Cross-Sector Innovation Initiative

Tackling Racism Head-on

Many communities around the country are actively working to achieve racial justice. In Cleveland, Ohio, a collective impact consortium known as Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga) has been hard at work for over 10 years to address this complex issue in a tangible way. Motivated by a desire to accomplish health and equity goals that are feasible only through collaboration, HIP-Cuyahoga was established in 2009 by the Cuyahoga County Board of Health (CCBH) and other partners. The partnership, boasting a membership of more than 300 community agencies and 1,000 individuals, is committed to transforming local health improvement through equity, racial inclusion, community engagement and collective impact, in order to inspire, influence, and advance policy, environmental and lifestyle changes that foster health for everyone in Cuyahoga County.

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.”

HIP-Cuyahoga identified two intertwined population health priorities through a collaborative 2019 Cuyahoga County Community Health Assessment: eliminating structural racism and enhancing trust and trustworthiness across sectors, people and communities. With funding from the Cross-Sector Innovation Initiative, HIP-Cuyahoga is using community-based system dynamics to engage community members, leaders and organizations in addressing the two priorities. This participatory modeling activity will generate a series of system maps that will illustrate the systems underlying racism, show how each entity contributes to the larger whole and enable participants to see and formulate interventions and strategies to address systemic issues.

The national spotlight on racism has ignited the community’s focus on racial equity. Organizations that were difficult to engage in the past now have publicly expressed a commitment to equity, diversity and inclusion and the need to eliminate structural racism. Cuyahoga County, Cleveland and other local municipalities and organizations all have declared racism a public health crisis, while similar testimony is being heard at the state level. This confluence of events has brought more momentum and attention to HIP-Cuyahoga’s work, providing an unprecedented opportunity to make a meaningful impact on racism in a major city. More information on HIP-Cuyahoga’s multifaceted efforts to combat racism is available on the HIP-Cuyahoga website and also can be found in this case study.

Communities around the country are actively working to achieve racial justice.

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