At a glance
The National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention (NCHHSTP) Equity Initiative optimizes synergies between existing equity activities to identify and support strategic opportunities to embed equity into the fabric of NCHHSTP’s workplace operations and public health programs.
The Equity Initiative
The National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention (NCHHSTP) developed an Equity Initiative to optimize synergies between the Center's existing equity activities, and to support the identification of additional strategic opportunities to embed equity into the fabric of NCHHSTP's workplace operations and public health programs.
The Equity Initiative includes an Implementation Plan that outlines the first steps of a long-term strategic process to place equity squarely at the forefront of all internal and external Center activities. The Plan is organized into three focus areas with goals, objectives, and activities to support achieving the goals:
- Ensuring a workplace culture that is inclusive, collaborative, and anti-racist, and one that encourages all staff to engage in dialogue about racism and other systems of oppression.
- Establishing workplace policies and procedures that further increase diversity, ensure fair and equitable opportunities for advancement, and eliminate discrimination.
- Refining our systems and processes for designing, funding, and evaluating research, policy, programs, and partnerships to ensure they are intentionally, systematically, and consistently focused on addressing the social and structural causes of health disparities.
This commitment to a long-term strategy for health equity is shared across CDC. In 2021, former CDC Director Rochelle P. Walensky, MD, MPH, declared racism a serious public health threat, and soon thereafter launched the CORE Health Equity Science and Intervention Strategy to integrate health equity into the fabric of all of the agency's work. CDC is committed to ensuring that all people have the opportunity to have the best health possible.
NCHHSTP's Commitment to Health Equity
NCHHSTP is committed to health equity, which is achieved when all people have the opportunity to attain their full health potential and no one is disadvantaged from attaining this potential because of their social position or other socially determined circumstances.12 In keeping with this commitment, NCHHSTP seeks to maintain a staff work environment that is diverse, inclusive, and equitable, so that, together, NCHHSTP can eliminate disparities in health and in all of its determinants through public health programs. Read more about these efforts:
- NCHHSTP Strategic Plan through 2026
- Establishing a Holistic Framework to Reduce Inequities in HIV, Viral Hepatitis, STDs, and Tuberculosis in the United States
NCHHSTP Workforce Analyses
Developing the Equity Initiative
The Impetus
In Spring 2019, the NCHHSTP Office of Health Equity (OHE) and the Health Equity Workgroup began a formal process to create a shared understanding and long-term strategy for advancing equity across the Center. As a part of this process, NCHHSTP leaders conducted site visits and consulted with state and local health departments (e.g., New York City and Chicago) that had implemented their own equity initiatives. After two years of research and planning by a team of representatives from all NCHHSTP Divisions and the Office of the Director (OD) working closely with an organizational change consultant, the Center launched the NCHHSTP Equity Initiative.
Leading with Racial Equity
The NCHHSTP Equity Initiative Implementation Plan has an initial emphasis on racial equity, and includes objectives aimed at identifying and implementing strategies to eliminate racial disparities in health. The Equity Initiative leads with racial equity because of the stark racial disparities associated with HIV, viral hepatitis, STDs, and tuberculosis, and because racial and ethnic inequities* pervade the social determinants of health, including housing, education, employment, environmental exposures, and exposure to the criminal justice system.[3] Racism is both a key determinant of population health and a root cause of racial health inequities.[1] ,3Thus, as experts have noted, "a focus on structural racism is essential to advance health equity and improve population health."[3]
While the NCHHSTP Equity Initiative leads with race, it also addresses disparities and discrimination related to, but not limited to, gender, sexual identity and orientation, income, geography, and disability status—all factors that deeply influence the incidence, morbidity, and mortality associated with infections under the purview of NCHHSTP.
Operationalizing the NCHHSTP Equity Initiative
NCHHSTP is made up of the Office of the Director (OD) and four divisions: the Division of HIV Prevention (DHP), the Division of Viral Hepatitis (DVH), the Division of STD Prevention (DSTDP), and the Division of Tuberculosis Elimination (DTBE). The Implementation Plan established three key structures to achieve the goals and objectives of the Initiative: An Equity Coordinating Group; several Equity Change Teams; and an Equity Evaluation Team.
The Equity Coordinating Group is composed of diverse (e.g., by job type, position level, and demographic characteristics) representatives from the Center, provides consultation and support to the Equity Change Teams, and coordinates cross-Center equity activities. The Equity Change Teams are charged with utilizing the goals and objectives of the Initiative to plan and coordinate equity activities within their organizational units. Finally, the Evaluation Team monitors and evaluates the plan, utilizing indicators, measures, and a detailed overall logic model, to monitor progress, effectiveness, and the impact of the Initiative. Results from the monitoring and evaluation process help the Center determine whether and which new, expanded, or modified activities are needed to accelerate progress toward achieving the Initiative's goals.
- Ford CL, Griffith DM, Bruce MA, Gilbert KL, eds. Racism: Science & tools for the public health professional. Washington DC: APHA Press; 2019.
- Braveman PA, Gruskin S. Defining equity in health. J Epid & Comm Health, 2003;57(4): 254-258.
- Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. The Lancet. 2017;389(10077): 1453 -1463.
- Although race and ethnicity are distinctly different social constructs, they are intertwined. "Racial diversity occurs within ethnically defined groups; ethnic diversity occurs within racial and ethnic groups; moreover, social forces differentially affect groups based on the interactions of race and ethnicity." In addition, "racialization fundamentally influences the social and public health implications of ethnicity."* Therefore, in the context of this document, the terms "racial disparities" and "race-based disparities" are intended to include ethnic disparities. *Ford CL, Harawa NT. A new conceptualization of ethnicity for social epidemiologic and health equity research. Soc Sci & Med. 2010;71(2): 251-258.