The freedom to live a healthy life is an essential part of the American promise. Thanks to incredible breakthroughs in medical treatment and care that freedom has been extended to more and more Americans. Diseases that were once death sentences have become manageable conditions.

Yet millions of Americans today still find their health determined by who they are or where they live. The impact of systemic discrimination impacts how much we earn, the neighborhoods and homes we live in, the schools we attend, the food we eat, and the jobs we have access to. Each of these factors affects the health of Americans more than what happens at a doctor’s office or hospital.

In Pete’s administration, achieving health equity will be a strategic priority: during his first 100 days in office, he will direct the federal government to develop a National Health Equity Strategy. He will designate and invest in Health Equity Zones to empower communities to combat their most pressing disparities and transform our under-resourced public health system, enabling public health departments to become champions of equity in their communities. His administration will both invest in training our health workforce to combat racism and bias when treating patients, and support more underrepresented groups entering the sector to achieve equitable representation.

Pete understands that health policies alone will not be enough to achieve health equity. Income, housing, education, food, access to clean water, and safety all have a profound impact on our health. That’s why Pete’s administration will adopt a “Health in All Policies” approach to embed health considerations into decision-making across federal agencies.

This plan should be viewed in concert with Pete’s other health policies, which will also help close inequities. His Medicare for All Who Want It plan achieves universal coverage, which disproportionately benefits people with low incomes, people of color, and those living in rural communities. His Healing and Belonging in America plan destigmatizes and decriminalizes mental illness and addiction, which will drastically improve mental health outcomes for LGBTQ+ people, veterans, and people of color. Pete’s Women’s Agenda for the 21st Century will end the maternal mortality crisis—which primarily affects Black, Native, and rural women—while his plan for LGBTQ+ Americans commits to ending the HIV/AIDS epidemic by 2030, which disproportionately affects gay and bisexual Black and Latino men, and transgender women.

This plan for health equity is just the beginning. It is a policy framework that empowers communities to collaborate with the federal government to eliminate systemic health disparities. We cannot replace discriminatory policies with neutral ones and expect the playing field to level itself. We must intentionally work to create an era of inclusion in health.

Designate and invest in Health Equity Zones and empower communities to address health disparities.

• Designate communities with significant health disparities as Health Equity Zones. These communities will receive federal funding to end their most pressing health disparities, with a programatic budget of $5 billion over 10 years.
• Health Equity Zones will establish multi-sector coalitions focused on health equity, which could include local housing authorities, food banks, environmental protection organizations, local NAACP chapters, health care systems, economic development agencies, and safe transportation groups.

Our national health care and public health systems do not equitably serve all communities. For example, people of color and members of other minority groups have been—through both negligence and intention—excluded from these systems. This remains the case even today. The Hyde Amendment, for example, primarily denies women of color access to essential reproductive health care services. Several states have sought to enact Medicaid work requirements, which will disproportionately deprive women with children and people with disabilities from accessing health care. 6We are long overdue in transforming our health care and public health systems not toward neutrality, but toward anti-racism, -misogyny, -homophobia, -ableism, and -xenophobia.

Empower public health departments as Chief Health Strategists for their communities and increase their funding through a Public Health Infrastructure Fund.

• Empower local public health departments to become Chief Health Strategists for their communities by giving them greater resources to identify the root causes of local health inequities across sectors, including housing, transportation, and criminal justice.
• Create a Public Health Infrastructure Fund, a mandatory funding stream to support state and local health departments, starting at a $500 million governmental contribution and ramping up annually until the gap of $4 billion a year between current spending and existing needs is met.

Train our health workforce to both combat racism and bias when treating patients, and address the exclusion of underrepresented groups in the health workforce.

• Train more health practitioners to identify and reduce bias by expanding incentives for the adoption of evidence-based programs shown to reduce disparities in health outcomes.
• Create grant programs for Historically Black Colleges and Universities, Tribal Colleges, and Hispanic-Serving Institutions to recruit underrepresented groups into health professions, including by increasing scholarships and financial assistance.
• Require that Medicare and Medicaid consider diversity when developing provider networks, and ensure that clinicians are adequately prepared to serve the patient populations in their network.

Develop and test innovative delivery and payment models to reduce health inequities by taking into account the social determinants of health.

Advance health equity at the state and local levels through a “Health in All Policies” approach.

Pete is determined to usher in a new era for health in America. One that recognizes that our policies must target systemic disparities in our health system. One that understands what happens in our lives outside the clinic is more important to our health and well-being than what happens in a hospital or doctor’s office. And one that makes achieving health equity—where everyone has a fair opportunity to be as healthy as they can be—a national imperative.