Building a Culture of Health Equity: New Initiative Launches with 10 State Health Agencies


Based on an unprecedented increase in public health funding and an extraordinary focus on the health equity divide during the COVID-19 pandemic, governmental public health and its partners have a once-in-a-generation opportunity to amplify a vision for vibrant communities where everyone can lead their healthiest life.

The Strategies to Repair Equity and Transform Community Health (STRETCH) Initiative is aimed at helping state health agencies seize this moment and create effective cross-sector and cross-agency coordination to build a culture of health.

Ten state health agencies have been invited to participate in the project, and these agencies vary across many dimensions, including region, centralized versus decentralized, organizational structure and size: Connecticut Department of Public Health, Kansas Department of Health and Environment, Maryland Department of Health, Minnesota Department of Health, Mississippi State Department of Health, Nevada Division of Public and Behavioral Health, Tennessee Department of Health, Vermont Department of Health, Virginia Office of Health Equity and Wisconsin Department of Health Services.

Our team at the CDC Foundation, along with the Association of State and Territorial Health Officials (ASTHO) and the Michigan Public Health Institute (MPHI), are working together to assist state/territorial teams in strengthening their community engagement, engaging in transformational change and building sustainable and equitable cultures of health.

Supported by the Robert Wood Johnson Foundation, the STRETCH Initiative will combine virtual learning as well as robust and tailored technical assistance to participants. The initiative will focus on creating collaborative partnerships between state teams and intermediary organizations that support their public health mission (public health institutes, community-based organizations, local health foundations, academic centers or other similar organizations) to build healthy and resilient communities to address the following:

  • Designing meaningful and lasting systems change and creating inclusive and equitable public health systems.
  • Embedding equity into State Health Agencies strategic priorities, community partnership approaches, program development and implementation, policies and practices.
  • Leveraging newly available and substantial level of funding for public health to create and implement sustainable financing strategies that drive meaningful public health impact.

Each state has assembled a team that includes senior leaders from the health department. The exact composition varies among the teams, but all teams include staff with the authority and responsibility to engage in planning for the department. In addition, teams include community members or representatives of intermediary partners. Each state team will focus on a key project.

These projects will center on building collaborative partnerships to take action to address health equity and build resilient communities. Some teams will adopt a state-wide approach, while others will take a place-based approach, focused on particular communities or regions. The teams will have the opportunity to develop a project that is aligned with and addresses their unique state priorities.

For almost two years, public health officials have been confronting the challenges of responding to a pandemic that has stretched a public health workforce that was already experiencing significant strain. Therefore, the STRETCH team is designing an approach to support the states that takes into account that fatigue and the many competing priorities their staffs may be experiencing. Over the yearlong project, the CDC Foundation, ASTHO and MPHI will assist states in implementing program and policy change by providing:

  • Virtual learning programming;
  • Peer-to-peer connections and networking opportunities;
  • Dissemination of federal, national and state/territorial resources and materials;
  • Robust and tailored technical assistance;
  • One on-site health department staff person, hired and funded by the CDC Foundation to support the work of the project.

This on-site staff person may serve in a variety of key roles, including project management, strategic planning, health equity coordination, liaison with jurisdiction-identified community partners, funding source navigation and identification of current or emerging best practices.

The STRETCH Initiative will focus on capacity building and technical assistance to achieve the overall goal of supporting state health organizations to strengthen their partnerships and planning with communities, develop connections and strategies to work with intermediaries more effectively and leverage new federal funding opportunities in ways that advance equity and community wellbeing.

Working together, we can build a stronger culture of health.

Lauren Smith Headshot
Lauren A. Smith, MD, MPH, is the chief health equity and strategy officer for the CDC Foundation.