Health Equity

Welcome to the health equity website of the Public Health Services (PHS) department in the County of San Diego Health and Human Services Agency. This website provides a history of health equity in PHS, current health equity efforts, and additional health equity resources. 


Since 2001, the Public Health Services (PHS) department in the County of San Diego Health and Human Services Agency (HHSA) has had a long history of focusing on social determinants of health and health disparities. In approximately the past 20 years, the County has made significant progress in addressing health disparities and committing to advancing health equity. In early 2000, the terms social determinants of health and health disparities were utilized; health equity was yet to be socialized. In 2008, HHSA made health equity a priority. This was followed by the health equity framework developed by the Public Health Officer.

PHS has dedicated significant resources toward these efforts. In 2001, the Reduce and Eliminate Health Disparities with Information (REHDI) Initiative was created. Currently, educational materials are posted on the PHS webpage in multiple languages. Following HHSA’s declaration of health equity as an Agency priority, in 2008, the Chronic Disease and Health Disparities Unit (later named the Chronic Disease and Health Equity Unit) was created, with its activities supporting the Building Better Health component of Live Well San Diego, focusing on nutrition, physical activity, and tobacco. In February 2010, PHS Public Health Officer created a health equity framework for the California Conference of Local Health Officers (CCLHO); it was used to integrate health equity into PHS to prepare for national public health accreditation. As part of this accreditation journey, in 2015, an Office of Health Equity was created (followed by including Climate Change in the name of the Unit in 2020); the Health Equity Working Group, also created in 2015, continues to meet every two months and to implement its internally focused health equity work plan; a departmental Health Equity Policy was also created. Lastly, PHS has developed Health Equity goals, which are part of the PHS Strategic Plan. Public Health Services' health equity efforts contribute to the overall County of San Diego and HHSA efforts to advance health equity.

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Vision, Mission, and Goal

Our Vision

Health Equity for San Diego County Residents





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Our Mission

Public Health Services (PHS) is committed to advancing health equity in San Diego County. We work collaboratively with community and partners to identify and eliminate health disparities in the region.

PHS advances health equity through both internal and external transformation, including:

  • Organizational Health Equity Assessments
  • Health Equity Working Group
  • Health Equity Charter
  • Health Equity Policy and Procedure
  • Health Equity Plan
  • Health Equity Framework
  • Annual Health Equity Work Plans
  • Performance Management
  • Health Equity Reports
  • Workforce development and training (e.g., Health Equity 101, Cultural Competency, Customer Service)
  • Engagement and partnership with residents, community, regional, state, and federal partners
  • Various public health programs (e.g., Perinatal Health Equity Program), and more.

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San Diego skyline

PHS Health Equity Goal

To help reduce and eliminate health disparities by providing information about health conditions, including infectious and chronic diseases, which affect various populations differently. Key influencing factors (i.e., social determinants of health) include, for example, age, geography, gender, race/ethnicity, and socio-economic status.

For population health data on health disparities in the County of San Diego, see the Health Equity Report.

