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Brownson RC, Mazzucca-Ragan S, Jacob RR, Brownson CA, Hohman KH, Alongi J, Macchi M, Valko C, Eyler AA. Understanding Health Equity in Public Health Practice in the United States. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:691-700. [PMID: 37290132 PMCID: PMC10373837 DOI: 10.1097/phh.0000000000001763] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
CONTEXT Understanding the extent to which equity-focused work is occurring in public health departments (eg, in chronic disease programs) can identify areas of success and what is needed to move the needle on health equity. OBJECTIVE The study objective was to characterize the patterns and correlates of equity-related practices in US state and territorial public health practice. DESIGN The design was a multimethod (quantitative and qualitative), cross-sectional study. SETTING The setting included US state and territorial public health departments. PARTICIPANTS Chronic disease prevention practitioners (N = 600) completed self-report surveys in July 2022 through August 2022 (analyzed in September 2022 through December 2022). MAIN OUTCOME MEASURES Health equity data were obtained across 4 domains: (1) staff skills, (2) work unit practices, (3) organizational priorities and values, and (4) partnerships and networks. RESULTS There was a wide range in self-reported performance across the health equity variables. The highest values (those agreeing and strongly agreeing) were related to staff skills (eg, the ability to describe the causes of inequities [82%]). Low agreement was reported for multiple items, indicating the lack of systems for tracking progress on health equity (32%), the lack of hiring of staff members who represent disadvantaged communities (33%), and limited use of principles for community engagement (eg, sharing decision-making authority with partners [34%]). Qualitative data provided tangible examples showing how practitioners and their agencies are turning an array of health equity concepts into actions. CONCLUSIONS There is urgency in addressing health equity and our data suggest considerable room for enhancing health equity practices in state and territorial public health. To support these activities, our findings provide some of the first information on areas of progress, gaps in practice, and where to target technical assistance, capacity building efforts, and accreditation planning.
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Affiliation(s)
- Ross C. Brownson
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri (Drs Brownson, Mazzucca-Ragan, and Eyler and Mss Jacob, Brownson, and Valko); Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson) National Association of Chronic Disease Directors, Decatur, Georgia (Drs Hohman and Alongi, and Ms Macchi)
| | - Stephanie Mazzucca-Ragan
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri (Drs Brownson, Mazzucca-Ragan, and Eyler and Mss Jacob, Brownson, and Valko); Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson) National Association of Chronic Disease Directors, Decatur, Georgia (Drs Hohman and Alongi, and Ms Macchi)
| | - Rebekah R. Jacob
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri (Drs Brownson, Mazzucca-Ragan, and Eyler and Mss Jacob, Brownson, and Valko); Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson) National Association of Chronic Disease Directors, Decatur, Georgia (Drs Hohman and Alongi, and Ms Macchi)
| | - Carol A. Brownson
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri (Drs Brownson, Mazzucca-Ragan, and Eyler and Mss Jacob, Brownson, and Valko); Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson) National Association of Chronic Disease Directors, Decatur, Georgia (Drs Hohman and Alongi, and Ms Macchi)
| | - Katherine H. Hohman
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri (Drs Brownson, Mazzucca-Ragan, and Eyler and Mss Jacob, Brownson, and Valko); Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson) National Association of Chronic Disease Directors, Decatur, Georgia (Drs Hohman and Alongi, and Ms Macchi)
| | - Jeanne Alongi
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri (Drs Brownson, Mazzucca-Ragan, and Eyler and Mss Jacob, Brownson, and Valko); Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson) National Association of Chronic Disease Directors, Decatur, Georgia (Drs Hohman and Alongi, and Ms Macchi)
| | - Marti Macchi
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri (Drs Brownson, Mazzucca-Ragan, and Eyler and Mss Jacob, Brownson, and Valko); Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson) National Association of Chronic Disease Directors, Decatur, Georgia (Drs Hohman and Alongi, and Ms Macchi)
| | - Cheryl Valko
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri (Drs Brownson, Mazzucca-Ragan, and Eyler and Mss Jacob, Brownson, and Valko); Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson) National Association of Chronic Disease Directors, Decatur, Georgia (Drs Hohman and Alongi, and Ms Macchi)
| | - Amy A. Eyler
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri (Drs Brownson, Mazzucca-Ragan, and Eyler and Mss Jacob, Brownson, and Valko); Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St Louis, St Louis, Missouri (Dr Brownson) National Association of Chronic Disease Directors, Decatur, Georgia (Drs Hohman and Alongi, and Ms Macchi)
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Becker CM, Bian H, Martin RJ, Sewell K, Stellefson M, Chaney B. Development and field test of the Salutogenic Wellness Promotion Scale - short form (SWPS-SF) in U.S. college students. Glob Health Promot 2022; 30:16-22. [PMID: 35897155 DOI: 10.1177/17579759221102193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Survey research is important for understanding health and improving practice among health professions. However, survey research can have drawbacks, such as overuse and excessively lengthy questionnaires that burden respondents. These issues lead to poor response rates and incomplete questionnaires. Low and incomplete response rates result in missing data and reduced sample size, damaging the value, usability and generalizability of the information collected. To address issues related to response rates and improve health research, shorter surveys are recommended because they impose less of a burden on respondents and are useful with larger populations. Health-related surveys also often focus on the factors leading to ill health without dedicating equal attention to factors supporting positive health. This study developed and tested a short form (SF) of the validated Salutogenic Wellness Promotion Scale (SWPS), which measures causes of health (rather than causes of disease), using responses from 2052 college students. The participants answered questions about their demographics and completed the SWPS and a perceived health assessment. Statistical tests demonstrated the SWPS-SF had significant relationships with the full SWPS, health status, and Grade Point Average (GPA). Statistical tests were also used to establish cutoff scores that had a high true positive and low false negative rate. These cutoff scores demonstrated a relationship of higher performance and better health. These promising results suggest this short test can provide valid information without burdening the respondents. Authors recommend additional tests be completed to validate the SWPS-SF.
