Washington's Health Equity Zones (HEZ) Initiative

About the Initiative

Differences in conditions where people are born, live, learn, work, and play, often referred to as social determinants of health, can influence who is healthy, who is sick, and who lives longer. Communities of color, low-income communities, and people in areas with limited access to health care are disproportionately impacted by health inequities, yet their voices, experiences, strengths, and cultural knowledge are often not centered in decision-making.

In 2021, Senate Bill 5052 created an important foundation for the Department of Health (DOH) to support communities in identifying geographically-based health equity zones, places where people face more limited access to health care and other conditions that negatively impact their health. Each zone will identify pressing health concerns and develop projects to address that zone’s unique needs.

The Health Equity Zones Initiative supports communities in effecting change at a local level by shifting decision-making to those who live and work in those communities. The initiative will challenge the systems and structures that perpetuate health inequities and build collaborative networks for collective action.

Read more about the principles that guide this work (PDF).

For updates on the selected zones and additional processes, visit the HEZ Initiative’s WA Portal site.

Creation of Health Equity Zones

Phase 1: Planning

In July 2021, DOH started engaging with agency and community partners to initiate the development of the Health Equity Zones Initiative.

The first year emphasized partner engagement and community-centered processes to build a sustainable foundation for the initiative.

Phase 2: Development

DOH supported the process of establishing a Community Advisory Council to lead the effort to select zones for the initiative. The first step involved sharing information about the initiative and the council in multiple languages to community members across the state.

Community members then led the process of selecting community representatives to serve on the council. DOH staff played a supporting role and provided technical assistance throughout the process. In response to feedback from people involved in the process, DOH also created a Community Workgroup with open membership to facilitate more community input on the HEZ Initiative.

The Community Advisory Council and Community Workgroup convened in April and May 2022, respectively, to guide the development of the HEZ Initiative. Between May 2022 and May 2023, the Community Advisory Council determined the criteria for nomination, released and promoted the nomination process, and scored nominations received. In June 2023, the Community Advisory Council met in person to select the urban and rural health equity zones. For information on the selected zones, visit the HEZ Initiative’s WA Portal site.

Phase 3: Implementation

Each of the selected Health Equity Zones will be led by a cross-sector community collaborative that reflects the diverse makeup of the community. DOH will provide technical support to the HEZ Community Collaboratives to identify health priorities and implement projects using strategies to improve health outcomes that are unique to their community. 

Phase 4: Sustainability

The pilot of the HEZ Initiative began with identifying three zones in Native, rural, and urban communities.  DOH will support the HEZ Community Collaboratives in identifying continued funding and other resources that allow for the growth of the HEZ Initiative.  Participatory evaluation will be used to assess the impact of HEZ Initiative and make ongoing improvements.

Stay Connected