The Use of Health Equity Impact Assessments to Modify Evidence Based Strategies within Local Health Departments in North Carolina

Abstract

Abstract: Background. Health equity impact assessments (HEIAs) inform the reduction of health inequities by evaluating programs or policies that affect target populations. Local health departments (LHD) receiving funding through the Improving Community Outcomes for Maternal and Child Health (ICO4MCH) Program conducted HEIAs for evidence-based strategies (EBSs). This paper describes the impact of HEIAs on the implementation of EBSs and highlights lessons learned during implementation of HEIA modifications. Methods. We conducted a content analysis using data from the HEIA Modification Tracker and focus groups to identify themes and lessons learned. Results. Fifteen HEIAs were conducted by five LHDs between 2016 and 2020. The most common modifications to EBS implementation were 1) increasing education and training for community members and 2) altering messaging mediums and language to reach intended audiences. Discussion. Health equity impact assessments serve as a systematic and tangible way to center health equity, reflect on past processes, and inform improvements.