Abstract
Conducting Health Equity Data Analyses at the Local Level: Piloting “Using Data to Identify Health Inequities: A Guide for Local Health Departments in Minnesota”
Cate Bosserman1, Ann Kinney, PhD2, Kim Edelman, MPH3, Nora Shields-Cutler, MPH2, Arielle McHenry, MPH2 and Jeanette Raymond4
(1)Minnesota Departmetn of Health, St. Paul, MN, (2)Minnesota Department of Health, St. Paul, MN, (3)Minnesota Department of Health, Minneapolis, MN, (4)Minnesota Department of Health, ST PAUL, MN
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
In April 2016, Minnesota Department of Health (MDH) published “Using Data to Identify Health Inequities: A Guide for Local Health Departments in Minnesota” (Guide). The Guide speaks to the need to develop a new approach for using data to address health inequities, and centers on the idea that health is complex and influenced by many intersecting individual, social, cultural and structural factors. The Guide leads local public health staff through a process for gathering information at each of these intersecting factors in order to identify disparities, investigate causes of health inequities and ultimately use these data to enact policy change.
MDH conducted a pilot in order to test the feasibility of the HEDA process and to inform changes to the Guide. Ten local public health departments across Minnesota were selected from a pool of 20 applicants to participate in the pilot. Pilot departments participated in a seven-month long community of practice (COP), through which MDH provided structured training and technical assistance to participants via a series of webinars, calls, and one in-person meeting.
Throughout the COP, MDH staff conducted a formative evaluation to provide rapid feedback, document lessons learned, and inform future statewide implementation. The evaluation used qualitative methods, including interviews and focus groups with pilot participants and the pilot planning team. MDH staff conducted thematic analysis of interview transcripts using the qualitative analysis software ATLAS.ti 7.5.17, and interpreted findings collaboratively with the pilot planning team.
Conducting a HEDA process at the local level is feasible and valuable for local public health departments. Participants indicated that the HEDA process facilitated the development of new relationships within their communities and advanced organizational discussion of and understanding about local health inequities. Pilot participants faced common challenges in conducting the HEDA, including time and resource constraints and lack of local data. Participants also found it challenging to move discussions with community members and decision makers away from individual causes of health inequities to structural causes. Lastly, HEDA requires a substantial amount of training and technical assistance, especially related to authentic community engagement and qualitative data collection and analysis.
Conduct evaluation related to programs, research, and other areas of practice