California?s large and diverse population has experienced significant disparities across COVID-19 infection, hospitalization, and death. COVID-19 has disproportionately affected many populations who are underserved, including many racial and ethnic groups and people living in rural communities. These populations may experience additional risk due to elevated rates of chronic disease that increase the severity of COVID-19 outcomes as well as secondary health impacts. Disparities are also reflected among communities experiencing socioeconomic disadvantage, those living in situations with less capacity to socially isolate, or who face barriers to accessing information, care and services; including essential workers, migrant laborers, persons whose primary language is not English, persons who are unhomed or undocumented. The activities in this proposal, the California Health Equity Initiative, aim to strengthen California?s state and local public health infrastructure in ways that address COVID-19 and advance health equity. Strategies, interventions, and services will consider systemic barriers and set the foundation to address future responses. Through a coordinated, community-involved approach, California will be able to reach populations currently at higher risk, underserved, and disproportionately affected to build and sustain trust, ensure equitable access to COVID-19 related services, and bounce forward to advance health equity for all Californians.California?s COVID-19 response efforts have leveraged an integrated statewide equity strategy with intentional action to address differences in outcomes across communities and populations. Equity-focused initiatives have been embedded in each arm of the response including data strategy, testing, contact tracing, communication, outreach, and vaccination. These efforts have fostered key relationships with community and social service partners, stakeholder groups representative of impacted racial and
ethnic populations, and those living in rural communities; including the Statewide Office of Rural Health. This grant will fund infrastructure at the state and local level that will build on and strengthen these relationships. This initiative is designed to be complementary and non-duplicative to activities being carried out and supported by other response funding streams, such as the Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC). Additionally, CDPH?s dedicated Equity Workstream in the COVID-19 response structure will support the coordination of this initiative through a comprehensive strategic approach.This initiative focuses on three strategies; improve data collection and reporting, expand public health infrastructure, and mobilize community partners and collaborators to advance health equity and address social determinants of health. Activities will include efforts to address data gaps to better describe and monitor disease and root causes of disparities, state-level equity quality improvement projects, local assistance to strengthen local equity infrastructure for at least 50 local health jurisdictions (including 21 rural jurisdictions), expansion of equity focused interventions, community engagement efforts, and targeted community-based pilot projects. All activities will contribute to a State Health Equity Plan creating a roadmap to bridge existing response activities into recovery.CDPH will leverage this funding opportunity to make a powerful leap forward in building equity infrastructure and action in California. The intended outcome of the California Health Equity Initiative is to reduce COVID-19 related health disparities, including addressing the social determinants of health drivers. These efforts will also contribute to a community-informed evidence base reflecting the importance and impact of equity infrastructure.
