Background: In November 2020, Cleveland City Council introduced legislation to create the Division of Health Equity & Social Justice within the Cleveland Department of Public Health. The focus of the HESJ Division is to find solutions to health inequities and disparities. The root causes of health inequities are systematic social, economic, and environmental disadvantages that affect groups of people. Health inequities are unfair and avoidable differences in health status and include outcomes such as; rates of chronic diseases like asthma, diabetes, and hypertension, life expectancy, likelihood of incarceration, and economic disparities.

Mission: The mission of the Division of Health Equity and Social Justice will be to improve the health outcomes and the overall quality of life and to remove barriers to resources in order to create thriving neighborhoods and a thriving city.

Vision: We envision a city where:

1. Health equity and social justice are the very foundation of all policy and decision-making practices, and allocation of resources.
2. Where diverse residents, community partners and employees are engaged, heard and involved in decision-making.
3. Collaboration and partnerships work in service to the emerging needs of the community as a whole.

Social Determinants of Health are conditions in the places people live, learn, work and play that affect a wide variety of health and quality of life risks and outcomes. Investing resources in quality of life can significantly improve health outcomes . The SDOH framework focuses on five key areas. HESJ Division initiatives will address multiple issues within these key areas, across departments

Healthcare Access & Quality	Neighborhood & Built Environment	Education Access & Quality	Economic Stability	Social & Community Context
Pillar 1	Pillar 2	Pillar 3	Pillar 4	Pillar 5

The work of the HESJ Division is concentrated in three areas:

External: Racism as a Public Health Crisis- Coalition (RAPHC) is a public private partnership between the City of Cleveland, community leaders and residents. The coalition was formed to develop a framework or strategic plan to address racism and its impacts in the city of Cleveland. RAPHC-Coalition HHS Committee Presentation.

Internal: The Interdepartmental Equity Team consists of representatives across departments of city government concentrating on dismantling inequitable outcomes in practices, policies, procedures and services.

Public Health Services: The following programs are housed in the HESJ Division; HIV/STI, MomsFirst, and the Office of Mental Health and Addiction Recovery. Programs are designed to increase equity and improve health outcomes and disparities caused by structural racism. www.cdc.gov/socialdeterminants