Harris County, TX is one of the fastest growing and diverse areas. We have 19% poverty, 78% high school graduation, and 11 zip codes on an air pollution watch list. All cause poor health (Kinder Institute, 2014), and some are avoidable, unnecessary, and reversible (health inequities). Harris County Public Health and Environmental Services (HCPHES) is a local health department in Harris County. In our most recent Agency Strategic Plan, we prioritized the elimination of health inequities. This required HCPHES to move from a health disparities and “improvisational” health equity approach to one that is coordinated, systemic, and institutionalized (NACCHO, 2009). This will also position HCPHES for conformity with new Public Health Accreditation Board (PHAB) requirements on health equity.

We began by selecting best practice process models for agency transformation, including Project Management practices and workforce development (NCHL, National Diversity Demonstration Project, 2009). We then formed a Health Equity Project Team of staff, diverse in demographics, tier, health equity experience, and role in public health practice. The Project Team was charged with conducting AS-IS and TO-BE analyses of health equity practice in HCPHES and to design a comprehensive agency-wide Health Equity Policy that ensures health equity is incorporated into all HCPHES programs, services, human resources, data management, and communications. The policy also puts forth universal health equity terms, frameworks, and staff training plans (Phase 1).  The policy will be implemented in the fall of 2015 (Phase 2).

The intent of this presentation is to share a replicable process for shifting local public health practice in the direction of health equity using internal policy adoption and staff engagement, the outcomes of which will also further attainment of new (version 1.5) PHAB accreditation measures for local health departments.