After issuing statements on racial justice during Summer 2020, health care institutions’ attention towards health justice has decreased substantially. Meanwhile, health equity work is often (1) uncompensated and (2) undertaken by people from under-represented communities. This combination results in a “minority tax” on these colleagues, causing ongoing professional and psychological harm.

This project aimed to set an expectation that health equity promotion should be valued similarly to other “normal” professional goals (e.g., clinical productivity, academic involvement, and Division citizenship). During FY2020-2021, “an equity mandate” was implemented in our Division of Primary Care at an academic safety net hospital in Oakland, California. Eligible faculty had 1% of total potential compensation made contingent on specifying and meeting a health equity goal in their non-clinical work. Goals were made through shared decision-making between the Division Chief and faculty members, centering on two questions: “How might your work impact health equity?” and “How might you measure the impact of your work on health equity?”