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Want to advance health equity for all Californians? Look to local health departments

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The following is guest blog from Berkeley Media Studies Group with the Bay Area Regional Health Inequities Initiative, the Public Health Alliance of Southern California, and the San Joaquin Valley Public Health Consortium:

More than medicine or even genetics, the conditions in which people live are the biggest predictor of how healthy our communities will be. These conditions—like access to safe and affordable housing, good jobs, and quality schools—are shaped by our decisionmakers and the policies, systems, and structures they create. But, in many places, these policies have led to deeply ingrained racial and health inequities. Like many of you, we at Berkeley Media Studies Group (BMSG), believe that every Californian, regardless of their race, income, or where they live, deserves good health. We also know that we don’t need to start from zero. Local health departments (LHDs) are already working to advance health equity in communities across California. By collaborating with and investing in groups that are making major progress toward equity, we can turn this vision into reality.

Why invest in local health departments?

More than 60 LHDs are already playing an important and unique role in advancing racial and health equity in California. However, scaling these efforts so that they impact health across the entire state requires all of us, including LHDs and the groups that support them, to take new approaches. That’s why investments in LHDs matter.

With a recent grant from the Blue Shield of California Foundation, BMSG is helping to build the communication capacity of three regional bodies, the Public Health Alliance of Southern California (Alliance), the Bay Area Regional Health Inequities Initiative (BARHII), and the San Joaquin Valley Public Health Consortium (SJVPHC), as they work with LHDs to bring racial and health equity to every Californian.

For example, the Alliance has been gathering data so California residents and policymakers can easily see how to shift resources and investments to address gaps so every neighborhood can thrive. The California Healthy Places Index (HPI) maps the community conditions known to affect health and ties them to viable, systemic actions that health departments and their partners can take. Since its launch in June 2018, governmental and philanthropic organizations have used the HPI to make equity-based decisions about more than $450 million in regional and state grant programs. Nearly 90 agencies, businesses, and community groups are using HPI to integrate equity and public health into their work.

BARHII members identified housing as a critical issue affecting public health in their region, as they saw Bay Area residents struggling under the rising rents, with some paying more than 50% of their monthly income for a roof over their heads, leaving little for food, healthcare, and other vital needs. This crisis has exacerbated existing health disparities, falling much more heavily on lower-income Black and Brown neighborhoods that already experience decades-shorter life expectancy compared to their whiter, wealthier neighbors. BARHII’s members led a regional response to the housing crisis to preserve existing affordable housing, protect tenants at risk of displacement, and produce additional affordable housing. This “3Ps” model has already shaped housing policy in the Bay Area and beyond.

SJVPHC has focused on supporting regional movements to improve access to healthcare in rural areas, develop cross-county action plans to address diabetes, and support member health departments in building capacity to change the policies, systems, and environments that make it harder for residents to be healthy. SJVPHC is building strong relationships that bolster equity-focused work. For example, member LHDs have partnered with tribal councils to focus on the needs of tribal elders, youth, and women, as well as general needs.

Scaling equity-based solutions across California

Urgent public health issues like housing and climate change do not affect one community or region alone, but touch every part of the state. Connecting local strategies while building a statewide approach can bring solutions at the scale we need. Regional coalitions like the Alliance, BARHII and SJVPHC are uniquely positioned to build capacity inside LHDs to make racial and health equity a reality. Because they partner with community stakeholders, they can help mobilize public and private sector power to support policy, system, and environmental improvements occurring outside any one LHD’s span of control. Collaboratively, the regional coalitions magnify the public health voice to marshal support for enduring racial and health equity.

Should your zip code determine your life expectancy? Local health departments say, no! Every person in the state should have the foundation for health: a safe, stable home; affordable and accessible food; a job they can get to in a reasonable time to make a living wage; and the infrastructure that sustains health everywhere. BMSG is proud to support these regional bodies and their partners as they create a state where health abounds no matter where you live.


In December 2019, Blue Shield of California Foundation’s trustees awarded $1.2 million to this project to expand and strengthen prevention policy. To learn more about this and other projects, please visit our grantee announcement page.

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