Developing Permanent Organizational Infrastructure for Health Equity
To ensure long-term change and sustainability of health equity efforts, rural organizations can look for
opportunities to incorporate equitable changes into their systems, protocols, and processes. Some strategies for
developing permanent organizational change for health equity include:
Embedding health equity staff positions in the organization or designating staff to serve on a health equity
team that will help guide organizational health equity efforts
Assessing organizational policies to identify any challenges to engaging communities or addressing social
determinants of health
Developing organizational strategic plans to eliminate disparities and advance health equity
Incorporating health equity into the organization's mission and/or vision
Formalizing partnerships and collaborations with partners through MOUs (memoranda of understanding) or other
Infrastructure updates, such as renovations to improve accessibility or hardware/software updates to capture
comprehensive demographic information
At the local government level, the National Association of
Counties lists examples of counties that have issued county declarations and resolutions or instituted
county committees and initiatives to advance diversity, equity, and inclusion. These policies and programs can
keep local governments and elected officials accountable for addressing equity in all aspects of their work.
Examples include commitments to:
Increasing diversity throughout local government, such as county boards and commissions
Building or expanding community partnerships
Allocating resources to address racism and disparities, such as by aligning a strategic plan for equity with
the county's annual budget process
Working across government agencies to promote equity in policymaking (see Health in all Policies)
Providing training on topics like disparities and racial equity for county departments, agencies, and
Changing the county's recruitment practices
Examples of Communities Developing Permanent Organizational Infrastructure for Change
The Washington State Hospital Association's Health Equity
Organizational Assessment notes that infrastructure changes could include a designated person or
people who assume responsibility and accountability for implementing health equity efforts. Other
infrastructure efforts include committing to the National
Standards for Culturally and Linguistically Appropriate Services (CLAS), designating individuals who
are responsible for leading health equity efforts, involving community members who experience inequities in
the planning and implementing of health equity efforts, and prioritizing equity in organizational missions
The State of Connecticut Department of Public Health has Health
Equity Policy and Procedures that apply to all department programs and services. Policies include
adherence to the CLAS standards.
The County Board of Supervisors in rural
Mono County, California, passed a resolution that recognized racism as a public health crisis and
asserted a commitment to advancing racial equity and reducing disparities. Actions listed include
participating in regular trainings on topics of diversity and discrimination and developing a workplan for
efforts related to justice, equity, diversity, and inclusion.
Questions for Consideration
How is the organization holding itself accountable to advancing health equity?
Who at the organization is involved in planning, designing, and implementing health equity efforts?
How is the organization operationalizing health equity in its work?
Resources to Learn More
Health Equity: Build Infrastructure to Support Health Equity Guidance for Health Care Organizations
Discusses efforts to build organizational infrastructure to support health equity with an emphasis on the
collection and use of race, ethnicity, and language (REaL) data.
Organization(s): Institute for Healthcare Improvement