From Principles to Practice: One Local Health Department's Journey Toward Health Equity.

Umair A Shah,Linda E Forys,Jennifer M Hadayia

doi:10.1089/heq.2016.0004

Umair A Shah, Linda E Forys + Show 1 more

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Journal: Health equity	Publication Date: Jan 1, 2017
Citations: 3	License type: cc-by

Affiliation: Harris Health System

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Few dispute that social determinants such as economics, education, and the environment are the true drivers of health. In fact, the recent “Public Health 3.0” publication is a national call to action for public health to focus upstream. Where there is less clarity is how to redesign public health practice to address social determinants. As an example of how local health departments can heed this national call, Harris County Public Health describes its movement from health equity principles to practice, which included reframing an understanding of health inequities and applying a multitiered infrastructure of policy and procedures for “retrofitting” practice.

Highlights

Earlier this year, some of our nation’s highest ranking health officials issued a national call to action to ‘‘boldly expand the scope and reach of public health.’’1 They appealed to all state and local public health agencies to make an upgrade to Public Health ‘‘3.0,’’ a modern understanding of public health that deliberately shifts attention upstream to the true drivers of health, which, the authors note, are not healthcare services, but the social determinants of health such as economics, education, and the environment.[1]For those in local public health who have been taking a deeper dive into the social determinants for some time, this was a welcome wake-up call
Six years have passed since Healthy People declared social determinants as one of our nation’s leading health indicators, and it has been more than a decade since the World Health Organization (WHO) established the Commission on Social Determinants of Health and shortly after issued its landmark report on closing the gap in social factors.[4,5,6]
Harris County Public Health offers an example as we have been deliberately moving from health equity principles to practice since 2014, including reframing our understanding of how health inequities occur and developing policy and procedures for ‘‘retrofitting’’ public health practice upstream

Summary

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Some of our nation’s highest ranking health officials issued a national call to action to ‘‘boldly expand the scope and reach of public health.’’1 They appealed to all state and local public health agencies to make an upgrade to Public Health ‘‘3.0,’’ a modern understanding of public health that deliberately shifts attention upstream to the true drivers of health, which, the authors note, are not healthcare services, but the social determinants of health such as economics, education, and the environment.[1]For those in local public health who have been taking a deeper dive into the social determinants for some time, this was a welcome wake-up call. Where there is less clarity and consensus in the field is how to redesign state and local public health to address social determinants in day-to-day practice.

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