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
Dr. Norman Oliver, the Virginia Commissioner of Health created HEWG during the initial formation of the COVID-19 Unified Command. Formal planning by the HEWG leadership team began on March 13, 2020. The Equity Leadership Taskforce works collaboratively to guide the overall work of HEWG and its subgroups. HEWG is the first-of-its-kind to exist within an emergency response body both in Virginia and the United States. The nearly 60-member HEWG serves as a cabinet-level mechanism and convenes representatives from the following groups:
- Virginia Health and Human Resources Secretariat agencies and advisory board;
- Office of the Secretary of the Commonwealth and related constituent advisory boards;
- Representatives from across the Commonwealth including private human service organizations, advocacy and stakeholder groups, community leaders, various faith leaders, etc.
A diverse HEWG is essential to ensure health equity is central to every decision made throughout the current crisis.
The purpose of the HEWG is to apply a health equity lens to the Commonwealth of Virginia’s COVID-19 response by:
- 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 used interchangeably, it is important to understand that equality does not equal equity. This is best demonstrated and explained by referencing the picture below. (Braveman & Gruskin, 2003)
In the image below, the bottom frame represents equality: people of different needs receiving the same resource. Since they all have different needs, it is evident that they all cannot use the resource to their benefit. As you can see, the woman in the wheelchair cannot use the resource effectively.
The top portion of the image below represents equity: people of different needs receiving resources that fit them specifically. Now, everyone can benefit from the given resource.
- Equity is giving everyone the amount of resources that they need. Communities that have less, will need more resources. Communities with more resources comparatively should receive less resources.
- Equality is giving everyone the same amount of resources.
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 both share and use to self-define their community. It typically denotes a shared history and current experiences of racism. An example of a community of color would be a group that self identifies as African American.
A term previously used to denote communities of color is ‘minority communities.’ As this term continues to age, it becomes increasingly inaccurate. First, the term can easily be interpreted as a reference to inferior characteristics. Second, the term ‘community’ can refer to a community that transcends geographical space. It is important to remember that race is a socially defined construct and therefore definitions of communities are dynamic and evolve over 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. As a result of this crisis, the demographic of at-risk, under-resourced, and underserved populations will grow. Therefore, it is imperative to use a health equity lens in the communications, policy, operations, logistics, planning, finance, and recovery components of Virginia’s response. HEWG predicts that the impact of this public health crisis has the potential to impact historically marginalized communities for generations.
Leading with an equity lens is generally 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.
Virginia’s Health Equity Leadership Taskforce is utilizing a novel data-driven approach to inform the COVID-19 Unified Command about at-risk populations and geographic areas of increased risk.This task force is the first-of-its-kind both in the Commonwealth of Virginia history and the United States to exist within an emergency response body.
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