Abstract

Context: Health disparities are among the critical public health challenges. Objectives: To analyze the extent to which local health departments (LHDs) perform activities for addressing health disparities, changes in proportion of LHDs’ performing those activities since 2005, and factors associated with variation in such engagement. Methods: We used the 2013 National Profile of LHDs Survey to perform Logistic Regression of activities LHDs performed to address health disparities. Results: About 20 percent of LHDs did not perform any activity to address health disparities. Significant decreases occurred since 2005 in the proportion of LHDs that performed health disparity reduction/elimination activities for four activities. LHD characteristics significantly associated (p≤0.05) with the increased likelihood of performing activities to address health disparities were: recent completion of community health assessment, community health improvement plan and agency wide strategic plan. Other significant positive impacts on such activities included per capita expenditures, local governance, having one or more local boards of health, larger population size and metropolitan status of the LHD jurisdiction. Conclusions: Reduced infrastructural capacity of LHDs has resulted in fewer LHDs addressing health disparities in their jurisdictions. LHD characteristics associated with higher performance of activities for health disparity reduction identified by this research have important policy implications.

Highlights

  • According to Braveman, health disparities are differences in the quality of healthcare and health status among population subgroups based on race, ethnicity, sexual orientation, immigration status, age, and socioeconomic status [1], and they represent a persistent public health problem [1,2,3,4,5,6,7,8]

  • The objective of this study is to examine and fill in knowledge gaps concerning local health departments (LHDs), by analyzing (1) the extent to which LHDs engage in strategies and activities for addressing health disparities and (2) variation in involvement of LHDs in specific activities in their efforts to address health disparities in their communities

  • LHDs engaged in prioritizing resources and programs for the reduction in health disparities decreased from 50.2% (2005) to 33.6%

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Summary

Introduction

According to Braveman, health disparities are differences in the quality of healthcare and health status among population subgroups based on race, ethnicity, sexual orientation, immigration status, age, and socioeconomic status [1], and they represent a persistent public health problem [1,2,3,4,5,6,7,8]. National plans, such as Healthy People 2020, are a call to action for reducing health disparities by addressing social determinants of health among disadvantaged populations.

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