Understanding Health Equity in Public Health Practice in the United States

Area of Science:

• Public Health Practice
• Health Equity Research
• Chronic Disease Prevention

Background:

• Assessing the extent of equity-focused work in public health is crucial for identifying successes and areas needing improvement.
• Understanding current health equity practices in public health departments is essential for advancing health equity.
• Chronic disease programs are a key area where health equity initiatives can be implemented.

Purpose of the Study:

• To characterize the patterns and correlates of equity-related practices within US state and territorial public health departments.
• To identify areas of success and gaps in health equity work in public health practice.
• To inform technical assistance and capacity-building efforts for health equity.

Main Methods:

• A multimethod, cross-sectional study design combining quantitative and qualitative data.
• Surveys were completed by 600 chronic disease prevention practitioners in US state and territorial public health departments.
• Health equity data were collected across four domains: staff skills, work unit practices, organizational priorities, and partnerships.

Main Results:

• Practitioner self-reported performance on health equity varied widely.
• High agreement was found for staff skills in understanding causes of inequities (82%).
• Low agreement was reported for systems tracking progress (32%), hiring diverse staff (33%), and community engagement principles (34%).

Conclusions:

• Significant opportunities exist to enhance health equity practices in state and territorial public health.
• Findings highlight progress, gaps, and target areas for technical assistance and capacity building.
• Urgent action is needed to address health equity and improve outcomes in public health.