The public health field has been instrumental in identifying how social determinants impact the health of individuals, families, and communities. Now that we better understand the vast and interconnected landscape of health, we also know that improving health outcomes is a complex challenge that extends far beyond the reach of traditional healthcare organizations.

The Robert Wood Johnson Foundation (RWJF) has strategically invested in organizations committed to building health equity in communities and reducing the disparities in health outcomes. These organizations, whose interventions collectively address key social determinants of health, are at the forefront of putting health equity concepts and principles into action.

Earlier this year, ARCHE invited a group of RWJF grantees to come together for the inaugural Health Equity Design (HED) Lab, “Challenges and Best Practices in Advancing Health Equity among RWJF Grantees.” The day-long HED Lab convening provided leaders from these organizations much needed time and space to reflect on their work, explore their efforts to operationalize health equity inside and outside of their organizations, and to identify emerging best practices in the field.

HED Labs convene thought leaders and community stakeholders to build consensus and incubate the best ideas that promote equity in key policy and program areas ripe for intervention or innovation. Its central focus is on changing policy, systems, practices and environments to affect the social determinants of health. The HED Lab process identifies best practices, recommendations and innovative solutions that can be deployed by policymakers and the field at large to advance change, as well as help drive research that addresses gaps in existing knowledge. The HED Lab facilitation process and research methodology were developed by Thicket Labs.

The HED Lab’s presentations, mapping activities, and discussions surfaced several core themes related to the current state of the field including core challenges and grantee needs that can be supported through the ARCHE program offerings. Our key learnings from the inaugural HED Lab are accompanied by recommendations to help grantees and the field at large address identified challenges and improve on what they’re already doing.

Among our key findings:

• Health equity is not yet well understood and complex to study and evaluate.ï‚·  The current political climate threatens efforts to achieve health equity.
• Current public policies are not designed to support health equity.
• Current solutions are not addressing our most pressing problems.
• Organizations are ill-equipped to address internal bias issues.

Recommendations stemming from the HED Lab include:

• Adopting lean approaches to learning could help operationalize health equity more quickly.
• Health equity organizations should focus on breakthrough innovations over incremental innovations.
• Health equity organizations should partner with communities to promote policy change.
• Organizations should focus on developing community engagement models for participatory policymaking to build community power.

We are grateful to all of the participants who were willing to contribute a full day (in some cases two) of their time to join us in Princeton, speak frankly about the challenges they face in their work, and apply themselves to envisioning new approaches for advancing health equity.