Beyond Training for Health Equity: How One Public Health Training Center is Addressing Equity

The disproportionate health, economic, and social impacts of COVID-19 on communities of color and the wave of national demonstrations calling for an end to police brutality in Black communities has shown us that public health as a field–and our entire nation–has much more work to do. We were fortunate to have had the opportunity to talk with Dr. Richard Hofrichter, senior director of health equity and social justice initiatives at the National Association of City and County Health Organizations (NACCHO), about the issue, and we wanted to revisit one particular part of his interview that focused on the idea of “training” public health professionals for social justice work.

Hofrichter doesn’t think of the work to prepare professionals for social justice as “training”; he believes the concept of training is too limited and makes assumptions that shift power and influence to those who are currently defined as “teachers” and away from those currently viewed as “learners.” 

According to Hofrichter, transmitting facts from teacher to learner about topics like inspecting a restaurant or calculating the incidence and prevalence of an illness is easy. “It’s much more difficult to ‘train’ people when it comes to addressing issues like structural racism,” he says. Instead, Hofrichter encouraged engagement in transformative dialogue to shift consciousness and help professionals discover new perspectives they may not have considered before.

The Public Health Learning Network (PHLN), the nation’s most comprehensive system of public health educators, experts, and thought leaders, was established to elevate public health practice by developing and disseminating high-quality, relevant, and accessible training and education opportunities for the public health workforce. In recent months, the 10 Regional Public Health Training Centers, who are the backbone of the PHLN, have been exploring traditional and nontraditional training approaches to advance health equity and racial justice. We were able to catch up with Hilary Merlin, training and communications specialist at the Region IV Public Health Training Center, to discuss some of the steps they have taken to address equity, including drafting a blog post that included the following passage:

Recent horrific incidents in our country have drawn renewed attention to the fact that racism is not only a public health issue, but a public health crisis. The Emory University and the Rollins School of Public Health communities have been swift to respond with statements from leadership and student organizations, vigils and commemorations, resource and reading lists, and educational events.

Here at the Region IV Public Health Training Center, we, too, acknowledge that systematic racism and racist violence continue to hurt our communities and that we are responsible for working to address these tough issues.

Our conversation with Hilary below has been lightly edited for clarity and length.

Region IV made a pretty bold statement in the blog post that not only acknowledges systemic racism and racist violence but takes responsibility for addressing those issues. Why do you think it’s important to do both those things as a public health professional? And in what other ways is Region IV addressing equity in public health?

To me, public health has always been about the protection of universal human rights, like the rights to safety, healthy food, clean air and water, and medical care, as well as to dignity and self-determination. Because racism is a threat to these fundamental rights, racism is a public health issue. 

Here at the Region IV Public Health Training Center, in addition to adopting an Anti-Racism Commitment, we’re in the process of conducting an internal equity assessment. Our team has reviewed multiple organizational equity assessment tools and identified common themes to guide our discussion over the next several months. We’ll be reflecting on things like our organizational culture, partnerships, and programming so that we can identify opportunities for improvement. 

You mentioned that the Anti-Racism Commitment is shared before every training, which seems different because oftentimes equity work is siloed or placed on a specific track. Why do you believe it’s important to put this statement in front of everyone who is taking a training regardless of what they’re learning? What kinds of responses have you received so far? And have you been surprised by any of the responses?

Yes, you’re exactly right. We have a strong track record of producing trainings that explicitly deal with equity, and we’ll continue to do that. But we’re using the statement with every training we produce because we know that these issues don’t have boundaries. The issues of equity and justice are always at play, no matter what topic or skill a training focuses on. We want to bring that to light. We also want to take responsibility for ensuring that participating in our trainings is a safe as possible for everyone, especially those who have spent their lives dealing with discrimination, microaggressions or hate.

The response has been positive. People were ready; they know why we adopted the statement. At the time we announced it, much of the country was focused on racism. Many organizations were making public statements condemning racist violence, including our umbrella institutions The Rollins School of Public Health and Emory University.

This was also around the time that many meetings and events shifted to Zoom, and racist Zoom bombing and security became issues. Our trainers and participants needed reassurance that we were going to be proactive about those threats. 

You ask professionals about their immediate training needs around racial inequity and health disparities in a survey on your website. What have you heard so far? How prepared (or unprepared) do you believe your PHTC and the field at-large is to deal with the type of training needs that you are receiving?

Yes, while needs assessment has always been part of our work, we launched a special needs assessment initiative to get at training needs related to racial inequity and health disparities. We’ve heard from folks interested in training related to specific populations and health problems, like improving access to services during COVID-19 for underserved Latino populations. And we’ve also received very broad requests from professionals who are interested in the role of public health in dismantling systemic racism and antiracism as a public health strategy.

As far as being prepared to meet these needs, I am optimistic. What we do is connect the population we serve (the governmental public health workforce, primarily) with leading subject matter experts and innovators. We create learning opportunities that enhance the capacity of the public health workforce. While these aren’t problems that can be solved quickly or easily, we know how to provide quality learning experiences that can help move things in the right direction. 

Region IV has quite a few equity trainings and workshops available. Do you think there are any gaps that still need to be addressed in the equity training that is offered or how it is provided? What are they and how are you planning to make those changes?

We are continuously asking these questions, and we will explore them in depth as part of the internal equity assessment that I mentioned previously. Yes, there are gaps that still need to be addressed, many of which are yet to be identified. For example, when a COVID-19 vaccine becomes available, we anticipate a need for training related to vaccine hesitancy and the role of racism. We do our best to be responsive to what’s happening in the field and to make our programming highly appealing and accessible to our target audience.


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