Using Law and Policy to Advance Health Equity: Recommendations from the White House Health Equity Task Force
July 13, 2022
On January 21, 2021, the Biden Administration issued a National Strategy for the COVID-19 Response and Pandemic Preparedness. One of the action items in the plan was to establish the COVID-19 Health Equity Task Force to make recommendations on strategies to mitigate health and social inequities due to COVID-19. The Task Force concluded its work in October 2021, issuing a Final Report and Recommendations. The report includes 36 recommendations involving law and policy that provide a framework for improving health outcomes.
On January 21, 2021, the Biden Administration issued a National Strategy for the COVID-19 Response and Pandemic Preparedness, which was supported by a series of Executive Orders addressing America’s coronavirus response. One of the action items in the plan was to establish the COVID-19 Health Equity Task Force to make recommendations on strategies to mitigate health and social inequities due to COVID-19. Executive Order 13995 established the task force, which was chaired by Dr. Marcella Nunez-Smith and started meeting in February 2021. The Task Force concluded its work in October 2021, issuing a Final Report and Recommendations and a Proposed Implementation Plan and Accountability Framework.
The final report has five priority areas and 316 recommendations, including 55 priority recommendations related to four suggested outcomes:
- Communications and Collaboration
- Data, Analytics, and Research
- Structural Drivers and Xenophobia
- Health Care Access and Quality
We know that law and policy are tools that drive structural discrimination, shaping the systems in which we operate and ultimately, our health outcomes. As noted in the Task Force report, “Racist, discriminatory, and otherwise socially and economically inequitable policies limit opportunities for health” (page 21). I reviewed the Task Force report for specific recommendations using the terms law, legal, legislation, policy, policies, statutes, and regulations, because they are important levers to address inequities. Thirty-six recommendations contain one or more of these terms across a broad range of topics (none contain the term “statute”).
Table of Recommendations Containing Identified Search Terms and the Topics Addressed.
|Term||Relevant Recommendations||Topics Addressed|
|Law or Legal (does not include “law enforcement”)||25, 133, 167, 168, 191, 207||· Housing – accessibility, affordability, eviction, discrimination|
· Discrimination-free health care
· Long COVID rights and services
· Crisis Standards of Care
|Law Enforcement||90, 104, 135, 137, 164, 308||· Role of law enforcement in behavioral health|
· Create, disseminate, and educate the public on hate crimes resources
· Presence at vaccine sites
· Compassionate release
|Legislation||80, 128, 185, 313||· Economic recovery and worker protections|
· Financial investment in behavioral health treatment, prevention, and harm reduction services
|Policy or Policies||12, 14, 33, 36, 74, 76, 86, 91, 130, 143, 196, 217, 218, 229, 239, 248, 254, 305, 308, 313||· Behavioral health care, insurance coverage, and workforce development|
· Housing policy changes
· Hate crime data
· Medicaid changes
· Equity in international pandemic preparedness and global cooperation
· Evidence-based strategies for reducing essential worker exposure to COVID-19
· Funding the National Health Care Workforce Commission
· Data, including standardization, disaggregation, and creating an equity dashboard
· Long COVID insurance coverage and treatment, support for families and caregivers
· Coverage for COVID-19 testing
· Culturally and linguistically responsive services
· Health care, access, and coverage as a human right
· Compassionate release
|Regulations||88, 190||· Broadband and telehealth|
· Housing for migrant workers
Nineteen of these recommendations are priority recommendations: 80 and 185 (worker protections); 88 (broadband and telehealth); 86, 90, 91, 104, and 128 (behavioral health); 133 (Crisis Standards of Care); 137 (best practices for vaccination sites); 167 and 168 (housing); 217 and 229 (Long COVID); 239 (COVID-19 testing coverage); 308 (compassionate release); and 130, 196, and 313 (recognizing health care, access, and coverage as a human right).
The recommendations in the Task Force report affect multiple agencies and sectors. With a Health in All Policies approach, any agency whose programs and services impact health can look to these recommendations to inform its own health equity strategies. One way to do that is to also conduct an assessment of what worked and didn’t work during the pandemic. In addition, whether or not there is a current public health emergency, your agency can always be in the habit of reviewing its policies and practices and making recommendations to improve intended outcomes. You also don’t need to reinvent the wheel. If any of these recommendations mirror what was going on in your jurisdiction, your agency may also be able to craft similar recommendations. Finally, the Task Force put forward accountability recommendations like suggested key performance indicators, a timeline, and a dashboard. No matter the setting, your agency can also propose ways to be accountable for implementing and monitoring changes to law and policy and the impact on health outcomes over time.
Recommendation 76 in the report is that “The Federal Government should evaluate the impact of the many structural and economic policy changes that were made during the pandemic, including those involving housing, criminal justice, and Medicaid.” The lesson here is that we should all evaluate policy changes made during the pandemic and make a determination about the best path forward. In particular, it is important that we assess the way the law – in the many forms can take – shapes all of the systems that we interact with in order to address structural discrimination and resulting inequities. If you wonder where law and policy can make a difference in health outcomes, the recommendations described here provide a good starting point.
This post was written by Dawn Hunter J.D., MPH, Director, Network for Public Health Law—Southeastern Region Office.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document do not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.