In 2015, HIP-Cuyahoga selected structural racism as a priority for its work based on the impact of redlining on population health outcomes and the understanding of racism as the root cause of other priority issues that had been identified. Notably at this point, the group recognized that system, not program, changes are needed to dismantle structural racism and their focus shifted accordingly. Data on health and place, and the need for data that reflect systems change, became the underpinning of their work. Moreover, the group also realized they needed to look internally, into their own organizations, to understand structural racism and make changes within before turning outward for public engagement and systems change work. HIP-Cuyahoga members were at very different places in understanding racial justice and therefore training and organizational assessments were conducted for member organizations. Resulting changes included embedding principles of equity into contracts, hiring and other internal processes. The group also considered the importance of language, noting they could not address the goal of “racial equity” without articulating the underlying issues of “racism.”

Additional outcomes include:

Equity Diversity and Inclusion (EDI) becomes a strategic priority

• CCBH is moving through a strategic planning process to include EDI as a priority, in the agencies current strategic plan. To date, the planning process has yielded an EDI philosophy and an overarching goal. Workgroups are developing objectives and activities for the focus areas including: 1) more diverse workforce; 2) business with more diverse vendors; 3) EDI informed work force; and 4) integration of EDI principles in agency policies, plans, and practices.

CCBH Continues to build internal capacity for EDI

• Sixteen members of CCBH’s Senior Leadership and Board attended a 2 day, in-depth, Racial Equity and Inclusion training presented by the Racial Equity Institute and hosted by HIP-Cuyahoga Anchor organization – Cleveland Neighborhood Progress.

Engage with your community’s history to understand the roots of inequities – Exploring Cuyahoga County’s long history of racial exclusion through housing policy helped HIP-Cuyahoga participants come together in understanding that structural racism is a foundational cause of health inequity. Rooting historical analysis into the context of your community’s reality helps make these issues more concrete and less abstract.

Develop a plan for financial sustainability – In addition to putting your efforts into building partnerships and a new narrative for health equity, make sure to also create a plan for financial resources and sustainability. Routinely revisit your financial status and outlook, and try to balance short-term and long-term funding for equity work.