Oregon's Approach To Demonstrating The Value Of A Modern Public Health System Through Accountability Metrics

Oregon's public health system uses accountability metrics to improve health, eliminate inequities, and practice stewardship. First enacted into law during the 2015 legislative session, with additions and clarifications made in the 2017 session, these metrics promote collective action across sectors, bring attention to the root causes of health inequities, and hold public health authorities accountable for performance improvement as they carry out core public health functions. This article describes the development of Oregon's accountability metrics and implications for future practice. In 2023, Oregon's public health leaders adopted a new set of health outcome indicators and process measures for communicable disease control and environmental health, with performance tied to financial incentives. Oregon's process is a model for other states developing an accountability framework in their pursuit of public health transformation. Oregon's work contributes to legislative and other policy decisions for measuring the success of approaches to eliminating health inequities and for applying performance-based incentives within the public health system.