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CPI in the news Article October 3rd, 2023
Health • Legitimacy

PRESS RELEASE: Earning trust to build equitable and healthy societies

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Health equity strategies in common: lessons from cities addressing disparities in holistic health, youth violence, and environmental contamination response

The Centre for Public Impact shares learnings from Earning Trust to Build Equitable and Healthy Societies programme, implemented in St. Louis, Detroit, Tampa, Montgomery County, Shelby County, and Guilford County

WASHINGTON D.C., October 3, 2023 -- Today, the Centre for Public Impact released Paths to health equity. The report shares learnings from the 15-week Earning Trust to Build Equitable and Healthy Societies (ET4HS) programme, including case studies from the six participating local governments, programme analysis, and key takeaways for other governments seeking to advance health equity.

The report is grounded on the experiences of programme participants in Detroit, MI; Guilford County, NC; Montgomery County, MD; Shelby County, TN; St. Louis, MO; and Tampa, FL. Over 15 weeks, ET4HS set the foundation for these governments to address pressing community disparities through cross-city workshops on power and building legitimacy, skill-based community engagement exercises, connection to local governments, and access to international public health experts. The programme challenged participants to tackle inequities in the social determinants of health, including education, wealth, care, community, and environment. At the end of the programme, each team presented the outcomes of their work, including action plans to advance or implement their findings:

  • Detroit will improve mental health services and accessibility by creating a centralised information page, a Mental Health Resource Guide, and implementing new training for city staff.

  • Guilford County will address health disparities by establishing a Community Advisory Council, improving transportation access to health services, using program data for strategic planning, presenting program findings to county leadership, and incorporating ET4HS equity approaches into their Community Health Assessment processes.

  • Montgomery County will further explore the root causes of youth violence by holding additional Community Listening Sessions that highlight diverse perspectives, including youth from violence-affected areas. They aim to reshape perspectives, address communal trauma, support youth programming, and ultimately reduce harm and violence in the county.

  • Tampa will address a shortage in youth work opportunities and build trust with the community by organising a health and community resource fair in East Tampa to provide job opportunities, check-ups, and safety training for youth.

  • Shelby County will build awareness of the critical next steps to address environmental lead contamination by presenting their ET4HS findings to local stakeholders and securing funding for an environmental scan to identify lead prevention and services gaps among local agencies.

  • St Louis will improve community engagement and trust-building by increasing visibility at community events, collaborating with community partners to reset Health Equity Indicators, developing health equity education materials for employees, launching a mobile outreach initiative, hosting an Equity Summit, and collaborating with the Regional Health Commission for training materials.

In addition to detailing each city case, the report synthesises lessons from across the participants' disparate foci and from international subject matter experts that other governments can implement when addressing their local health equity challenges. According to the report, governments should adapt strategies to better foster community trust, encourage inclusive engagement for community empowerment, build collaborative partnerships, utilise data, and share power.

To read the report, please visit: 


“We’re proud to support CPI and the Earning Trust to Build Equitable and Healthy Societies program, and we’re excited that, as part of this program, these cities and counties connected with global experts working to advance solutions for health equity,” said Shilpa Shankar, program associate at the Robert Wood Johnson Foundation. “We have a lot to learn from the experiences of communities around the world facing similar challenges, and we hope participants can continue to engage in mutual cross-border knowledge sharing in the future.”

“The Earning Trust to Build Equitable and Healthy Societies program challenged local governments to tackle inequities in the social determinants of health. We are proud that participants rose to the challenge, taking an equity-centered approach to a wide range of topics, including lead contamination, mental health, violence, and job opportunities,” said Giselle Cordero, Program Manager at the Centre for Public Impact. “Though a breadth of health determinants were addressed, clear trends on how to best center equity emerged during the program that other local governments can learn from. We hope other public servants will use insights from the report to ensure that their health approach is designed with equity at the forefront.”

“By participating in the Earning Trust to Build Equitable and Healthy Societies Program, we created space to hear real feedback from real people about the state of ‘trust’ between our community and the Guilford County Division of Public Health,” said Eli Saavedra, Healthy Communities Program Supervisor at Guilford County Division of Public Health. “These conversations - held between public health employees, trusted community partners, and residents - helped provide insight into what 'access to care' means to the people being impacted by our services every day. This opportunity provided us with tested tools and techniques to prioritise the community’s voice in shaping how we do our work. Long-term, we envision continuing to work with our diverse community and provide a permanent space for listening and co-creation sessions – which will involve capturing the community's voice in the decision-making process. We recognize that it will take hard work, time, and organisational commitment to make this work, but we're optimistic about the future.”

