Operationalizing Equity

ASTHO is a national capacity-building and technical-assistance provider that supports state and island initiatives that eliminate health disparities. This includes programs that help populations at high-risk of poor health outcomes and who have been historically underserved, including rural, racial, and ethnic minoritized communities. We inform methods to help agencies adopt cross-sector and cross-agency coordination to build a culture of health equity at the programmatic and organizational level.

Where much of public health programming is categorical, our approach starts with the assumption that health inequities are not natural or inevitable and therefore requires a shift to focus on systemic causes that influence our systems.

ASTHO’s technical support prioritizes transformation strategies to improve public health infrastructure, race and ethnicity data collection, and responses to events that exacerbate disparities. ASTHO provides assistance engaging community health workers and community-based groups, and establishing a culture of health equity through policies, practices, and quality improvement measures.


STRETCH Framework: A Health Equity Approach

A framework to guide efforts to create meaningful systems change to achieve health equity.

Explore the Framework

Introduction to Multi-Sector Intersections and Collaborations to Advance Health Equity

A report highlighting equity-focused partnerships with public health and other governmental sectors.

Access the Report
Public Health Review podcast logo

The Health Equity Divide: The Health Equity Divide: Chronic Disease and COVID-19

A podcast featuring chronic disease and health equity experts discussing how public health agencies can reduce COVID-19 health disparities in communities of color and rural parts of the country.

Listen to the Podcast

Latest Operationalizing Equity Resources

Team members talk during a STRETCH meeting

Empowering Connection Through STRETCH

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A woman in a meeting looks over her shoulder and smiles

A Blueprint for Workplace Health Equity Circles

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Eliminating Structural Racism to Achieve Health Equity Policy Academy

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Midsection shot of doctors standing around a table, working on medical charts

From the Chief Medical Officer: What Needs to Change to Achieve Better Health Equity Metrics

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View of the sea and cliffs in Pago Pago, American Samoa

Building an Island Health Equity Framework for the Future

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Islands Health Equity Framework

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A raised, wooden trailway in the forest

Accessible Community Design to Support Physical Activity and Outdoor Recreation for People of All Ages and Abilities

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Magellan monument in Guam

Overcoming Baked-In Inequities and Promoting Health Equity in the Island Areas

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ASTHO collaborates with a diverse group of stakeholders ranging from philanthropy, nonprofit, academia, and healthcare, including:

  • CDC’s Center for State, Tribal, Local, and Territorial Support
  • CDC Foundation
  • CDC Office of Minority Health and Health Equity
  • Center of Health Care Strategies
  • Human Impact Partners
  • Michigan Public Health Institute
  • National Association of Community Health Workers
  • National Association of County and City Health Officials
  • National Association of State Offices of Minority Health
  • National Network of Public Health Institutes
  • National Organization of State Offices of Rural Health
  • Robert Wood Johnson Foundation

Strategies to Repair Equity and Transform Community Health (STRETCH)

ASTHO leads a learning community comprised of ten state jurisdictions and their cross-agency and community-based organization partners to foster information sharing and peer learning about:

  • Designing meaningful, lasting systems change to create inclusive, equitable public health systems.
  • Embedding equity into priorities, programs, policies, and practices.
  • Leveraging new funding through financing strategies to drive impact.

ASTHO, the CDC Foundation, and the Michigan Public Health Institute selected state health agencies to participate in the STRETCH learning community, which engages intermediary organizations including health providers, philanthropy, academia and others, to support governmental state public health agencies to achieve health equity. The STRETCH Initiative aims to be an extension of their team, helping them build and expand equitable health systems.

National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities

In partnership with CDC, NACCHO and NNPHI, ASTHO is a member of National Technical Assistance Provider Network designated to support OT21-2103 grantees. The purpose of the network is to support grantees to address COVID-19-related health disparities and advance health equity by expanding state, local, island, United States territorial, and Freely Associated State health department capacity and services. OT21-2103 grantees may submit technical assistance requests to their project officer or work with their agency points of contact to input requests into the CDC TA Portal.

Do you have technical assistance questions?

Email the Programmatic Health Equity Initiatives and Strategy team