An interview with Jeff Hall, Deputy Director of the Office of Minority Health and Health Equity and Chief of the Minority Health and Health Equity Team at the CDC
The emphasis on health equity publicly and at all levels of government has been building since the 2000s and reached unprecedented levels amid the Covid-19 pandemic. For Jeff Hall, Deputy Director of the Office of Minority Health and Chief of the Minority Health and Health Equity Team at the CDC, that means the time has never been better for making improvements.
“With the window of opportunity that we have open expressing itself the way that it has, some of the conversations even, at a very basic level, that are now possible about equity were not as possible in times past,” Hall said. “We’re really trying to take advantage of this time to have equity be embedded within everything, to really, truly have it be at the center of all we do in ways that we’ve never had opportunities to do in the past.”
He highlighted three ways that’s happening.
1. CDC’s CORE Health Equity Science and Intervention Strategy: “We, for the first time, have agency-level endorsement for this, we have agency-level commitment to this and the CORE Health Equity Science and Intervention Strategy is designed to be the foundation for ensuring that not only do we just talk about equity, but that we have it factored into our funding, factored into our policies, factored into our programs,” Hall said. “That particular strategy is really creating an environment internally where work on health equity is supported.”
2. Data modernization: The agency is working to change the way it collects data to be able to tell local stories. That means focusing on more than quantitative information. “We … are trying to do projects and initiatives that give the voice for the data to those populations in places in which they originate,” Hall said.
“There are initiatives, for example, that are intended to really not just have a community be the source of the data, but they are to be the owners of the data. We are working to ensure that the data that get produced don’t just get extracted from people, but they’re borne out of the lived experiences that people have and are really created in ways where they won’t just be useful in ways for government public health; people can use them to be agents of change locally, to make sure that they have a hand in ensuring that where they live is going to be as strong and as robust as possible.” Project REFOCUS: Racial Ethnic Framing of Community-Informed and Unifying Surveillance is an example of this. It uses CDC Foundation funding to provide a real-time crisis monitoring system and educational resources for public health practitioners.
3. Internal conversations: CDC components have hosted webinars and training related to defining and pursuing health equity, Hall said. “We have to have these discussions to be sure that the many different understandings that are there have a chance to be seen and heard, and we can try to figure out our way into at least some common space with that,” he said. The way he approaches that is through a systemic, rather than individual, perspective. “I think about it as what’s referred to as opportunity structures,” Hall said. “An example of an opportunity structure might be the education system that one particular place has access to verses another place. Education is very strongly associated with health and with opportunity in society generally.”
CDC’s Office of Minority Health and Health Equity started in the 1980s as a result of a report commissioned by then-Secretary Margaret Heckler that marked “the first time the Department of Health and Human Services … has consolidated minority health issues into one report.” The office has seen a lot of growth and development since then, but one thing has remained consistent: the focus on the reduction and elimination of health disparities.
That’s because “it is not just some ideal,” Hall said. “It is something that has to be pursued in real ways, with attention not just to what it is that will improve individual health, but we have to see structural and systemic change so that when this window of opportunity closes — windows don’t stay open forever — there will have been gains and achievements made such that hopefully populations in places will be much better off than they were before.”