“The City of St. Louis Department of Health benefited greatly from participation in the Earning Trust to Build Equitable and Healthy Societies program,” said Dr. Julie Gary, Behavioral Health Bureau Chief for the City of St. Louis, MO. “We took deliberate and critical steps forward in health equity planning and action. Experiencing this program with other cities across the world inspired us as we face similar and daunting challenges in our daily work that are the result of decades of structural racism. Through the skills and inspiration gained in this program, we are poised to partner with our community to roll out an impactful citywide health equity plan in the next few months.”

“I was thrilled to work on this ET4HS Project with colleagues across Shelby County, TN. I have worked for both local government and in the non-profit field for over 30 years and have answered the same questions now as I did 30 years ago about the hazards of lead in our community. During this project, I was especially moved by the interviews we conducted with people in our community who are looking for help and don’t know where to go. I am excited that Green & Healthy Homes Initiative (GHHI) and the Shelby County Team will be asking our local Healthy Homes Partnership to endorse an environmental scan to identify the roles of the 30+ agencies responsible for lead poisoning prevention and lead services,” said Sharon Hyde, Program Manager at Memphis/Shelby County Green & Healthy Homes Initiative. “We learned in listening sessions that the community believes government has a responsibility to assure children are lead safe. Through the scan we aim to clarify agencies’ moral and legal accountability, as well as the referral pathways for various lead services.” 

“The ET4HS program not only challenged us to assess the ways in which the practice of community engagement has been decimated by social-political climates, but offered us a roadmap and tools to begin revisioning a practice that authentically engages the people” said the Montgomery County Government Cohort.

“Detroit’s residents with disabilities number more than 123,000 and are five times more likely to report mental distress over those Detroiters without disabilities. This is staggering and may not even reflect residents with hidden disabilities or those who are not identifying as such. Through our community listening sessions, sensitivity trainings and providing useful information on our website and other social platforms, Detroit’s Core Team is laser-focused on taking impactful steps to assist our disability communities – based on what they say they need; not just what we perceive they need,” said Anthony Zander, Director of the City of Detroit’s Civil Rights, Inclusion & Opportunity Department

“The ET4HS program has been an empowering journey. Our Detroit cohort includes disability advocates, leaders, and experts passionate about positive change and improvement. Through our collective efforts, I am now equipped with the essential tools and transformative strategies to advance accessibility, inclusivity, and mental health support at the local level, within my community, and beyond,” said Christopher Samp, Director, City of Detroit’s Office of Disability Affairs.

"Through the Earning Trust to Build Equitable and Healthy Societies program, we've witnessed the power of collaboration and community engagement,’’ said Latrobe Health Advocate Jane Anderson.Health equity is achieved through trust, inclusivity, and a commitment to listening and responding to the voices of our communities. “Along with many others, I am dedicated to reshaping perspectives and addressing disparities, through place-based approaches. Together, we can build a healthier, more equitable future for all."

Lesley Agams, Executive Director of Women's Crisis Centre in Umuaka, Nigeria said, “Sharing our experience and lessons in community development with CPI and the Earning Trust to Build Equitable and Healthy Societies program was a privilege. Learning between the North and the South is long overdue. We have similar challenges and aspirations. Cross-national learning enriches both of us and I look forward to the growth of this excellent idea.”

D C’fine Okorochukwu, CEO of the Centre for Public Health said, “It was a great experience participating in Centre for Public Impact Earning Trust to Build Equitable and Healthy Societies program as a public health international subject matter expert in health equity which was implemented in St. Louis, Detroit, Tampa, Montgomery County, Shelby County, and Guilford County with the government officials. The program is highly rewarding based on the outcome of the interventions which are based on a community, person-centered, trauma-informed approach that emphasizes the need for equity, diversity, and inclusion through a well-structured participatory approach of the community stakeholders and individuals. The government officials and members of the community appreciated the importance of working together for a common which is a great result that will lead to sustainable long-term outcomes of equity. It is also very important that the lesson and the experience should be extended to all the states in of USA.”

"It was an honor to be a part of the training team in the ET4HS program. The participants were energized, engaged and invested in learning new ways to center [health] equity. Their commitment to this process gives me hope that our communities can be transformed in crucial ways toward racial justice, healing and wellness. I am excited to see what these teams go on to do," said Cassandra Rowe, Co-Director of Survivor Wellbeing at North Carolina Coalition Against Domestic Violence.


Support for this program was provided in part by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

About the Centre for Public Impact

At the Centre for Public Impact, we believe in the potential of government to bring about better outcomes for people. Yet, we have found that the systems, structures, and processes of government today are often not set up to respond to the complex challenges we face as a society. That’s why we have an emerging vision to reimagine government so that it works for everyone.

A global not-for-profit organisation founded by the Boston Consulting Group, we act as a learning partner for governments, public servants, and the diverse network of changemakers who are leading the charge to reimagine government. We work with them to hold space to collectively make sense of the complex challenges we face and drive meaningful change through learning and experimentation.



Elysa Neumann

Communications Specialist

Centre for Public Impact

+1 ‪202-630-3383‬

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