Advancing Health Equity: Facilitating Action on the Social Determinants of Health Among Public Health Departments

Employee Perceptions About Public Health Agencies' Desired Involvement in Impacting Health Equity and Other Social Determinants of Health

CONTEXT

Despite a growing consensus in public health to address health inequities and leverage social determinants of health (SDoH), the level of public health practitioners' readiness to become the agents of change in promoting health equity and shaping SDoH is not well researched.

OBJECTIVES

To examine (1) the level of public health agency employees' perceived desirability for impacting health equity and SDoH, and (2) the impact of employee characteristics such as a (PH WINS) public health degree and awareness of health in all policies on such desirability.

METHODS

Data from the 2017 Public Health Workforce Interests and Needs Survey were used in examining the sense of desirability among agency employees for affecting health equity and SDoH in the agency jurisdictions.

RESULTS

Fifty-seven percent of health agency employees believed that their agencies should be very involved in affecting health equity in their jurisdictions. Fairly smaller proportions of employees believed in the desirability of affecting SDoH, and the proportions who believed that the agency should be very involved in affecting specific SDoH were 17.8% for affecting the quality of transportation, 18.5% for affecting the economy, 22.2% for quality of housing, 22.4% for quality of the built environment, 25.4% for K-12 education system, and 34.5% for impacting the quality of social support systems. Agency employees without a public health degree had significantly lower odds (P < .05) of believing that the agency should be very involved in affecting health equity.

CONCLUSIONS

With increasing efforts to reduce health inequities and leverage SDoH for improved population health, gaps exist in the public health workforce's perceived desirability for their agencies to be involved in such efforts. These gaps exist among employees regardless of their demographic characteristics, length of tenure, or agency setting. Policy and practice initiatives aimed to improve health equity might benefit from our findings positing a need for education regarding SDoH and health equity. Our study findings imply the need for interventions for improving alignment between employee beliefs and organizational priorities for an effective transformation to Public Health 3.0. Fostering cross-sector partnerships with a focus on Health in All Policies (HiAP), SDoH, and health equity must be a high priority for public health agencies, which can be formalized through organizational strategic plans.

Strategies for Cost Saving Through Social Determinants of Health

EXECUTIVE SUMMARY

Healthcare costs in the United States are the highest in the world and getting higher. To combat these rising costs, social determinants of health need to be addressed. Healthcare organizations can use one or more of three strategies to address these social determinants: (1) collaborating with community-based organizations to help maintain and improve health, (2) working with policymakers to implement public health interventions, and (3) building housing and communities that are focused on health.