Writing a Health Department’s First Health Equity Policy

by Cora Burgoyne

Writing the Health Equity Policy

The Unified Government Public Health Department conducted a health equity self-assessment in the fall of 2018. The tool used was the Local Health Department Organizational Self-Assessment for Addressing Health Inequities by Bay Area Regional Health Inequities Initiative (BARHII). This toolkit was developed by BARHII to help local health departments execute a comprehensive organizational assessment of their capacity to address health inequities. This assessment tool was chosen based on the experience of other local health departments across the nation. One of the outcomes of this self-assessment was the need for the health department to make concerted efforts to address health equity. The purpose of the health equity policy was to provide high level guidance for the inclusion of health equity in all policies, procedures, services and interventions at the health department.

The initial step in creating a Health Equity Policy was identifying the Public Health Accreditation Board (PHAB) standard and measure related to this activity:

Domain 11 Standard 11.1 Measure 11.1.4 Guidance
Maintain Administrative and Management Capacity Develop and Maintain an Operational Infrastructure to Support the Performance of Public Health Functions Policies, processes, programs, and interventions provided that are socially, culturally, and linguistically appropriate to specific populations with higher health risks and poorer health outcomes. Provide a policy or procedure that demonstrates how health equity is incorporated as a goal into the development of policies, processes, and programs.

A scan of the literature was conducted to identify resources relevant to creating a health department-specific health equity policy. The resources identified that had pertinent information on health equity to be used for the UGPHD Health Equity Policy were:

Using the health department’s Policy and Procedure Template, a draft Health Equity Policy was created.

The main sections of the policy include:

  • Background on health equity in Wyandotte County and why it’s important to embed into the work of the health department
  • Programmatic considerations
  • Tools to assess and promote health equity
  • Recruitment and retention of workforce
  • Strategic planning
  • Budgeting and finance practices
  • Education and training of workforce

After the policy was written, a formal review process was conducted between the Community Health and Planning and Operations Division. When the final draft was completed, it was submitted to the director and deputy director of for final review. The final draft was authorized by the director and added to the Unified Government Public Health Department Employee Manual. An email was sent to all staff by the Director about the policy and where it could be located on March 13, 2019.

Evaluation

To evaluate the effectiveness of the Health Equity Policy, the UGPHD will implement the BARHII Organizational Self-Assessment for Addressing Health Inequities staff and collaborative partner survey every three years, beginning in 2018, and publish the results for staff review. It will be the responsibility of health department leadership to review, analyze, and create an actionable plan for addressing the findings in the BARHII assessment.

Results

The health equity policy will provide high level guidance for the inclusion of health equity in all policies, procedures, services and interventions at the UGPHD. Following these equity guidelines, divisions will be able to collaborate within the department and with community partners and stakeholders to develop policies, procedures, services and interventions that advance health equity goals. As laid out in the policy, staff are required to complete their Workforce Development plan in Kansas-Train by November 1 every year. By November 1, 2019, employees of the UGPHD will be required to complete classes that have specific health equity content. The health equity policy met the PHAB documentation requirement standard 11.1, measure 11.1.4.

Lessons Learned and Significance

This small project was the health departments first step to formalizing it’s commitment to health equity and beginning to make it part of every day discussion. It was great to collaborate with other divisions to gain perspective on what they believe was important to include in health equity considerations. This policy, as well as others I worked on for my capstone should serve as a foundation for health equity work moving forward. By putting a primary focus on health equity, we are inviting health considerations into discussions and decision-making processes relevant to 21st century public health practice.

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