RALEIGH — In late October, the N.C. Department of Health and Human Services (NCDHHS) rolled out its Annual Report to the North Carolina Medical Society and Commission for Public Health.
The report’s top priority is “health equity,” and the term “equity” appears 97 times in 65 pages. The annual report includes references and links to the Healthy NC Plan 2030 and the NCDHHS 2021-2023 Strategic Plan.
The term “equity” also appears 44 times in the 26-page NCDHHS Strategic Plan. The plan’s top priority is to “Advance health equity by reducing disparities in opportunity and outcomes for historically marginalized populations (HMP) within NCDHHS and across the state.”
The NCDHHS report was presented to the Commission on Public Health by Dr. Elizabeth Tilson, NCDHHS’ state health director and the chief medical officer at their October meeting.
NCDHHS received $40 million in “health equity funding” from the Centers for Disease Control and Prevention (CDC). The purpose of the funding is to “support advancing health equity and decreasing disparities.”
Tilson noted that NCDHHS has hired its first ever chief equity officer, Victor Armstrong; and former Democratic state legislator, Angela Bryant, was placed in the newly created role of deputy equity officer.
“Today’s announcement marks another step forward in our commitment to embed equity into every aspect of our work and to promote an inclusive, equitable workplace that reflects the communities we serve, where everyone feels a sense of belonging, and our diverse backgrounds and experiences are valued and recognized as strengths,” said DHHS Secretary Mandy Cohen in the Sept. 20 press release on the new hires.
“We are fortunate to bring on two leaders with tremendous talent, experience, and dedication to public service,” Cohen said.
According to the release, Armstrong’s duties will include “developing, implementing, facilitating, and embedding health equity strategic initiatives into every aspect of DHHS’ programs, services, actions, outcomes and internal employee culture,” and he will oversee the Office of Health Equity, Office of Rural Health, and the Office of Diversity and Inclusion.
In an Oct. 26 press release, NCDHHS touted signing onto a “Health Equity Pledge.” The action taken by Armstrong and NCDHHS is the first government agency to sign the pledge and is among “40 cross-sector healthcare organizations.”
“Health equity only exists when all people have the opportunity to attain their full health potential, and no one is disadvantaged because of their social position or other socially determined circumstance,” NCDHHS chief health equity officer Victor Armstrong said in the release. “Transparent review of demographic data shines a light on where gaps still exist and will help focus efforts so we achieve our collective goal of equitable access to health care.”
The purpose of the pledge is to demonstrate a commitment to collecting data about “race, ethnicity, language and gender and then share what they learn to develop best practices across the industry.”
On the national front, the American Medical Association has released a document titled “Advancing Health Equity: A Guide to Language, Narrative and Concepts.”
“It is critical to address all areas of marginalization and inequity due to sexism, class oppression, homophobia, xenophobia and ableism,” the guide’s preface reads. “Yet conversations about race and racism tend to be some of the most difficult for people in this country to participate in for numerous reasons, including a lack of knowledge or shared analysis of its historical and current underpinnings, as well as outright resistance and denial that racism exists.”
The preface section goes on to say, “Given the deep divides that exist between groups in the United States, understanding and empathy can be extremely challenging for many because of an inability to really ‘walk a mile in another’s shoes’ in a racialized sense. Collectively, we have an opportunity and obligation to overcome these fissures and create spaces for understanding and healing.”
The guide’s glossary includes social justice terms such as “cultural appropriation” and includes gender identity terminology. The guide also specifically has a section on “anti-racism” that includes quotes by Critical Race Theory activist, Ibram X. Kendi.
The guide’s conclusion states, “We believe that naming and disrupting dominant narratives that obscure the fundamental causes of health inequities is a vital act.”
The conclusion goes on to say that the work must not stop there and that doctors and health care workers “need to ensure behavior and practice change,” and collaborate with and advocate for historically marginalized communities “to address societal systems of oppression.”
Researchers are also singled out and called on to “re-examine taken-for-granted conventions in grant writing and scholarly publishing—identifying and challenging dominant narratives that are deeply rooted in those powerful systems.”
