Addressing health disparities, increasing government legitimacy, and fostering community trust for equitable and healthier societies.
The Earning Trust to Build Equitable and Healthy Societies (ET4HS) program is a dedicated initiative that addresses health disparities while increasing government legitimacy in local communities. Through an international network, participating cities and counties learn and source innovative solutions for health equity challenges, gaining access to proven approaches tailored to their context. The program fosters relationships between the government and the community, laying the foundation for more effective governance. Teams receive valuable resources, including workshops, community engagement exercises, and expert insights, to positively impact health outcomes.
At the core of ET4HS is the concept of “earned legitimacy,” recognizing that a government’s credibility depends on trust and support from its people. By addressing complex social factors and systemic barriers that lead to disparities, local governments rebuild trust with affected communities, creating equitable and healthier societies for all.
The 2023 cohort and our international partners
In the 2023 cohort, six local governments will joined with community partners to address issues ranging from inequities faced by the disability community to lead contamination to building trust for greater collaboration. Selected cities and counties include: Detroit, MI; Guilford County, NC; Montgomery County, MD; Shelby County, TN; St. Louis, MO; and Tampa, FL.
ET4HS connects these U.S. governments to a global network advancing solutions for health equity. Our 2023 international partners include: Butuan, Philippines; Latrobe Valley Health Assembly, Australia; Latrobe Valley Health Advocate, Australia; Lusaka, Zambia; La Fábrica de Renca, Chile; and Umuaka, Nigeria.
How our program helps governments
During the ET4HS program, government participants develop skills to better work with communities and then create a plan to tackle a specific local health equity issue.
Participants receive the following support while working on their city-specific health equity issues:
- A series of cross-city exercises and workshops where all participants come together to learn about and discuss concepts that are core to building legitimacy. Topics can include examining where power sits, sharing power, and reimagining more legitimate systems.
- Individualized support from a Learning Liaison, serving as a CPI coach and trained in the core components and skills of the curriculum, to guide and facilitate the work of the city team throughout the program.
- Skill-based exercises that equip teams with core community engagement and legitimacy skills, preparing them to apply what they learn in their local communities to increase trust between government and residents.
- Mini-cohort sessions where city teams working on similar problem scopes are connected to discuss learnings and best practices, accelerating their progress towards health equity solutions and building legitimacy.
Testimonial
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. 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.
Eli Saavedra
Health Communities Program Supervisor, Guilford County Division of Public Health
