Working in collaboration with grassroots organizers, advocacy organizations, and other government partners, the Alameda County Public Health Department, California, helped change local policies and practices related to housing habitability, affordability, and access to eliminate housing and health inequities in low-income communities. See Advice for Local Health Departments below for more ways to take action. As the health department had limited capacity to address the root causes of these health disparities, Department leaders created and funded a new Community, Assessment, Planning and Education CAPE unit.
The unit evolved to include staff focused on community capacity building, internal capacity building, and policy change. In , ACPHD started a participatory strategic planning process that included internal discussions on racism, gender discrimination, and class exploitation; 7 community forums; dialogues with the Public Health Commission and ACPHD staff on a vision for a healthy Alameda County; interviews with county supervisors and other key stakeholders; and 2 planning retreats.
This process strengthened their vision to integrate a health equity practice within the organization, and guided subsequent activities that garnered staff and partner commitments. Leadership knew that staff had diverse health equity experiences and could use those experiences to activate more health equity work within the Department.
For example, many ACPHD staff experienced racism, classism, and other forms of oppression and were leaders addressing these issues in their churches, families, neighborhoods, and community groups.
At the same time, line staff, who had been vocal about inequities and wanted to do more on root causes, were unsure how to navigate restrictive grants, budgets, and internal infrastructure. Other staff had less exposure to considering the role of oppression for health and their role in addressing these issues to achieve health equity. ACPHD developed a 5-module Public Health training series for all staff, to create space for dialogue, cross-learning, and developing a shared language to normalize institutional change and shifting power.
