Disability Inclusion in Local Public Health Community Health Assessments and Community Health Improvement Plans.

Area of Science:

• Public Health
• Health Equity
• Disability Studies

Background:

• Community Health Assessments (CHAs) and Community Health Improvement Plans (CHIPs) are foundational tools for local health departments (LHDs).
• Ensuring these processes are inclusive of all populations, including people with disabilities, is crucial for effective public health strategies.
• Previous research has not fully quantified the extent of disability inclusion within these LHD-level planning documents.

Purpose of the Study:

• To quantify and describe the level of disability inclusion in CHAs and CHIPs at the LHD level.
• To identify factors associated with greater disability inclusion in these public health planning processes.

Main Methods:

• Cross-sectional study utilizing data from the 2019 National Association of County and City Health Officials (NACCHO) Profile.
• Analysis focused on CHAs and CHIPs from Public Health Accreditation Board-accredited LHDs.
• Statistical analysis, including adjusted odds ratios (aOR), was used to determine associations.

Main Results:

• Less than 25% of LHDs reported specific goals, objectives, or activities for people with disabilities in their CHIPs.
• Inclusion of a disability partner on CHA/CHIP steering committees was associated with a 3.2 times greater odds of disability inclusion (aOR = 3.2, P < .01).
• CHAs/CHIPs developed by mixed community partner groups (not official coalitions) showed a 5.04 times greater odds of disability inclusion (aOR = 5.04, P = .005).

Conclusions:

• Disability inclusion and representation in LHD CHAs and CHIPs are currently limited.
• Active engagement with disability partners and diverse community collaborations are key drivers for enhancing inclusion.
• Findings can inform the development of improved CHA and CHIP processes and tools to promote disability inclusion in public health.