Report Publish Date: February 2022
This report summarizes Louisville, Ky.’s health, wellbeing, and equity journey from 2016 to 2021, as part of RWJF’s Sentinel Communities Surveillance project.
“Louisville’s capacity to promote health, wellbeing, and equity is led by various city government departments, but also involves healthcare organizations, a robust nonprofit sector, workforce development organizations and coalitions, local foundations, and anchor institutions,” the authors write. “The Louisville Metro Department of Public Health and Wellness (LMPHW) is considered a strong leader and source of information on health in the community.”
Over the five years of the study, the authors noted an increase in funding and infrastructure for health. Louisville’s large, multisector health initiatives were focused on equitable policy, trauma-informed child and youth services, and coordinated data for equity and environmental health.
Begun in 2016, RWJF’s Sentinel Communities Surveillance project tracks how a Culture of Health is developing in 29 communities across the country. The authors wanted to describe key challenges, opportunities, and insights in Louisville.
For this report, the authors conducted 31 hourlong, semi-structured interviews between early 2017 and fall 2021. Interviewees came from a number of different types of organizations and sectors.
“Louisville’s journey to promote health, wellbeing, and equity is one that illustrates how a community can start to move from shared values to action on health equity and upstream drivers of health, and also one that sheds light on how entrenched power structures may inhibit change despite good Intentions."
—RAND Corporation
The authors say city leaders and partners laid the groundwork for change by “establishing common language and providing technical assistance, data, and reporting resources—and the events of 2020 catalyzed new commitments. Other communities can learn from Louisville’s approaches to make these changes, as well as the challenges they encountered, to inform their own journeys.”
Louisville is a highly segregated, mid-size city in northern Kentucky. It is known for having an innovative local government and a long-term commitment to health equity but also has shown little improvement in economic and health inequities over the past five years. The community benefits from strong health-related capacity in the form of the Louisville Metro Department of Public Health and Wellness, major healthcare systems, and robust workforce development and nonprofit sectors. Highly collaborative public-private-nonprofit coalitions and cradle-to-career efforts support youth education and career readiness, and new investments in infrastructure and commitments to community benefits have been established in historically marginalized neighborhoods. Louisville’s Center for Health Equity spurred embedding equity and recognition of root causes throughout Louisville Metro Government (LMG) and across stakeholders in the community. Its “Health Equity Report” is one of many sources of data that has been used for community benefit. Despite the city’s established equity agenda and shared understanding of health and wellbeing, the fatal shooting by police of Breonna Taylor, the COVID-19 pandemic, and other events of 2020 shed light on lack of true progress for equity, systems failures, and leadership challenges. Starting in 2020, organizations began to look more deeply at equity commitments and actions intended to eliminate systemic racism, including the role of evaluating and shifting entrenched power structures.
Robert Wood Johnson Foundation, February 2022
Figure 1: Population characteristics for Louisville, Kentucky Page 2
This study and report was conducted and created by:
A library of research and perspectives about Sentinel Communities, 30 diverse communities around the country.