Taking a step back: One public health department's year long initiative to look beyond health services to address health disparity

A priority issue for public health is the disparity that continues to exist in most health outcome measures based on race, ethnicity or socioeconomic differences, and is evident in our county-wide data. Public health practitioners have been striving to alleviate these differences by focusing health education and prevention interventions on specific population subgroups. Although well-intended, this approach has been unsuccessful in substantially alleviating health disparity.

A new approach that moves beyond health interventions to a focus on addressing the social determinants of health is key to eliminating health disparity. Our health department developed a year long learning module to introduce social equity to the Board of Health, County Commissioners, community leaders, and staff. The curriculum is based on the Unnatural Causes: Is Inequity Making Us Sick? series, including material from the companion website. Audiences received at least one 30-60 minute session and participated in social equity discussions. An survey was administered at the start and end of the intervention to assess changes in opinions about the importance of social determinants of health. City leaders were recognized for their policy work that positively influenced health disparity.

The learning sessions were well received by participants who were made much more aware of the impact of social inequity on health. Future health department strategies are focused on social policy and environmental change more than individual-based programming. Our model curriculum can be easily adapted for other health departments and community leaders. Impact on health disparity will be tracked in future county wide data collection.