225838 Public Health Service Disparities: An issue of social justice

Wednesday, November 10, 2010 : 9:00 AM - 9:15 AM

Alberto J.F. Cardelle, PhD, MPH , MPH Program, East Stroudsburg University, East Stroudsburg, PA
Victoria Montero, MPH , Community Health Department, St. Luke's Hospital and Health Network, Bethlehem, PA
Barbara Tornatore, MPH, CHES , Department of Health, East Stroudsburg University, East Stroudsburg, PA
There has been significant work completed on the factors that contribute to health care disparities, highlighting both disparities by geographic areas and demographic sub-groups. However, there has been limited analysis of this type of disparity with regard to basic public health services. The existing analysis of the quality of local health departments by NACCHO and the Public Health Accreditation Board are important components in the effort to strengthen the country's public health infrastructure. However, the analyses overlook issues of disparity that exist between areas with basic public health services and those that lack even a basic local health department, and the social and economic factors that contribute to it.

Using the case of Pennsylvania which has the lowest public health workforce in the country, this paper uses GIS mapping to identify areas of public health service disparity. The analysis first maps the entire state by areas with high and low number public health workers per capita (as an indirect measure of access). The analysis then construct various layers of data to establish spatial correlation between the areas of disparity and a) socio-economic characteristics, b) political representation, c) demographic characteristics, and d) levels of existing health services.

The initial results show that significant disparity exists. In certain areas of the state a single zip code boundary changes the complement of public health workers from 24 per 100000 to 2. The initial results also show that these disparities are positively correlated with limited political representation, lower population density, and rapid population growth.

Learning Areas:
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
1) Describe types of public health infrastructure disparities. 2) Discuss GIS applications. 3) Discuss the factors associated with public health infrastructure.

Keywords: Public Health Infrastructure, Funding

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Public health policy researcher
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.