Building capacity to address systemic and institutional roots of social and health inequitiesGrowing awareness and understanding of the social determinants of health and health equity do not necessarily translate into sustainable change of our traditional health system; and as we struggle to create a national health system that advances health equity, existing social norms and institutional policies frequently replicate the very same inequitable practices we seek to be address. For example, the healthcare and public health sectors openly appreciate the power of community health workers (CHWs), Promotores de salud, and other grassroots agents of change in improving health outcomes in diverse communities. However, current initiatives using CHWs and Promotores de Salud as “extensionists” in health improvement efforts often puts these community workers at risk for harms associated with secondary stress. While tasked with addressing important emerging priorities, such as building social connection and cohesion, CHW’s, both paid and volunteer, are often immersed in systems that neither educate them about these risks; nor help to generate the social, institutional and personal conditions needed to promote their reduction. Just as promoting health equity and a culture of health in communities requires the inclusion of strategies that address social determinants of health, the prevention of secondary stress in grassroots community workers relies on more than individual behavior change; but rather must include a shift in the social norms and institutional policies and practices that enable and promote those healthy behaviors.
Coaction Institute’s efforts to build capacity to address systemic and institutional roots of social and health inequities include:
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