MCH organizations. The initiative has also partnered with state legislative caucuses to brief legislators on issues affecting the MCH population. Direct funding is earmarked for the Nurture NJ campaign, including much of their community outreach work; however, the initiative also works with partners to obtain support for various programs under the larger umbrella. For example, state budget dollars in 2020 were allocated to increase Medicaid reimbursement for midwifes and fund implicit bias training at labor and delivery hospitals, as well as Federally Qualified Health Centers, as a part of advancing Nurture NJ’s mission. Overall, the initiative has assisted in procuring around $19 million for various MCH-related programs in the state thus far.
NC Medicaid is introducing an enhanced payment to Carolina Access primary care practices serving beneficiaries from areas of the state with high poverty rates.
The Oregon Health Authority published a report on COVID-19 race, ethnicity, language and disability (REALD) data that highlights the inequitable impact of the disease on specific racial and ethnic groups, and challenges faced by those with language, disability and health access barriers. In 2020, the Oregon Legislature passed a law (House Bill 4212) that requires health care providers to collect REALD information at health care visits related to COVID-19, and to share this information with Oregon Health Authority (OHA).
CORE creates training, tools, and processes for local officials, staff, and the community to intentionally identify and disrupt implicit biases and systemic inequities in policymaking.
First Lady Tammy Murphy and national public health expert Dr. Vijaya Hogan released the Nurture NJ 2021 Strategic Plan, a strategy to reduce New Jersey’s high rates of maternal and infant mortality and eliminate the racial disparities responsible for these deaths. The Plan includes over 70 specific, actionable recommendations for maternal health stakeholders across all sectors.
North Carolina’s vaccine tracking dashboard, which includes statewide demographic data on people who have received either the first or second dose of the vaccine by race, ethnicity, gender, and age group.
Pennsylvania Department of Human Services Racial Equity Report 2021
Presentation that Oregon Health Authority made at the 2020 NAHDO conference about Oregon’s APAC/APCD and leveraging race and ethnicity data from other state data sources.
As health inequities continue to be exacerbated by the COVID-19 pandemic, there is concerted energy to address this topic across states. Oregon has had a longstanding focus on health equity and employed two foundational strategies that can serve as examples for other states seeking to further their health equity efforts. Oregon first developed a common language and defined what “health equity” meant in the state. The state also engaged community partners to ensure that the community voice was apparent in policy decisions on the state level. When combined, these strategies have helped Oregon develop a foundation to build and implement subsequent health equity efforts in the state.
The COVID crisis is revealing the extent of the disparities facing black, indigenous, and people of color. People of color are infected by COVID and dying of COVID at rates higher than their percentage of the population. Black, Hispanic, and American Indian and Alaska Native people are also at higher risk of being hospitalized with COVID. Medicaid has an opportunity and a responsibility to lead efforts to advance health equity by virtue of the population it serves and its unique leverage point within states as a payer. Medicaid Directors at NAMD’s Fall 2020 meeting illustrated how they are taking steps to address equity both internally, among their staff, and externally, among the members they serve.
California’s Blueprint for a Safer Economy includes a health equity metric which will be used (along with other metrics) to determine a county’s tier. The purpose of this metric is to ensure California reopens its economy safely by reducing disease transmission in all communities. This document outlines the equity metric and requirements which is effective October 6, 2020.
The Louisiana Department of Health’s (LDH) Office of Community Partnerships and Health Equity, in partnership with LDH agencies, is working to assess, understand, and improveexisting practices and policies, as well as deliver intentional strategies that will build health equity and be informed by (i.e., leverage) Louisiana’s health disparities and inequities.
The Louisiana Department of Health’s (LDH) Office of Community Partnerships and Health Equity, in partnership with LDH agencies, is working to assess, understand, and improveexisting practices and policies, as well as deliver intentional strategies that will build health equity and be informed by (i.e., leverage) Louisiana’s health disparities and inequities.