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PHS Timeline

PHS Health Equity timeline
  • In 2001, Public Health Services (PHS) developed Reduce and Eliminate Health Disparities with Information (REHDI) Initiative to recognize health inequities across specific populations.
  • In 2008, the Health and Human Services Agency made “health equity” an Agency priority.
  • In Spring 2008, PHS established a Chronic Disease and Health Equity Unit devoted to the promotion of wellness and prevention of illness, disability, and premature death due to chronic diseases and health disparities. This unit focusses on policy, systems and environmental factors to advance health equity.
  • In 2010, the County of San Diego Board of Supervisors adopted Live Well San Diego, a long-term initiative. Live Well San Diego includes three components: Building Better Health, Living Safely, and Thriving.
  • In July 2010, the PHS Public Health Officer created the Health Equity Framework for CCLHO. A subsequent article was published promoting this effort.
  • In 2010, PHS staff participated in the Public Health Institute (PHI) second cohort of the California/Hawaii Public Health Leadership Institute (CHPHLI), focused on health equity.
  • In 2012, PHS was able to assess the County of San Diego Health and Human Services Agency (HHSA) 5,400 plus staff members on skills and organization practices and infrastructure needed to address health equity. The Health Equity Assessment was separated into three parts to provide information on which areas to target to ensure that staff is able to address health equity. This was the first BARHII survey for staff on health equity and cultural competency from the BARHII Toolkit
  • In October 2014, the County of San Diego Board of Supervisors adopted the third component of Live Well San Diego, Thriving, which encompasses a broad range of areas that are interconnected and foundational to the quality-of-life for everyone in the region. The County of San Diego Public Health Services also became a member of Big Cities Health Coalition and participated on its health equity working group.
  • In 2015, PHS hired its first Health Equity Coordinator, published its first ever Health Equity Plan (2015-2020), and created a Public Health Services Office of Health Equity (now named Office of Health Equity and Climate Change).
  • In 2016, PHS undertook a series of tailored health equity workshops by branch to operationalize health equity and/or embed health equity into public health practice at the branch level.
  • In 2017, PHS developed a series of mandatory Public Health 101 trainings for PHS staff including a Health Equity 101, History of Public Health 101, Concepts in Public Health 101, and Climate Change 101.
  • In 2018, PHS leadership published a Health Equity article with Public Health Accreditation Board (PHAB) for the Journal of Public Health Management and Practice.
  • Also in 2018, PHS undertook the second BARHII survey for staff on health equity and cultural competency from the BARHII Toolkit, and developed a Health Equity Tool for Programs to assist staff in operationalizing and embedding health equity in their public health practice.
  • In the fall of 2019 achieved a 90+% completion rate of the mandatory health equity training for all staff.
  • In 2019, Branch Health Equity goals were added to the Public Health Services Strategic Plan
  • In 2020, produced the COVID-19 Health Equity Strategy.
  • In 2021, San Diego County declared racism as a public health crisis and produced the second Health Equity Plan (July 1, 2021).
  • In 2022, PHS expanded its cultural and social observance calendar and added minority health research as a regular feature of monthly cultural and social fliers, launched the Health Equity website, and updated the 101-training series, and the Health Equity Policy.

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PHS Health Equity Framework

Fiscal Years 2020-2021, 2021-2022, and 2022-2023

The Public Health Services Health Equity Framework provides a snapshot of our 3-year Health Equity Plan. Note: Climate Change, Diversity, and Inclusion are part of the Health Equity Plan.

Health Equity Framework

Health Equity Definitions

Health is a state of complete physical, social, and mental well-being, not merely the absence of disease or infirmity. Public Health refers to what we as a society do collectively to assure the conditions in which people can be healthy.

Health Disparities are preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.

Health Equity is when all groups in a population have fair and just opportunities to attain their full health, well-being, and quality of life.

Health Inequity is differences in population health status and mortality rates that are systemic, patterned, unfair, unjust, and actionable, as opposed to random or caused by those who become ill.

Public Health 3.0 refers to a major upgrade in public health practice that emphasizes cross-sector work to affect the social determinants of health and advance health equity. Public Health 3.0 challenges us to incorporate health into all areas of governance. It is led by the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Health (OASH). It calls for us to boldly expand public health to address all aspects of life that promote health and well-being, including:

  • Economic development
  • Education
  • Transportation
  • Food
  • Environment
  • Housing
  • Safe neighborhoods

Population Health refers to the health of a population as measured by health status indicators and as influenced by social, economic, and physical environments, personal health practices, individual capacity and coping skills, human biology, early childhood development, and health services.

Social Determinants of Health refer to conditions in places where people are born, grow, live, play, work, and age that could affect a wide range of health risks and outcomes. These conditions are referred to as social determinants of health (SDOH). Examples include:

  • Education
  • Income
  • Genetics
  • Race/Ethnicity
  • Social status
  • Social support network
  • Physical environment
  • Gender


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Social Determinants of Health

Health Equity Resources

Local and Regional Resources

State Resources

National and Federal Resources

Global Resources

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Data Resources

The Community Health Statistics Unit (CHSU) provides health statistics that describe health behaviors, diseases, and injuries for specific populations, in addition to health trends and comparisons to national targets. View the Health Equity Dashboards.

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