Equitable Enforcement to Achieve Health Equity GUIDE cover image

Equitable Enforcement to Achieve Health Equity: An introductory guide for policymakers and practitioners

Sep 15, 2020 | Guest Author

ChangeLab Solutions has published Equitable Enforcement to Achieve Health Equity, an introductory guide that helps policymakers and practitioners use equity-informed enforcement of public health policies to help break the cycles of injustice and inequitable health outcomes experienced by underserved communities.

Public health policies have catalyzed major health improvements for people living in the United States. But without enforcement — that is, a means of incentivizing compliance — these policies are less likely to produce their intended effects. Equitable enforcement is a process of ensuring compliance with law and policy that considers and minimizes harms to people affected by health inequities.

Enforcement actions taken in the name of public health can sometimes harm, discriminate against, or otherwise undermine the health of the very people whom the laws are meant to protect. In fact, enforcement that is carried out inequitably can create, maintain, or exacerbate health inequities. Equitable enforcement, by contrast, can hold wrongdoers accountable while protecting the health and well-being of individuals and the wider community.

By posing a series of questions to consider when drafting, implementing, and enforcing a policy, ChangeLab Solutions’ resource helps policymakers, advocates, and enforcement officials explore (1) the equity implications of traditional public health enforcement tools, and (2) strategies to avoid unintended negative consequences when enforcing violations of the law. Equitable Enforcement to Achieve Health Equity also discusses best practices in design and development of enforcement provisions to help avoid inequitable impacts and promote community health.

Equitable enforcement is crucial for measures and policies that affect public health in areas such as retail licensing, employment, education, and housing. Download the full guide to learn more about equitable options for administrative, civil, and criminal enforcement in a wide variety of public health policy areas.


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NACCHO periodically invites guest authors to write first-person accounts of their work in public health. To submit your own story for consideration, please visit our form.

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