In the Louisiana Department of Health (LDH), barriers to health (BTH), are seen as those factors that prevent an individual, popu-lation, and/or community from acquiring a) access to health services and/or b) achieving their best health.1 LDH also recognizes that barriers to health can be systems (i.e. structural determinants) that offer health care and services; these systems are shaped by a wider set of forces: economics, social policies/social norms, and politics.3Further, it is also important to note what may be a barrier to one person, population, and/or community may be an asset to others, based on social and cultural factors. Thus, all people, populations, and communities are not all the same and there must be intentionality in ensuring that all whom LDH serve are treated and provided services in a matter that take into consideration-programmatically respond to the environments and circumstances of people, populations, and communities—supporting them in achieving their fullest, best health.
As announced on August 28, 2020, the Blueprint for a Safer Economy includes a health equity metric which will be used (along with other metrics) to determine a county’s tier. The purpose of this metric is to ensure California reopens its economy safely by reducing disease transmission in all communities. This document outlines the equity metric and requirements which is effective October 6, 2020.
An executive plan of action in response to Ohio’s Minority Health Strike Force’s report, “COVID-19 Ohio Minority Strike Force Blueprint,” which addresses racism and promotes long-term health equity through 34 recommendations.
In April 2020, Louisiana announced the formation of a COVID-19 Health Equity Task Force. In June 2020, the task force provided recommendations relative to health inequities which are affecting communities that are most impacted by the coronavirus.
Members of Governor Gavin Newsom’s Task Force on Business and Jobs Recovery urge business and civic leaders to take action to build a more inclusive, resilient economy.
Based on recommendations of the Health Disparity Task Force, Governor Tom Wolf announced the state is now collecting sexual orientation and gender identity data as part of the state’s COVID-19 data collection effort.
The Ohio Department of Health created a new position that will build on existing efforts to respond to health inequity by working directly with local communities on their specific long-term health needs and Ohio’s response to COVID-19.
Governor Mike DeWine formed the COVID-19 Minority Health Strike Force on April 20, 2020, in response to the disproportionate impact of COVID-19 on minorities in Ohio. The strike force contracted with the Health Policy Institute of Ohio (HPIO) to develop this “COVID-19 Ohio Minority Health Strike Force Blueprint.”
The state of New York is expanding access to testing for communities of color and low-income neighborhoods by establishing an initial 24 testing sites at churches in predominantly minority communities in downstate New York.
In an effort to address health disparities, the Governor of North Carolina signed an executive order directing resources to historically underutilized businesses, ensuring equitable distribution of pandemic relief funds, and supporting mass testing of migrant farm workers and food processing plant workers.
In a letter to the state’s Patient Protection Commission, the Governor of Nevada requested that the Commission develop long-term policy recommendations that address COVID-19 and broader health equity concerns.
The Wisconsin Department of Health Services (DHS) announced $10 million in funding for health care providers serving the state’s most underserved populations, including rural health clinics, tribal health clinics, community health centers, and free and low cost clinics.
The Virginia Department of Health and the Health Equity Task Force partnered with a local media outlet to provide information about the next phases of the recovery process and its implications for health equity.
The Virginia Department of Health and the Health Equity Task Force partnered with a local media outlet to provide information about the next phases of the recovery process and its implications for health equity.
The Governor of New Jersey signed legislation, S2357, requiring hospitals to report demographic data to the Department of Health, including age, ethnicity, gender, and race of individuals who have tested positive for COVID-19, who have died from COVID-19, and who have tried to get testing but have been turned away.
The task force will act in an advisory capacity to the Governor and study the causes of racial disparities in the impact of COVID-19 and recommend actions to immediately address such disparities and the historical and systemic inequities that underlie them.
The state of Michigan established the Michigan Coronavirus Task Force on Racial Disparities, which is charged with identifying the drivers of existing racial disparities in COVID-19 outcomes and recommending policies addressing such disparities. The Michigan Safe Start Plan utilizes public health metrics such as impacts on at-risk populations as criteria to trigger movement into consequent phases of reopening.
The second edition of the Health Equity Guide for Public Health Practitioners and Partners is intended to support practitioners and partners engagement in multifaceted approaches to addressing health equity.