Date of Award

Summer 7-14-2021

Degree Type

Dissertation

Degree Name

Doctor of Public Health (DrPH)

Department

Public Health

First Advisor

Collins O. Airhihenbuwa, PhD

Second Advisor

Christine E. Stauber, PhD

Third Advisor

Jeffrey E. Hall, PhD, MA, MSPH, CPH

Abstract

Objective: Local health departments (LHDs) serve as the primary implementer of efforts to prevent, reduce, and eliminate health disparities. Previous research examined the factors that influence the strategies and disease outcomes of health disparity work by LHDs, but little is known about the perception of impact of these strategies. The purpose of this study is twofold: 1) to identify activities from a pre-identified list of nine that current chronic disease personnel perceive as most impactful and 2) identify leader, organization, or external factors that contribute to a local health department's utilizing the activities perceived as most impactful. Methods: LHDs identified by the National Association of County and City Health Officials (NACCHO) were asked to respond to an online cross-sectional questionnaire. Preferred respondents were those who worked in chronic disease prevention. Respondents were asked to select activities viewed as most impactful in addressing health disparities from those that appeared in the 2016 NACCHO Profile of Local Health Departments (Profile). The selection of activities was summed and the top three informed the creation of a variable to conduct regression analysis on a total of 16 leader, organization, and external variables found in the 2016 Profile. Study Population: 482 LHDs selected by NACCHO to complete a bonus module in the 2016 Profile which inquired about activities to address health disparities. Measure: The completion of all three of the activities viewed most impactful activities to address health disparities. Results: 133 individuals from 105 LHD selected the following activities as most impactful: supporting community efforts to change the causes of health disparities; prioritizing resources and programs specifically for the reduction in health disparities; and describing health disparities in your jurisdiction using data. Activities completed as reflected in the Profile indicate that LHDs consistently utilized the first and third activity. Less than half of the time (44%), LHDs indicated that they prioritized resources and programs for the reduction in health disparities. There was no leader characteristic associated with the completion of the three activities. Organization and external characteristics associated with completing these three activities was participation in alcohol and other drug policy advocacy (p

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