Following R.I.’s Lead, Washington Creating Health Equity Zones

Feb. 28, 2022
Using data and support from Washington state epidemiologists, communities that identify as Health Equity Zones will receive technical assistance to implement projects to improve health in their communities

Washington has become the second state to begin to create Health Equity Zones to support communities in addressing the disparities they want to prioritize. The effort in the Evergreen State is modeled after one in Rhode Island.

In 2021, Washington passed legislation to create Health Equity Zones. According to the state Department of Health (DOH), the first year will emphasize developing partnerships and community-centered processes to sustain this work long-term. DOH is also looking for continued funding and other resources that can support the future of the initiative.

DOH is working to establish a Community Advisory Council. The goal is to develop zone criteria this spring, and identify specific zones this summer, with support of two to three zones beginning in the fall.

Using data and support from state epidemiologists, communities that identify as Health Equity Zones will receive ongoing technical assistance to implement projects to improve health in their communities.

Partners in this work will include representatives from communities disproportionately impacted by health inequities, Accountable Communities of Health, Governor's Interagency Council on Health Disparities, local health jurisdictions, and other community health organizations and agencies.

In May 2020, Healthcare Innovation detailed Rhode Island’s effort to health equity zones (HEZ). “It has been a journey 15 years in the making, and started with trying to figure out how we move further upstream and hit those root drivers contributing to poor outcomes,” explained Christopher Ausura, chief of special projects for the Health Equity Institute at the Rhode Island Department of Health. “It has been a frustration in public health and in the healthcare delivery system to keep seeing the same patients, and putting so much time and effort into trying to improve outcomes and we are not seeing them improve.”

The state’s public health department worked to shift its investment portfolio to help communities make changes at the structural level. HEZ is the culmination of lessons learned in trying to address social and economic drivers of health. “We found that it is impossible to fix food access without addressing issues around economic disparities and income and transportation,” Ausura said. HEZ gives communities money not just to address one specific need but to rally around geographies. It builds a collaborative out of organizations that have a vested interest in improving conditions in that community. “We give them resources to build the collaborative out, conduct a formal needs assessment in the community and develop an action plan,” he says. There are currently 10 health equity zones up and running now, with a goal of increasing that number to around 40.

The bill creating the Washington zones was sponsored by Sen. Karen Keiser of Washington’s third legislative district, which contains parts of Seatac, Des Moines, Kent and Burien. A January 2021 Washington State Wire story quoted Keiser speaking in a hearing on the topic: “We’ve had the 30,000-foot level approach to health equities, through the department of health and our provider insurer plans and so forth,” Keiser said. “What we don’t have is ground level infrastructure. We don’t have the community voices, and we don’t have the local leadership structure that really closes the loop that is missing on trying to address this problem of health disparities. We have the data. We know geographically where we have health disparities. It is quite clear, and I will just mention that the Seattle-King County Department of Health issued a report just last month that shows that, for instance, in my district we have a higher rate of preterm births and also medical complications with maternal cases. We have higher household rates for asthma, for stroke, for diabetes than the rest of the county. We have a lower life-expectancy, up to five years lower life-expectancy, then the rest of the county. And we have higher hospitalization rates. So we need to build connections and trust and the culturally competent communications with our local communities to try and achieve the change in outcomes.”