Equity Work Among Accredited Health Departments in the United States, 2015-2021

Minimal research has examined the number of health departments conducting work related to equity and/or the kind of work, if any, they are conducting. We examined the relationship between public health accreditation and work related to health equity by analyzing accredited health departments' responses to a prompt in the Public Health Accreditation Board's (PHAB's) annual report.

We analyzed self-reported responses from accredited health departments to questions about emerging public health issues and innovations in PHAB's annual report. We identified themes using a priori and inductive coding.

A total of 316 health departments submitted an annual report from January 2015 through December 2021. Of those health departments, 283 (89.6%) stated in their annual report that they engaged in work related to health equity, 50 (17.7%) of which provided a narrative about this work. Of those 50 health departments, the most common theme reported was community partnership, described by 23 (46.0%) health departments. The next most reported themes were COVID-19 vaccine access for racially or socioeconomically marginalized communities (n = 17, 34.0%) and programs related to health equity (n = 16, 32.0%).

We found that most accredited health departments conduct work related to health equity. Further research is needed to examine characteristics that influence a health department's likelihood of conducting equity work. Models and resources on how health departments, particularly small health departments, can begin equity work would be valuable.