Robert Wood Johnson Foundation Says CDC Should Center on Equity

On Dec. 7, the Robert Wood Johnson Foundation (RWJF) published a brief that focuses on how the U.S. Centers for Disease Control and Prevention (CDC)—and state and local partners—can leverage the current moment to make sure that every person and community in the country can thrive.

The brief, entitled, “Centering Equity in the Nation’s Public Health System” details five considerations that complement equity strategies that CDC raised in its “Moving Forward” assessment, released earlier this year.

A press release on the brief says that “After the COVID pandemic revealed critical weaknesses in the U.S. and global public health systems, CDC thoughtfully examined its pandemic response. The assessment and recommendations included in CDC “Moving Forward” focused on enhancing the  timeliness, clarity, and effectiveness in agency actions in addition to governance, structure, and workforce matters. While equity was emphasized as a core value driving the reforms, CDC and state and local public health agencies would benefit from a bolder vision and detailed strategies to make our public health system truly just.”

That said, “RWJF’s five considerations include:

  1. Vision, leadership, and governance. CDC should take a holistic approach to equity and position and resource equity efforts for success. Efforts must span workforce, strategy, and programs as well as culture, policies, and organizational structure.
  2. Partnerships and trust. CDC should pair strong national leadership with a decentralized model of action that resources and empowers state and local partners, including community-based organizations. With this infrastructure, CDC would be better positioned not only to respond to public health emergencies but also to foster more just systems of public health that are accessible and visible to all.
  3. Data and accountability. CDC must measure progress and hone its strategy based on the experiences and outcomes of people most affected by structural discrimination. As recommended by the National Commission to Transform Public Health Data Systems, CDC and other federal health agencies should develop and implement standards for data collection aiming to include marginalized groups and their unique perspectives.
  4. Communications and narrative. While tracking messages, mindsets, and misinformation, the agency must communicate accessibly and strategically. The goal should be an equity-focused narrative, tailored for various audiences, that fosters a broader understanding of racism—not race—as the cause of poorer health outcomes for people of color.
  5. People and culture. CDC must value equity when recruiting, training, and evaluating staff and when conceptualizing public health expertise. CDC should develop a set of health equity competencies, spanning all parts of the agency. Externally, it should fund state and local health departments to build equity knowledge, skills, and commitments across the public health system.”

The release adds that regardless of politics, leaders agree that a strong and effective CDC is important to the health and wellbeing of individuals in the U.S. Congress and the administration should provide CDC with political independence in order to follow the best public health strategies, provide enough and stable funding to the CDC as well as state, local, tribal, and territorial health departments they work with. The COVID-19 pandemic uncovered weaknesses in our nation’s public health system and, according to the brief, the answer is a holistic, bipartisan response.