The COVID-19 crisis exposed inequities that existed long before the pandemic began. Alarming racial and economic disparity data of COVID-19 infection and death rates have brought equity to the forefront of many jurisdiction’s emergency response efforts, prompting many to transform their disaster and recovery strategies.

The Public Health Alliance and the Bay Area Regional Health Inequities Initiative partnered to release an imperative report on “Embedding Equity into Emergency Operations: Strategies for Local Health Departments During COVID-19 & Beyond.” The brief outlines case studies, resources, and priority recommendations that counties and cities can take to explicitly and intentionally embed equity staff and practices into their emergency operations structures and throughout the public health emergency response and recovery process.

On August 7th, 2020, the Alliance hosted a webinar with our BARHII partners, over 180 attendees,and a panel of national equity leaders. The panel sharedsuccesses and challenges the experienced when embedding equity into their jurisdiction’s emergency response. We’ve included some key takeaways and follow-up resources from the webinar below.

Embedding an Equity Officer in the Emergency Operations Structure

The key recommendation that all speakers sharedwas the need to embed equity into the official emergency operations structure. By embedding an Equity Officer position in the command structure of the Emergency Operations Center (EOC), the speakers helped build organizational support for equity-centered response structures. This change reflects therecognition that an equitable response must be prioritized throughout COVID-19 and beyond.

Investing in Equity Staff and Capacity Building Before, During, and After a Crisis

‍The speakers identified that having an equity champion, specifically an Equity Officer,in the Emergency Operations Center (EOC) is critical to ensuring that equity isn’t an afterthought in theemergency responseprocess. In addition to an official equity position, a key theme in the webinar discussion was the need for greater equity capacity within Local Health Departments overall. The speakers consistently talked about being the onlyequity staff,or one of a very small team, within their departments. As their equity teams were pulled into emergency response efforts, many had to juggle responsibilities in multiple roles. This aligns with what we’ve heard from our own Alliance members: that more flexible funding is needed to hire additional dedicated equity staff and/ortotrain existing staff on equity principles before an emergency occurs.

In Long Beach, Equity Officer Katie Balderas was the only full-time staff member focused on equity and had to move quickly to build an equity response team.
Katie Balderas, Equity Officer, City of Long Beach, Dept. of Health and Human Services

San Francisco and Seattle King County benefited from having a history and equity infrastructure already established in their government structures. In San Francisco, Dr. Ayanna Bennett, the Director of Health Equity, also served as the Incident Commander and was able to rely on a larger equity team. This facilitated the integration of equity considerations early on in the COVID-19 response, but as Dr. Bennett highlighted, it was still challenging as the community engagement process was often not compatible with the emergency response structure.

Building An Equitable Foundation through Cross-sector Partnerships

Working across sectors is essential to fortifying diverse partnerships within emergency response systems and supporting long-term health equity. Speakers discussed how they worked with external agencies within their jurisdiction that are non-traditional partners. While there are minor organizational barriers to consider, pursuing a culture of equity is a continual process that works best when it welcomes challenges.

A key lesson from Dr. Bennet: embedding equity is an ongoing process not a one-time event that must expand beyond the equity team to all sectors working on the emergency response.
Dr. Ayanna Bennet, Incident Commander & Director of Health Equity, San Francisco Department of Public Health

Authentically Partnering with Community to Advance Equity and Build Trust

Being responsive to community requests helped jurisdictions advance an equitable response more quickly. The speakers identified a willingness to listen and take responsibility as critical for building community trust. In Long Beach, this meant recognizing the ways community members had felt left-out of government decision-making in the past. In San Francisco, community members pushed for community-level data which told a different story about who was impacted. Dr. Bennett stressed that it takes time to incorporate authentic community involvement and build trust with community, which was difficult to do in crisis-response mode.

Mariel Torres-Mehdipour discussed how the health department quickly put together a Latinx response team with community members and accessible weekly video calls broadcasted on Facebook Live. They also recruited contract tracers from the Latinx community and partnered with community organizations to build trust.
Mariel Torres-Mehdipour, Emergency Response Equity Officer, Seattle-King County, Department of Public Health

Finally, there is no one-size-fits-all approach. Local health departments are approaching equity in their emergency operations differently, depending on their organizational structure, funding, and local political context. There are many ways to approach and incorporate equity into emergency operations. Read the full brief for more models and recommendations for formally embedding equity into a jurisdiction’s emergency response.