More Than Activity: The Effect of Sustained Engagement in Digital Alcohol Support Interventions for Regional and Remote Communities.

Racism is a determinant of population health, which manifests in various ways through unfair practices, processes, and policies that result in inequitable access to resources and opportunities. These inequities also shape who participates in legislative decision-making, how policy problems are framed, and the types of solutions pursued, potentially contributing to the absence or inadequacy of policies that effectively address racism. In response, racial equity and social justice (RESJ) policies, through legislation, executive orders, regulations, and administrative actions (i.e., statutes and rule-making), have been increasingly integrated into federal, state, and local governance. These efforts have largely comprised the creation of equity offices and government leadership positions, the development of racial equity action plans, and the use of tools such as racial equity impact assessments and mandatory equity training. At the federal level, Executive Orders 13985 (2020) and 14091 (2023) on established “whole-of-government approach to embedding equity principles within federal operations. These actions directed agencies to conduct equity assessments, develop equity action plans, and strengthen civil rights enforcement capacity across service delivery, procurement, and budgetary processes. At the state level, Maryland, for example, has emphasized accountability and training mechanisms, including legislation requiring health care professionals to complete implicit bias training when renewing licenses. Local governments, in the Washington, D.C., Maryland, and northern Virginia (DMV) metropolitan area, have been at the forefront of RESJ policy innovation. Montgomery County, Maryland’s (2019) and Washington, D.C.’s (2021) each established dedicated equity offices, mandated racial equity impact assessments (REIAs), required racial equity training for government employees, and incorporated equity action plans and performance tracking tools. Fairfax County, Virginia’s (2016) similarly institutionalized equity action planning across county agencies, although it did not adopt a formal REIA requirement. Collectively, these examples illustrate the range of mechanisms local governments are using to embed equity principles across governance and decision-making processes to tangibly address social and health inequities.