Leveraging Science to Advance Health Equity: Preliminary Considerations for Implementing Health Equity Science at State and Local Health Departments

Abstract

Context: In 2021, the Centers for Disease Control and Prevention (CDC) launched CORE, an agency-wide strategy to embed health equity as a foundational component across all areas of the agency's work. The CDC established a definition of health equity science (HES) and principles to guide the development, implementation, dissemination, and use of the HES framework to move beyond documenting inequities to investigating root causes and promoting actionable approaches to eliminate health inequities. The HES framework may be used by state and local health departments to advance health equity efforts in their jurisdictions.

Objective: Identify implementation considerations and opportunities for providing technical assistance and support to state and local public health departments in advancing HES.

Design: A series of implementation consultations and multi-jurisdictional facilitated discussions were held with state and local health departments and community partners in 5 states to gather feedback on the current efforts, opportunities, and support needs to advance HES at the state and local levels. The information shared during these activities was analyzed using inductive and deductive methods, validated with partners, and summarized into themes and HES implementation considerations.

Results: Five themes emerged regarding current efforts, opportunities, and support needed to implement HES at state and local health departments. These themes included the following criteria: (1) enhancing the existing health equity evidence base; (2) addressing interdisciplinary public health practice and data needs; (3) recognizing the value of qualitative data; (4) evaluating health equity programs and policies; and (5) including impacted communities in the full life cycle of health equity efforts. Within these themes, we identified HES implementation considerations, which may be leveraged to inform future efforts to advance HES at the state and local levels.

Conclusion: Health equity efforts at state and local health departments may be strengthened by leveraging the HES framework and implementation considerations.

FIGURE 1

CDC Principles of Health Equity Science for Public Health Action Abbreviations: CDC, Centers for Disease Control and Prevention. Recreated with permission from CDC.

FIGURE 2

A Visual Representation of the Multi-Jurisdictional Facilitated Discussion Topics Abbreviations: CDC, Centers for Disease Control and Prevention; HES, health equity science; NGO, nongovernmental organizations This visual map represents the key points captured during the multi-jurisdictional facilitated discussions with state and local health departments and NGOs on HES. During the discussions, participants were introduced to CDC’s HES concepts (visible on the left side of the figure) and then were asked to share challenges, successes, and support needs around HES-related topics that emerged from earlier implementation consultations with state and local health departments (visible in the middle and right side of the figure). Those topics included the need to elevate qualitative data, include impacted groups/communities, and evaluate impact to advance HES at state and local health departments.