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Affiliation(s)
| | - Hui Bian
- East Carolina University, Greenville, NC, USA
| | | | | | | | - Beth Chaney
- The University of Alabama, Tuscaloosa, AL, USA
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Sellers K, Leider JP, Bogaert K, Allen JD, Castrucci BC. Making a Living in Governmental Public Health: Variation in Earnings by Employee Characteristics and Work Setting. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25 Suppl 2, Public Health Workforce Interests and Needs Survey 2017:S87-S95. [PMID: 30720621 PMCID: PMC6519878 DOI: 10.1097/phh.0000000000000935] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT This article examines factors related to earnings in the context of the governmental public health system's urgent need to recruit and retain trained public health workers as many in the existing workforce move toward retirement. METHODS This article characterizes annualized earnings from state and local public health practitioners in 2017, using data from the 2017 Public Health Workforce Interests and Needs Survey (PH WINS), which was fielded in fall/winter 2017 to more than 100 000 state and local public health practitioners in the United States. The response consisted of 47 604 public health workers for a response rate of 48%.We performed descriptive statistics, bivariate analyses, and interval-based regression techniques to explore relationships between annualized earnings, supervisory status, gender, years of experience, highest degree (and whether it was a public health degree), job classification, race/ethnicity, union/bargaining unit, paid as salary or hourly wage, setting, and region. RESULTS Higher supervisory status, higher educational attainment, white non-Hispanic race/ethnicity, male gender, salaried employment, bargaining unit (labor union) position, certain geographic regions, having a clinical/laboratory/other scientific position, and working in either a state health agency (SHA) or a large local health department (LHD) setting are all associated with higher salary. Having a public health degree versus a degree in another area did not appear to increase earnings. Being a person of color was associated with earning $4000 less annually than white peers (P < .001), all else being equal. The overall regression model showed a gender wage gap of about $3000 for women (P = .018). Supervisors, clinical and laboratory staff, public health sciences staff, and union staff also earned more than their counterparts. DISCUSSION As multiple factors continue to shape the public health workforce, including increasing racial/ethnic diversity, continued retirements of baby boomers, and the growth of bachelor's-level public health education, researchers should continue to monitor the gender and racial/ethnic pay gaps. This information should help the field of governmental public health as it endeavors to rebuild its capacity while current workers, many at the highest level of leadership, move on to retirement or other jobs. Public health leaders must prioritize equitable pay across gender and race/ethnicity within their own departments as they build their organizations' capacity to achieve health equity.
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Affiliation(s)
- Katie Sellers
- de Beaumont Foundation, Bethesda, Maryland (Drs Sellers and Castrucci); Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota (Dr Leider); Workforce Research, Association of State and Territorial Health Officials (ASTHO), Arlington, Virginia (Ms Bogaert); and Department of Community Health, Tufts University, Medford, Massachusetts (Dr Allen)
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Mase WA, Hansen AR, Smallwood SW, Shah G, Peden AH, Mulherin T, Bender K. Disease Intervention Specialist Education for the Future: An Analysis of Public Health Curricula. Public Health Rep 2018; 133:738-748. [PMID: 30304646 DOI: 10.1177/0033354918792014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The objectives of this study were to (1) determine the degree of alignment between an existing public health curricula and disease intervention specialist (DIS) workforce training needs, (2) assess the appropriateness of public health education for DISs, and (3) identify existing curriculum gaps to inform future DIS training efforts. METHODS Using the iterative comparison analysis process of crosswalking, we compared DIS job tasks and knowledge competencies across a standard Council on Education for Public Health (CEPH)-accredited bachelor of science in public health (BSPH) and master of public health (MPH) program core curricula offered by the Georgia Southern University Jiann-Ping Hsu College of Public Health. Four researchers independently coded each DIS task and competency as addressed or not in the curriculum and then discussed all matches and non-matches between coders. Researchers consulted course instructors when necessary, and discussion between researchers continued until agreement was reached on coding. RESULTS The BSPH curriculum aligned with 75% of the DIS job tasks and 42% of the DIS knowledge competencies. The MPH core curriculum aligned with 55% of the job tasks and 40% of the DIS knowledge competencies. Seven job tasks and 9 knowledge competencies were considered unique to a DIS and would require on-the-job training. CONCLUSIONS Findings suggest that an accredited public health academic program, grounded in CEPH competencies, could address multiple components of DIS educational preparation. Similar analyses should be conducted at other CEPH-accredited schools and programs of public health to account for variations in curriculum.
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Affiliation(s)
- William A Mase
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Andrew R Hansen
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Stacy W Smallwood
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Gulzar Shah
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Angela H Peden
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Ted Mulherin
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Kaye Bender
- 2 Public Health Accreditation Board, Alexandria, VA, USA
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