Date of Award


Document Type



College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Robin Narruhn


Therry Eparwa


Interpersonal racism, bias, and discrimination can often directly contribute to poor healthcare outcomes. Their correlation can be seen in infant mortality, maternal mortality, life expectancy, heart disease, cancer, and more (Bailey et al., 2017; Gee & Ford, 2011). The COVID-19 health pandemic reinforces this pattern of health inequity. Structural inequalities during the pandemic further emphasized racial and ethnic disparities in BIPOC populations. BIPOC populations are more likely to have conditions associated with increased risk of illness from COVID-19 relative to their white counterparts (Raifman et al., 2020). Barriers to achieving health equity include lack of policy addressing health inequities and inadequate training for providers to recognize the root causes of health disparities and create solutions. Recommendations by the Institute of Medicine addressing disparities and unequal treatment lack accountability and have yet to be consistently developed, implemented, and evaluated (Bailey et al., 2017).

In 2021, Washington Senate Bill (SB) 5229, also known as the Health Equity Bill, was passed. Starting January 1, 2024, licensed healthcare providers must complete health equity continuing education training every four years. Members of the Community Health Board Coalition (CHBC) in Seattle, Washington were instrumental in the writing of the bill, providing expertise, and testimony to legislators regarding the need for the bill. The health equity training curriculum requires standards and criteria based on available research and evidence. Currently, members of the CHBC are collaborating with stakeholders to provide curriculum structure and content for SB 5229. This project’s goal was to provide evidence-based best practices and concepts for health equity anti-racism training aligned with SB 5229 requirements. Recommendations for curriculum include community involvement, education on historical causes of health disparities (racism, bias, social structures), provider self -reflection and implicit bias education, assessment and accountability, structural competency framework and more.