Supporting the transformation of California's public health agencies

A public health worker at a mass vaccine site

California’s city and county public health departments have been transforming themselves in the face of three connected crises — the COVID-19 pandemic, resulting economic downturn, and renewed urgency to fight racial injustice.

These vital government agencies have dramatically scaled up services since 2020 to respond to a new virus that in California has sickened more than 10 million and killed almost 100,000 people so far. They rolled out prevention, testing, information, and immunization services at an unprecedented speed and scale. On top of that, many departments rapidly adjusted their own policies and practices to address the health inequities that disproportionately impact communities of color with low incomes. Inequities along lines of race, gender, and income are not new. But the pandemic exacerbated and exposed these issues, prompting many public health departments to confront those inequities with new intensity.

For many public health systems, doing all of this felt necessary — impossible not to do. But it also stretched many departments to — or beyond — the limits of their resources and capacity.

Stepping up for the future of public health

At Blue Shield of California Foundation, part of our work to align systems with community priorities involves helping public systems move toward a tighter focus on racial equity and a deeper, more lasting partnership with communities most affected by health inequities and domestic violence. Those communities know their needs and strengths best. And, when communities and systems work closely together, they make changes that are more responsive and lasting.

Public health agencies exist to address the health of all people. They prioritize prevention and the underlying social determinants of health. In California, state and local public health agencies have been at the vanguard of explicitly linking health with racial, gender, and economic inequities. That’s what makes them ideal leaders in forging strong community partnerships.

As a Foundation, we support a wide array of organizations that, in turn, support public health departments. One of them, Human Impact Partners, works to make racial equity central to public health practice. California also has an incredible network of organizations — including Bay Area Regional Health Inequities Initiative (BARHII), Public Health Alliance of Southern California, and the San Joaquin Valley Public Health Consortium — working across regions or the entire state to build public health departments’ capacity to achieve more equitable health outcomes. For example, early in the COVID-19 pandemic, health officials in many Central California counties felt disconnected from state agencies. The San Joaquin Valley Public Health Consortium organized weekly meetings that helped these officials quickly identify common questions and concerns across the region, building power in advocating for their communities. That practice continues. Like many emergency responses that began during the pandemic, it has proved to meet longstanding, unmet needs. Maintaining these gains, and making new ones, is central to the Foundation's support of public health departments and the communities they serve.

Together, our grantees and their public sector partners are sharing best practices, extending their resources through collaborative efforts, and expanding their influence to advocate for, establish, and implement better policies. They are prioritizing racial equity and community partnership at all levels of their work. Ultimately, we believe, these practices will lead to the improved quality of life, well-being, and health outcomes that we want to see in California.

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