Inclusive and intersectoral: community health improvement planning opportunities to advance the social determinants of health and health equity
Abstract Background Community health improvement plans (CHIPs) are strategic planning tools that help local communities identify and address their public health needs. Many local health departments have developed a CHIP, yet there is a lack of research on the extent to which these plans address root...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-023-17496-5 |
| _version_ | 1797355428224434176 |
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| author | C. Ross Hatton Rasika Kale Keshia M. Pollack Porter Yeeli Mui |
| author_facet | C. Ross Hatton Rasika Kale Keshia M. Pollack Porter Yeeli Mui |
| author_sort | C. Ross Hatton |
| collection | DOAJ |
| description | Abstract Background Community health improvement plans (CHIPs) are strategic planning tools that help local communities identify and address their public health needs. Many local health departments have developed a CHIP, yet there is a lack of research on the extent to which these plans address root causes of health disparities such as the social determinants of health. This study aims to inventory the social determinants of health included in 13 CHIPs and examine facilitators and challenges faced by local health departments and partners when trying to include the social determinants of health. Methods We conducted a comparative plan evaluation by scoring 13 CHIPs on their inclusion of equity orientation, inclusive planning processes, and five social determinants of health: health care access and quality, the neighborhood and built environment, economic stability, social and community context, and education access and quality. To supplement the plan evaluation, we conducted 32 in-depth interviews with CHIP leaders and stakeholders to understand the factors contributing to the inclusion and exclusion of the social determinants of health in the planning process. Results CHIPs received an average score of 49/100 for the inclusion of the social determinants of health. Most plans addressed health care access and quality and the neighborhood and built environment, but they often did not address economic stability, the social and community context, and education access and quality. Regarding their overall equity orientation, CHIPs received an average score of 35/100, reflecting a relative lack of attention to equity and inclusive planning processes in the plans. Interviews revealed that challenges engaging partners, making clear connections between CHIPs and social determinants, and a lack of capacity or public and partner support often led to the exclusion of the social determinants of health. Recommendations to improve planning processes include improving data infrastructure, providing resources for dedicated planning staff and community engagement incentives, and centering equity throughout the planning process. Conclusions Although local health departments can leverage CHIPs to improve population health and address health disparities, they face a range of challenges to including the social determinants of health in CHIPs. Additional resourcing and improved data are needed to facilitate broader inclusion of these determinants, and more work is needed to elevate equity throughout these planning processes. |
| first_indexed | 2024-03-08T14:11:05Z |
| format | Article |
| id | doaj.art-4ce0d229a9f24065a14648a50b3f4350 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-08T14:11:05Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-4ce0d229a9f24065a14648a50b3f43502024-01-14T12:41:35ZengBMCBMC Public Health1471-24582024-01-0124111610.1186/s12889-023-17496-5Inclusive and intersectoral: community health improvement planning opportunities to advance the social determinants of health and health equityC. Ross Hatton0Rasika Kale1Keshia M. Pollack Porter2Yeeli Mui3Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public HealthDepartment of International Health, Johns Hopkins Bloomberg School of Public HealthDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public HealthDepartment of International Health, Johns Hopkins Bloomberg School of Public HealthAbstract Background Community health improvement plans (CHIPs) are strategic planning tools that help local communities identify and address their public health needs. Many local health departments have developed a CHIP, yet there is a lack of research on the extent to which these plans address root causes of health disparities such as the social determinants of health. This study aims to inventory the social determinants of health included in 13 CHIPs and examine facilitators and challenges faced by local health departments and partners when trying to include the social determinants of health. Methods We conducted a comparative plan evaluation by scoring 13 CHIPs on their inclusion of equity orientation, inclusive planning processes, and five social determinants of health: health care access and quality, the neighborhood and built environment, economic stability, social and community context, and education access and quality. To supplement the plan evaluation, we conducted 32 in-depth interviews with CHIP leaders and stakeholders to understand the factors contributing to the inclusion and exclusion of the social determinants of health in the planning process. Results CHIPs received an average score of 49/100 for the inclusion of the social determinants of health. Most plans addressed health care access and quality and the neighborhood and built environment, but they often did not address economic stability, the social and community context, and education access and quality. Regarding their overall equity orientation, CHIPs received an average score of 35/100, reflecting a relative lack of attention to equity and inclusive planning processes in the plans. Interviews revealed that challenges engaging partners, making clear connections between CHIPs and social determinants, and a lack of capacity or public and partner support often led to the exclusion of the social determinants of health. Recommendations to improve planning processes include improving data infrastructure, providing resources for dedicated planning staff and community engagement incentives, and centering equity throughout the planning process. Conclusions Although local health departments can leverage CHIPs to improve population health and address health disparities, they face a range of challenges to including the social determinants of health in CHIPs. Additional resourcing and improved data are needed to facilitate broader inclusion of these determinants, and more work is needed to elevate equity throughout these planning processes.https://doi.org/10.1186/s12889-023-17496-5Community health improvement plansSocial determinants of healthHealth equity |
| spellingShingle | C. Ross Hatton Rasika Kale Keshia M. Pollack Porter Yeeli Mui Inclusive and intersectoral: community health improvement planning opportunities to advance the social determinants of health and health equity BMC Public Health Community health improvement plans Social determinants of health Health equity |
| title | Inclusive and intersectoral: community health improvement planning opportunities to advance the social determinants of health and health equity |
| title_full | Inclusive and intersectoral: community health improvement planning opportunities to advance the social determinants of health and health equity |
| title_fullStr | Inclusive and intersectoral: community health improvement planning opportunities to advance the social determinants of health and health equity |
| title_full_unstemmed | Inclusive and intersectoral: community health improvement planning opportunities to advance the social determinants of health and health equity |
| title_short | Inclusive and intersectoral: community health improvement planning opportunities to advance the social determinants of health and health equity |
| title_sort | inclusive and intersectoral community health improvement planning opportunities to advance the social determinants of health and health equity |
| topic | Community health improvement plans Social determinants of health Health equity |
| url | https://doi.org/10.1186/s12889-023-17496-5 |
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