Commonwealth of Virginia COVID-19 Equity Leadership Task Force
The COVID-19 equity leadership task force directs the work of the Health Equity Work Group (HEWG) as part of the unified command for the Commonwealth of Virginia. Given the Commonwealth's commitment to inclusive excellence, this innovative and historic equity mechanism will be institutionalized and embedded in all future disaster planning events. The Governor's Office of Diversity, Equity, and Inclusion will partner with the Virginia Department of Emergency Management and all other relevant agencies or stakeholders as part of the leadership of any future unified command structure.
Health Equity Working Group (HEWG) Description
The HEWG was built into the initial forming of the COVID-19 Unified Command structure as directed by Dr. Norman Oliver, the Virginia Commissioner of Health. Formal planning by the HEWG leadership team began on March 13, 2020. Collaboratively the equity leadership team guides the overall work of the HEWG and all of its subgroups. The first-of-its-kind in Virginia state history and nationally to exist within an emergency response body, the nearly 60-member HEWG serves as a cabinet-level mechanism that convenes representatives from:
- each agency and advisory board of the Virginia Health and Human Resources Secretariat
- the Office of the Secretary of the Commonwealth and related constituent advisory boards
- leadership from relevant state entities across the Commonwealth; as well as representatives from private human service organizations, advocacy and stakeholder groups, community leaders, and diverse faith leaders in order to ensure health equity is central to every decision made throughout this crisis.
The purpose of the HEWG is to apply a health equity lens to the Commonwealth of Virginia’s COVID-19 response by proactively and reactively:
- Identifying and prioritizing resources and decision points impacting marginalized and at risk individuals and communities.
- Supporting intentional inclusion of the needs of at-risk and marginalized individuals and communities within each working group related to preparedness, mitigation, response, and recovery.
Centering Common Language
Equality ≠ Equity While sometimes being mistakenly used interchangeably, it’s important to understand that equality is not the same as equity. This is best demonstrated and explained by referencing the picture below. (Braveman & Gruskin, 2003)
What we see on the bottom is equality: people of differing needs, receiving the same resource. Because they are of differing levels of need, we can clearly see that everyone does not benefit from the resource. In fact, in at least one case one of the individuals can’t use it at all.
What we see on the top is equity: people of differing needs, receiving the resources they actually need. Because each individual is receiving what they need, they can all benefit.
Equality is giving everyone the same amount of resources.
Equity is giving people the amount of resources they actually need. This means communities with less, should receive more.
When all people and communities have the opportunity to attain their full potential and highest level of health. (CommonHealth ACTION, Braveman and Gruskin, 2003).
Differences in health status among distinct segments of the population including differences that occur by gender, race or ethnicity, education or income, disability, or living in various geographic localities.
Disparities in health [or health care] that are systemic and avoidable and, therefore, considered unfair or unjust.
Communities of Color
Communities of color are identity-based communities that hold a primary racial identity that describes shared racial characteristics among community members. The term aims to define a characteristic of the community that its members share (such as being African American) that supports self-definition by community members, and that typically denotes a shared history and current/historic experiences of racism.
An older term for communities of color is that of “minority communities” which is increasingly inaccurate given that people of color are majority identities on a global level. That term has also been rejected for its potential to infer any inferior characteristics. The community may or may not also be a geographic community. Given that race is a socially-defined construct, the definitions of these communities are dynamic and evolve across time. (Curry-Stevens, Reyes & Coalition of Communities of Color, 2014)
How the Unified Command Should Apply Equity in its Decision-Making
In order to ensure that we emerge from this crisis as a stronger Virginia, the HEWG has determined that every facet of the Unified Command response and recovery must apply an equity lens. This lens is of even greater imperative in light of the predicted implications and complications this unique public health crisis event will have on at-risk populations. Further, as a result of the catastrophic nature of the crisis, the demographic of those who identify as at-risk, under-resourced, and underserved will widen to those who traditionally never identified in these vulnerable ways. Therefore elevating the health equity lens in all parts of the response is as equally important as all functions of communications, policy, operations, logistics, planning, finance, and recovery. Further, the HEWG predicts that the impact of this public health crisis will be felt for years and perhaps for generations for communities that have historically been under resourced or underrepresented.
Leading with an equity lens generally is commensurate with, but not limited to the following factors:
- Governance and Procedural Equity - Identified by broadening vertically and horizontally the diversity of those who are delegated for collaborative problem-solving and decision-making, which also includes a rejection of toxic and manipulative control or power;
- Resource Allocation and Placement - The way in which resources and services are procured, promoted, and provided in proximity to those who most need or require them to survive or thrive. Measures of equality for resource allocation are not prioritized;
- Outcomes - A descriptive and transparent synthesis of which population(s) or who survives or thrives, who is adversely impacted or resilient, who is affected by collateral or generational damage, and/or who is legally liable for a continuum of outcomes; and
- Solutions and Problem-Solving - The extent to which solutions are intentionally transformative, justice-oriented, and liberating from the systemic and structural inequities and bias that are sustained by the dominant culture’s ways of knowing and commitment to the status quo.
(Curry-Stevens, Reyes & Coalition of Communities of Color, 2014)
Commitment to Innovation and Application
The HEWG is committed to serving the community with comprehensive and innovative community outreach strategies and interventions. In the past, we have:
- Partnered with county and city leaders to distribute masks, hand sanitizer, and outreach material to those most in need using geospatial data
- Facilitated virtual health equity training that can be accessed by any HEWG organization
- Collaborated with a multidisciplinary team of local leaders to integrate testing, outreach, and commodity distribution, to include computer and internet allocation to support distance learning
- Identified prime testing areas using data stratified by race/ethnicity, chronic health conditions, and other social and environmental risk factors with consideration given to the cultural, linguistic and physical needs of each community
Braveman, P. and Gruskin, S. (2003). Defining equity in health. Journal of Epidemiology community Health, 57(4), 254-258.
Curry-Stevens, A., Reyes, M. E. & Coalition of Communities of Color (2014). Protocol for culturally responsive organizations. Portland, OR: Center to Advance Racial Equity, Portland State University.
COVID-19 Unified Command Organization Chart
Safer at Home: Phase One Religious Services
Racial Equity Impact Assessments of Economic Policies and Public Budgets
Task Force Representatives
Governor's Office - Cabinet
Janice Underwood, PhD
Chief Diversity Officer
Office of Governor Ralph S. Northam
Alaysia Black Hackett, MPA, JD
Special Assistant to the Chief Diversity Officer
Virginia Department of Health (VDH)
Sable K. Nelson Dyer, JD
Unified Command Health Equity
Office of Health Equity Virginia Department of Health (VDH)
Virginia Department of Emergency Management
Curtis C. Brown
Chief Deputy State Coordinator
Virginia Department of Emergency Management (VDEM)
Lauren R. Powell, MPA, PhD
Equity Consultant, VDEM
National Health Equity Leader