Historically, one of the roots of structural racism is a lack of community voice in defining policy priorities and how policy decisions are made. Decisions are often made by private and public sector professionals without active co-leadership from community members the policies will ultimately impact. To effectively address structural racism and promote racial equity in San Diego County, the University of California San Diego – Center for Community Health (UCSD-CCH) project Centering Community Voice in Collective Action to Address Structural Racism and Promote Health Equity aims to fundamentally shift the power dynamic of policy decision making to ensure community voice is central to policy prioritization and development. The project’s overarching goal is to implement policy and practice changes that address structural racism and health disparities through a multi-sector, community-centered policy review, assessment, prioritization, development, and implementation process influencing a range of policies and practices that foster racial and health equity across San Diego County.
This will be accomplished through formation of a Community Council, which will bring together multi-racial, multi-ethnic residents from across the County to guide and enact policy change locally and regionally. Located at the U.S.-Mexico border, San Diego County is one of the most ethnically and culturally diverse regions in the nation, with over 30% Hispanic/Latino residents, over 25% foreign-born, and over 40% speaking a language other than English at home, along with the second largest U.S. concentration of Somali and Middle Eastern immigrants and more American Indian reservations than any other U.S. county. The project’s Community Council will be explicitly diverse, inclusive, and representative of underserved communities across San Diego that are directly impacted by structural racism and health disparities, and create an infrastructure for community-driven policy change to address structural racism and disparities according to community needs and priorities. The Council will build on and be integrated with the existing CCH-led San Diego County Childhood Obesity Initiative (COI), the longest-running multi-sector partnership of its kind utilizing a collective impact approach to reduce and prevent childhood obesity through policy, systems, and environmental change.
Key activities will include formation of the Community Council group; community resident training and capacity building; review of community-centered data, stories, and priorities; community-led policy scan/assessment and policy agenda development aligned with the OMH Coordinating Center’s policy assessment framework; and community-engaged policy-advocacy activities related to a minimum of two policy priorities per year. Policy and practice efforts will focus on racial and health equity topics including public safety, housing challenges, obesity, food assistance, and others according with community priorities and guided by the project’s Disparity Impact Statement. Key outcomes will include engagement in and diversity of the Community Council; self-reported cohesion and relationships between Council members and multi-sector partners; improvements in knowledge, skills, attitudes, and self-efficacy to enact policy/advocacy change following training/capacity building; the degree to which community data is incorporated into policy priorities; Community Council level of influence on policy agenda and actions; and policy/advocacy outcomes and anticipated community impacts.
The project will be led by UCSD’s Center for Community Health, backbone organization for the COI along with Global ARC and the YMCA of San Diego County, key partners in formation of a pilot Community Council group. The UCSD Herbert Wertheim School of Public Health (SPH) will lead evaluation of the project’s impact and dissemination of findings and lessons learned.