Recommendation: Engage in community-wide health equality dialogues that address racial and ethnic health disparities, particularly the impact of structural racism on the health and well-being of communities of color in the region.

What we heard: Creating health equality involves more than just improving the quality and availability of health care. It requires understanding the roots of health inequality and the impact of structural racism on the lives and health of people of color. Once we understand how history, institutional practices, public policies, and cultural stereotypes intertwine in ways that perpetuate discrimination, inhibit opportunity and economic mobility, and eventually lead to poor health outcomes, we can create a new agenda for achieving health equality.

What we’ve done to advance this recommendation

• Our 11^th Annual Meeting, Roots and Remedies: Creating Health Equality Through Social Justice, featured Dr. Camara P. Jones, a pioneer in the research on the impact of structural racism on health. Dr. Jones provided the keynote address to nearly 250 of our community partners.

• Convened a discussion among local health funders on health and racial justice with Lori Villarosa, Executive Director of the Philanthropic Initiative on Racial Equity and Makani Themba-Nixon, Executive Director of The Praxis Project.

• Worked with the Health Policy Institute at the Joint Center for Political and Economic Studies to identify local champions for its PlaceMatters Initiative, a national, community-based, multi-year initiative designed to identify the complex underlying causes of health inequities and to define strategies to address their root causes.

• Program Officer Jacquelyn Brown spoke about philanthropy’s role in addressing structural racism and promoting health justice at the Place Matters Design Lab IV in February 2007, the Grantmakers in Health Annual Meeting in February 2007, and the American Public Health Association Annual Meeting in November 2007.

• Provided a grant to the Philanthropic Initiative on Racial Equity and the Applied Research Center to measure the impact of our foundation’s work on racial justice outcomes. This study included an assessment of CHF’s internal operations, grantmaking, and external communications. A final report will be available in early 2008.

• Screened two episodes of the forthcoming PBS documentary series, Unnatural Causes: Is Inequality Making Us Sick? at our 12^th Annual Meeting in September 2007. Following the film, Dr. Adewale Troutman, director of the Louisville (KY) Metro Public Health & Wellness Department and founder of its innovative Center for Health Equity, delivered a keynote address on creating health equity through social justice.

What we’ve learned:

How we define racial health inequity inevitably shapes our intervention.   Taking a more holistic, social determinants approach to eliminating racial health disparities requires changing paradigms that focus solely on changing the individual health behaviors and increasing access to health care to transforming those socioeconomic structures, policies, and practices that maintain the inequities that cause racial and ethnic health inequity.  

There are emerging research, collaboration, and program models around the country that are clearly identifying the underlying causes of health inequities and developing strategies informed by this knowledge. These models include examples of how public health workers, community health advocates, health funders, government agencies, policymakers and others are joining forces with their peers who work in education, housing, jobs/labor, criminal justice and transportation to envision and develop a comprehensive approach to creating systems that create and promote a just and healthy society. These models need to be held up and supported.

Next steps:

We will use recommendations from the report by the Applied Research Center and the Philanthropic Initiative for Racial Equity to develop a plan to build both internal and external capacity to address social and racial justice issues.

Resources, model programs and practices:

Unnatural Causes:  Is Inequality Making Us Sick?

A four-hour documentary series that will sound the alarm about America's glaring socioeconomic and racial inequities in health, and search for its root causes.

RACE—The Power of an Illusion

As a primer to Unnatural Causes, RACE—The Power of an Illusion is a provocative three-hour series that questions the very idea of race as biology.

Louisville Center for Health Equity

Recognizing that traditional public health practices have value but cannot succeed by themselves, the Louisville Center for Health Equity was established to address the social and economic conditions that impact the civic well-being of Louisville residents.

National Association of City and County Health Officials (NACCHO) Health Equity and Social Justice  

Increasing health inequities have implications for public health practice, and NACCHO seeks to identify approaches to eliminate them through a perspective grounded in principles of social justice.

The Opportunity Agenda  

Through an integrated strategy of communications, research, and advocacy, the Opportunity Agenda works with social justice organizations and leaders to connect with core American values and expand the constituency for opportunity in the United States.