Assessing local health department capacity to address health inequities: Organizational self assessment tool

The Bay Area Regional Health Inequities Initiative (BARHII) is a collaboration of eight Bay Area public health departments (PHDs) striving to formulate a new approach to eliminate health inequities and create healthy communities. The primary focus is the underlying social conditions that contribute to disproportionate rates of preventable disease and death in certain communities and on the institutional policies and practices that shape those conditions. BARHII provides a forum in which PHDs can learn from each other as they attempt to change their practice and engage more effectively in activities at a regional level, including policy advocacy and interaction with regulatory and planning agencies.

BARHII's Internal Capacity Committee (ICC) has been developing strategies to transform local health departments by identifying the organizational capacities that are essential to effectively address these issues. ICC members participated in a series of consensus-building discussions to consolidate the resulting matrix of eighteen workforce competencies and organizational standards which will serve as the basis for future capacity building within PHDs.

During this process, an organizational self assessment was identified as an effective tool for gauging the extent to which the essential LHD capacities were present and consistently applied in LHDs. These original concepts have been supplemented with a broader base of public health expertise and organizational development literature. The final product; a comprehensive Self Assessment Tool is currently being piloted in City of Berkeley Public Health Department. The tool, lessons learned from the tool development and piloting process, and recommendations for adaptation will be shared.