Abstract
Purpose: Chronic diseases cause a significant proportion of mortality and morbidity in the United States, although risk factors and prevalence rates vary by population subgroups. State chronic disease prevention practitioners are positioned to address these issues, yet little is known about how health equity is being incorporated into their work. The purpose of this study was to explore perceptions of health equity in a sample of state chronic disease practitioners.Methods: Participants were selected in conjunction with a related evaluation of the National Association of Chronic Disease Directors (NACDD) capacity-building and evidence-based efforts. Four states were chosen for study based on variance in capacity. Directors in each of the states were interviewed and using snowball sampling, 8–12 practitioner interviews were conducted in each state, digitally audio recorded and transcribed. Using a comparative coding technique, themes and analyses were developed.Results: Comments from the practitioners fell into three main and inter-related categories. First, they discussed the varying degrees of integration of health equity in their work. The second theme was collaboration and the importance of working within and outside of departments, as well as with the community. The third theme related to measurement and the need for better data that can be used to garner support and measure impact.Conclusion: Chronic disease practitioners can play an important role in achieving health equity. Integrating this work more fully into chronic disease prevention and health promotion, developing strategic partnerships, tracking efforts, and measuring impact will improve practice and ultimately population health.
Highlights
Chronic diseases account for the majority of deaths in the United States and prevention efforts remain a vital component of public health.[1]
There is a need for information, data, and knowledge about the communities with which they can better tailor messages and engage with communities, legislators, boards, and decision makers to affect change. The information from these interviews is helpful in understanding existing health equity efforts within state chronic disease prevention work units and suggests some recommendations for improvement
It was apparent from the interviews that work related to addressing health equity was not absent, but it did not exist to the extent that would have maximum impact
Summary
Chronic diseases account for the majority of deaths in the United States and prevention efforts remain a vital component of public health.[1] surveillance data show that mortality and prevalence rates for chronic diseases vary greatly among population subgroups. In the United States, the 2015 rate of cerebrovascular mortality was significantly higher for non-Hispanic blacks (61.3%) compared with non-Hispanic whites (47.7%).[2].
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