This NACCHO Exchange article emphasizes the critical role of local health departments (LHDs) in addressing systemic health inequities by shifting from traditional engagement methods to authentic power-sharing with grassroots community power-building organizations (CPBOs). It outlines frameworks for understanding and redistributing power and highlights successful collaborations that have led to equitable policy changes. The article also discusses how these partnerships have been instrumental in driving COVID-19 responses, policy advocacy, and long-term equity-focused strategies.