Evaluating the impact of public health ethics activities

Public health officials often must navigate thorny ethical and professional challenges such as fairly allocating scarce resources or safeguarding the public’s health without unduly encroaching upon personal liberty.  To weigh competing claims, public health ethics offers an appropriate process. It is designed to systematically clarify, prioritize, and justify possible courses of public health action based on ethical principles and stakeholder values, as well as on scientific evidence and other pertinent information.  The importance of having a process in place to address ethical issues has been validated recently by the Public Health Accreditation Board’s (PHAB). PHAB recognizes the importance of understanding the ethical dimension of public health practice for achieving effective measures and policies and for ensuring that decision making is fair, reasonable, transparent, and justifiable. PHAB’s latest iteration of their Standards and Measures now requires documentation of a health department’s capacity to identify, analyze, and resolve ethical issues.  To assist in documenting the impact of public health ethics activities, the CDC Public Health Ethics Unit has initiated an effort to:

• develop a simple logic model that will clarify expected activities and outcomes of a general public health ethics activity.
• identify other key components of a public health ethics activity that will be monitored to help track performance for accountability purposes as well as for making continuous quality improvements.
• develop potential indicators, measures, and related data sources that will monitor the public health ethics activity.  

The presentation will first describe the process used to develop the logic model. It will then discuss the model’s key components, such as suggested outcomes, indicators, and measures, examining them from a short-term, intermediate, and long-term perspective. The influence of contextual factors, such as leadership support, economic environment, political climate, and social factors will also be explored.  The presentation will then consider how demonstrating the impact of a public health ethics activity can benefit local health departments.  Finally, it will highlight some approaches for building public health ethics infrastructure within a local health department.  Sufficient time will be allowed for audience input and for suggestions on how to improve our logic model.