Structuring Equity Into Minnesota's COVID-19 Response: Lessons Learned and Future Investments

Background: The Minnesota Department of Health (MDH) integrated 3 intentional teams into their novel coronavirus 2019 (COVID-19) response to ensure equity was not lost in the speed of response. Implementation: These teams—the Cultural, Faith, and Disability Communities Branch, Tribal COVID-19 Healthcare Team, and Vaccine Equity Branch were able to reach communities through trusted partners, elevate the voices of communities most impacted, respect tribal sovereignty, establish equity leadership, and set equity goals and metrics. Lessons Learned: The top-down nature of incident command, combined with pre-COVID-19 systems and structures that impede equity, led to both barriers and opportunities for centering equity in response efforts. Inclusion of staff and community voice in decisions and guidance leads to better results; each community's unique needs have to be considered. Equity metrics and goals help direct resources to the most disadvantaged. State, local, and tribal public health infrastructure was built quickly and needs ongoing resources to be sustained. Future Investments: MDH is leveraging new funding to embed successful response structures into the organization. These structures are intended to build state, local, and tribal capacity and address systemic challenges at MDH. Conclusion: While equity can be incorporated into pandemic response and incident command structures, ongoing investment to support public health infrastructure is vital to sustaining equity.