Repairing Equity and Transforming Community Health

With the influx of public health funding and the impacts of the COVID-19 pandemic, there is renewed focus on cultivating projects that envision vibrant, healthy communities. Acknowledging the tremendous amount of health equity work underway in communities, as well as the competing priorities of public health staff, the Strategies to Repair Equity and Transform Community Health (STRETCH) Initiative works with state health agencies to build a more equitable health culture through effective cross-sector and cross-agency coordination.

To support this effort, our team at the CDC Foundation is partnering with the Association of State and Territorial Health Officials (ASTHO) and the Michigan Public Health Institute (MPHI), working alongside state and territorial teams to strengthen state health agencies’ community engagement.

Gladys Peters, Mississippi Department of Health, addresses state health agencies at the STRETCH Summit, an in-person event for the STRETCH initiative.

Godwin Nwando, Health Equity Manager, Nevada Division of Public and Behavioral Health and Lauren Smith, Chief Health Equity Officer, CDC Foundation

Team members from ASTHO, MPHI and CDC Foundation, the partner organizations behind the STRETCH Initiative, gather at the in-person STRETCH meeting.

Through the support of the Robert Wood Johnson Foundation, the STRETCH Initiative combines virtual learning and robust, tailored technical assistance that centers equity in all public health domains while helping state teams work toward systemic change.

“Now is the time to be bold,” said Hilary Heishman, senior program officer at the Robert Wood Johnson Foundation. “It is an important time to make changes that create opportunities for everyone in our society to thrive. Strengthening public health with an eye to the future is fundamental to this vision.”

The STRETCH framework is comprised of five domains of work that are essential for achieving health equity: community-led approaches, place-based initiatives, workforce development and organizational infrastructure, data-driven management and finance systems.

Though the framework provides a common health equity foundation, the priorities of each community differ. STRETCH works in partnership with 10 participating state health agencies and their teams to understand their assets, challenges and opportunities as well as their specific systems, including funding and workforce systems.

Now is the time to be bold. It is an important time to...create opportunities for everyone in our society to thrive.

The 10 participating health agencies each assembled a team including senior leaders from the health department, community partners, local health departments, financial partners and others. Each team developed a project within the five domains of the STRETCH framework centering on building collaborative partnerships to address health equity and develop thriving communities. By bringing together cross-departmental and cross-sector teams, the state agencies gained different perspectives and continue to shift the dialogue to ensure a community focus to their work.

STRETCH took a user-centric approach to technical assistance support by providing peer learning opportunities across the 10 states as well as individualized coaching to each of the state teams. To support these teams throughout the development of their projects, a team member from ASTHO, MPHI and the CDC Foundation works alongside the state teams to further develop their work plans and guide them through a systems-change approach—focusing on policies and procedures, building relationships, addressing power dynamics and shifting mental models. The STRETCH framework is designed to support power-sharing in community partnerships while building ongoing trust with communities and across sectors.

By addressing root causes of health inequities within our communities, we can build meaningful, lasting systems change to create inclusive, equitable public health systems and, ultimately, improve health equity.



The Strategies to Repair Equity and Transform Community Health (STRETCH) Initiative is supported by the Robert Wood Johnson Foundation. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, the Robert Wood Johnson Foundation. The 10 state health agencies participating in the project include: Connecticut Office of Health Strategy, 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.

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