Racial Health Equity Plans in the 30 Largest US Cities.

Area of Science:

• Public Health Policy
• Health Equity Research
• Urban Health Studies

Background:

• Significant racial inequities exist in US city life expectancies, with gaps exceeding 10 years.
• These disparities are perpetuated by systemic racism, social structures, and policies, necessitating population-level interventions.
• Local health departments (LHDs) are strategically positioned to implement these crucial changes.

Purpose of the Study:

• To assess the extent to which LHDs in the 30 most populous US cities incorporate racial health equity into their formal strategic health plans.
• To evaluate the inclusion of specific, measurable equity goals and related organizational practices within these plans.

Main Methods:

• An environmental scan and document review of formal health plans from LHDs covering the 30 most populous US cities.
• Assessment of equity priorities, measurable goals, organizational structures, data utilization, and formal declarations related to racial equity.
• Data collection was conducted between January and August 2022.

Main Results:

• Only 13 of 29 LHDs explicitly focused on racial health equity in their plans; just seven had specific, measurable goals.
• Twenty-five LHDs presented local data on racial health inequities.
• Most LHDs declared racism a public health crisis, and about half had dedicated equity positions or focused COVID-19 efforts on equity.

Conclusions:

• Few large cities effectively integrate anti-racism principles into formal LHD strategic planning.
• While LHDs recognize racial health inequities and collect relevant data, there's a critical need to establish concrete, measurable equity goals and allocate resources for their achievement.