Build Internal Infrastructure and Capacity

How public health departments can build internal infrastructure and capacity to advance health equity and racial justice

Health equity and racial justice in practice require a strong internal infrastructure — roles, systems, and resources — dedicated to advancing equity goals. This infrastructure allows public health departments to more effectively align, advance, and sustain internal and external equity efforts.

Effective health equity infrastructure needs:

• Dedicated roles and resources: Allocating staff time and financial resources to equity work is necessary for timely, effective, and consistent implementation of health equity strategies.
• Strong leadership commitment: Leaders need to use their power to commit organizational resources to equity work, and make health equity and racial justice organizational priorities.
• Transparent communication: Consistent, open communication about equity priorities, strategies, roles, and resources helps build understanding and support for these strategies across staff and programs.
• Shared analysis: A collective understanding of what health equity and racial justice strategies are, why they are important, and how they connect to all areas of work strengthens internal support and resourcing.
• Accountability mechanisms: Clear systems for setting and tracking metrics, defining roles and decision makers, and tracking progress supports continuity of health equity work.

To ensure a sturdy, sustainable internal infrastructure, health departments also need to invest in ongoing capacity building for staff. Staff need the skills and analyses to implement equity strategies and internal support to build these capacities. This includes providing ongoing training opportunities, fostering a culture of self-reflection and personal accountability, and creating supportive Communities of Practice and racial identity affinity spaces where staff can collaborate and innovate towards equitable outcomes. Through ongoing staff training and education, health departments are more able to implement strategic equity practices in partnership with the community.

Action steps health departments can take to build internal infrastructure and capacity:

• Create workgroups to lead equity work by identifying equity champions within your department and giving them support and authority to make policy and practice recommendations that center equity
• Foster shared leadership and engagement across staff, by including responsibilities for health equity and racial justice strategies in staff roles and job descriptions
• Allocate financial resources for equity work through baselining funding for equity work and staff roles in the organization’s budget; working with and compensating community partners; investing in programs that serve communities that are most impacted
• Provide opportunities for ongoing staff learning and reflection, where staff can name how root causes of inequities impact them and their communities, and identify collective capacity to effect change
• Develop accountability measures in the form of rules, metrics, and evaluations to ensure fairness when building programs and serving the public