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Why was the Pathways to Population Health Equity (P2PHE) framework developed?​ 

Despite noteworthy bright spots, as a public health system, we were not all prepared with the approaches, resourcing or infrastructure to approach the pandemic in a way that built on equity, trust, strategy, and systems.  We are suffering the consequences of a fracturing of relationship and trust with the public.  Public health has always prioritized health equity–but we have not always had the tools or set-up to help us take strategic action together with the public. 


P2PHE helps to fill this gap.  Pathways to Population Health Equity offers a framework, roadmaps, compass, and associated tools for public health practitioners to build a more prepared, resilient, and proactive public health system at every level. The framework and associated tools can be adapted to the issues most prominent in your own jurisdiction.


Photo Credit to Dario Valenzuela

How was the framework developed?

At the request of the Centers for Disease Control and Prevention, WE in the World and ASTHO sought to adapt a field-tested, multi-sector population health equity framework, Pathways to Population Health*, for use by public health to strategically advance health equity. To do that, the following steps were taken:


1.     Conducted a landscape analysis of existing public health frameworks about population health

2.     Built on examples of use of the existing framework in public health and health care

3.     Held four design sessions with community residents with lived experience of inequities, public health department leaders, federal agency leaders

4.     Developed tools for use by the field

5.  Shared these with those who had participated in the design sessions for feedback and refinement

More details about the process can be found in the full framework report

*The original Pathways to Population Health framework was developed by health care and public health professionals for health care change agents in the context of 100 Million Healthier Lives, convened by the Institute for Healthcare Improvement, and has since been adapted for business, social service and faith communities by Well-being and Equity in the World.

Who developed Pathways to Population Health Equity?

Over 45 public health change agents in a process facilitated by Well-being and Equity (WE) in the World, the Association of State and Territorial Health Officials and the Centers for Disease Control and Prevention.


Well-Being and Equity (WE) in the World transforms relationships and systems to advance intergenerational well-being and equity on a foundation of racial justice. WE do this in partnership with people with lived experience of inequities, organizations, and communities across the world who are building a shared movement for thriving together. WE do this by developing frameworks and tools that change the way we think and act; accompanying organizations and communities to apply these frameworks to create real world change at scale; building strategic networks that can make these a new norm; and building the capacity of a community of accompaniers.


The Association of State and Territorial Health Officials (ASTHO) is the national nonprofit organization representing public health agencies in the United States, the U.S. Territories, and the District of Columbia, and over 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, formulate and influence sound public health policy and ensure excellence in state-based public health practice. ASTHO's primary function is to track, evaluate, and advise members on the impact and formation of public or private health policy which may affect them and to provide them with guidance and technical assistance on improving the nation's health.


The adaptation of Pathways to Population Health Equity was supported by the Centers for Disease Control and Prevention, Center for State, Tribal, Local, and Territorial Support (CSTLTS), which provided both funding and guidance to the project.

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