Health Equity and Social Justice

Diversity Crop

The goal of NACCHO's Health Equity and Social Justice program is to advance the capacity of local health departments (LHDs) to confront the root causes of inequities in the distribution of disease and illness through public health practice and their organizational structure.

The program's initiatives explore why and how certain populations bear a disproportionate burden of disease and mortality and what power structures and institutions generate those inequities, in order to design strategy to eliminate them.

NACCHO's Health Equity and Social Justice initiatives include:

  • The Roots of Health Inequity: A Web-Based Course for the Public Health Workforce, offers health department staff a place to investigate the relationship between social injustice—the fundamental cause of health inequities—and everyday public health practice.
    • NEW: NACCHO recently released unit 6 for the Roots of Health Inequity course, "Advancing Public Narrative for Health Equity and Social Justice." Visit to see the new content. A handbook version, under the same title, is available for download. The handbook is recommended for use in a facilitated dialogue process.
  • The Building Networks Project: (2013-2016) Aligning Public Health and Community Organizing (funded by the W.K. Kellogg Foundation and the Kresge Foundation) linked public health with the discipline and strategies of community organizing in five states in the Midwest: Michigan, Minnesota, Missouri, Ohio, and Wisconsin. The goal was to create strong, flexible, and durable statewide teams by devising strategies for realizing structural reforms. These reforms refer to transforming the decision-making processes and power structures that produce unhealthful living and working conditions by making them more democratic and accountable. As a result, communities can become more effective and powerful in supporting the social change necessary to eliminate health inequities.
  • Health Equity and Social Justice Toolkit, a searchable database of Health Equity tools, publications, and resources, available in NACCHO's Toolbox; and;
  • Publications tailored to local health departments, including the anthology Expanding the Boundaries: Health Equity and Public Health Practice (2014, 72pp); and Exploring the Roots of Health Inequity: Essays for Reflection (2014, 63pp).

Roots of Health Inequity is an online learning collaborative and web-based course designed for the public health workforce. The site offers a starting place for those who want to address systemic differences in health and wellness that are actionable, unfair, and unjust. Based on a social justice framework, the course is an introduction to ground public health practitioners in concepts and strategies for taking action in everyday practice.

Funded by the National Center for Minority Health and Health Disparities at the National Institutes of Health in 2011, the course is open free of charge to any professional interested in addressing the root causes of health inequity. The course material is written primarily for local public health department staff at all levels. The interactive site includes five units and features a rich source of case studies, readings, presentations, video, audio, and group-directed discussions.

Participants can also expect to:

  • Build a community of peers dedicated to addressing health equity.
  • Strategize more effective ways to act on the root causes of health inequity.
  • Lay the foundation for an organizational culture committed to tackling social injustice.

Go to to learn more about how to register and participate. For more information, including guidance documents about how your organization can use the course, please contact [email protected]

Course Resources

  • Roots of Health Inequity Facilitator's Guide: The Roots of Health Inequity is an online learning collaborative designed for the public health workforce. Based on a social justice framework, the course introduces public health practitioners to concepts and strategies for taking action in everyday practice. For groups that wish to enhance the online course with in-person discussion sessions, this Facilitator’s Guide, updated in September 2016, provides in-depth guidance on facilitating social justice conversations, as well as detailed discussion and activity suggestions.
  • Roots of Health Inequity Lesson Plans and Guide (Companion Guide): This guide offers six lesson plans focused on specific aspects of public health practice. These plans include activities and readings that describe components of a conceptual framework informing the values, strategic plans, and assessment activities at a LHD that is committed to confronting health inequities. The guide also describes tips and tools for using RHI including guidelines for forming successful learning groups and facilitation and meeting organizing tips for the Roots of Health Inequity curriculum.
  • Roots of Health Inequity Instructional Video: This video offers a tour of the website and course units. It offers guidance about how to register for the course, create a learning group, and use the website's features. You can link to the video from YouTube or use the YouTube embed code to add the video to a website.
  • Main Features of this Course: Learn about the website's features, the community, and how to use the course.
  • Index of Course Units: Each unit provides an in-depth look at a specific topic using various types of learning modalities — interactive maps and timelines, slideshows, geographic story-telling, resource libraries, video presentations, and interviews with practitioners.
  • Navigating the Units: Find and use the parts of the course that most interest you.
  • Create & Lead a Group: The course material is designed around group participation — primarily through group discussions on specific topics and the results of activities in the units. Learn how to plan, select, and create a Learning Group on the website.
  • Advancing Public Narrative for Health Equity and Social Justice: Relying on examples, exercises, and questions for reflection and dialogue, this resource supports public health practitioners and their allies in becoming effective narrative strategists, as they strive to achieve health equity.

Promotional Material

  • Roots of Health Inequity Presentation: Share this presentation about the Roots of Health Inequity with your partners and colleagues.
  • Roots of Health Inequity informational booklet: Learn about our purpose, why it matters, and why now.
  • Roots of Health Inequity Promotional Statements: Use these promotional statements and the social media content to share RHI with partners. Lift the language in the PDF for newsletters, online resource libraries, Facebook, LinkedIn, and Twitter.
  • Video: How are you using the Roots of Health Inequity? In this video, Dr. Linda Rae Murray (Chief Medical Officer for the Cook County (IL) Department of Public Health), Kimberly Pettiford, MPH (Community Health Promotion Specialist, The County of San Diego Health and Human Services Agency) and Dr. Jennifer Hebert-Beirne (Clinical Assistant Professor, University of Illinois at Chicago) discuss why Roots of Health Inequity is a critical tool in the fight against heath inequities.

Health Equity and Social Justice 101 Online Training Series was developed to build knowledge and inform the practices of LHDs and their partners on health equity and social justice (HESJ) key concepts, principles, and applications.

  • HESJ 101 Training: Part I The Politics of Health Inequity features Dr. Richard Hofrichter discussing how structural racism and class oppression are implicated as root causes of health inequities as well as strategies for acting upon root causes.
  • HESJ 101 Training: Part II Intersectionality discusses intersectionality, a framework for understanding how multiple social identities (i.e. race, gender, class) intersect and are experienced at the individual level and reflect interlocking systems of privilege and oppression at the structural level, as well as applications for public health practice.
  • HESJ 101 Training: Part III Stories from the Field features local public health practitioners discussing how to embed health equity and social justice into public health practice.

Hofrichter, Richard and Bhatia, Rajiv, eds (2010) Tackling Health Inequities Through Public Health Practice: Theory to Action, New York; Oxford University Press, 600 pp.

Hofrichter, Richard, ed (2003) Health and Social Justice: Politics, Ideology, and Inequity in the Distribution of Disease,San Francisco: Jossey-Bass, 688 pp.

NACCHO (2014) Exploring the Roots of Health Inequity: Essays for Reflection, Washington, D.C., NACCHO, 63pp.

Prentice, Bob (2014) Expanding the Boundaries: Health Equity and Public Health Practice, Washington D.C., NACCHO, 72pp.

The health equity team has developed several policy statements for topics such as:

  • Health and Disability
  • Health Equity and Social Justice
  • Immigrant Health
  • Immigrants, Refugees, and Asylees with Communicable Diseases
  • LGBT Health
  • Mass Incarceration and Racism
  • Police Violence and Racism
  • Women's Health

You can find all of the policies and examples of letters to Congress, on the policies page.

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For more information about our health equity program, contact [email protected].

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