Using a balanced scorecard approach to achieve health equity within a state health department

One of the overarching goals of Healthy People 2020 is to “Achieve health equity, eliminate disparities, and improve the health of all groups.” Public health agencies across the country are working to operationalize this goal within their organizations. However, they face many challenges in translating the evidence base regarding the social determinants of health and the causes of health inequities into public health practice that advances health equity. In 2011, the Delaware Division of Public Health identified health equity as one of its strategic priorities and launched an organization-wide planning effort for its implementation. A consulting firm, the Results that Matter Team, provided technical assistance on strategy map development through the Association of State and Territorial Health Officials. Over the course of 18 months, individuals from across the agency met to develop strategic cross-cutting objectives, and related activities and performance measures. Refinement of the health equity strategy map is ongoing, and will eventually link the Division's comprehensive strategy with a performance management system for tracking progress and improving quality. This presentation will describe the strategy mapping process that was used, highlighting the value of such a planning framework, as well as some of the challenges faced. We believe that sharing early lessons learned from Delaware's experience may benefit other public health agencies as they work to integrate health equity efforts into more traditional public health practice and contribute to the achievement the national Healthy People goal.