Public Health Accreditation and Health Equity

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Centers for Disease Control and Prevention Public Health Accreditation and Health Equity CDC Support of Accreditation and Health Equity Activities Liza Corso, MPA Senior Advisor for Public Health Practice and Accreditation Office for State, Tribal, Local, and Territorial Support, CDC June 16, 2017

CDC s Role in Accreditation Support Supporting the national program through PHAB Advancing readiness in the field Funding national partner organizations that provide technical assistance, educational resources, and trainings Accreditation Support Initiative National Public Health Improvement Initiative (NPHII) Public Health Performance Improvement Network (phpin) Annual Public Health Improvement Training (PHIT) Establishing incentives for preparing and for accreditation status Building connections to CDC-supported areas and funding streams

Major Areas of Effort in Accreditation Readiness Building awareness and communication Self-assessment against PHAB standards Cross-agency coordination, identification of documentation, and accreditation process Prerequisites/other key plans and systems Community Health Assessment (CHA) (Standard 1.1) Community Health Improvement Plan (CHIP) (Standard 5.2) Strategic Plan (Standard 5.3) Workforce Development Plan (Standard 8.2) Performance Management System (Standard 9.1) Quality Improvement (Standard 9.2)

Paving the Road to Health Equity https://www.cdc.gov/minorityhealth/publications/health_equity/index.html

Community Health Assessment/Improvement Plans Major area of activity in the field PHAB analysis of early CHAs/CHIPs In-depth analysis of first 53 accredited sites (46 local, 7 state) Assessed under Version 1.0 standards Broad range of partner organizations identified e.g., o 98.1% partnered with healthcare organizations o 94.3% partnered with education o 58.5% partnered with faith-based organizations Diverse types of indicators population outcomes, community outcomes, process outcomes o Many included attention to specific populations 69.8% of CHIPs included indicators addressing social determinants of health/health equity Evaluation data show influence of PHAB standards even among those not formally engaged in accreditation Source: Data provided by the Public Health Accreditation Board.

Data from Accredited Sites Selected Measures Measure 3.1.2 Health education and health promotion strategies 86% (n=175) of health departments fully or largely demonstrated the Version 1.0 measure Equally positive results for sites using Version 1.5 Measure 11.1.3 (11.1.4 in V 1.5) Socially, culturally, and linguistically appropriate approaches in health department processes, programs and interventions 94% (n=175) of health departments fully or largely demonstrated the Version 1.0 measure Equally positive results for sites using Version 1.5 Source: Data provided by the Public Health Accreditation Board.

Annual Reports from Accredited Sites Accredited health departments that have completed at least one cycle of annual reports 73/94 (78%) indicate they have worked on health equity 21 reports provide more detail, such as Partnering/coordinating with other organizations Doing more in-depth analyses of disparities (three sites discuss work at the zip code level) Creating more opportunities for individuals in disadvantaged communities to provide input to health department Working on social determinants such as education, employment-related services, payday loans Training to staff to help them better view work with a health equity lens; four health departments describe creating internal offices or councils focused on health equity Working in areas hit hard by crime or partnering with criminal justice system Source: Data provided by PHAB.

Quotes from the Field The importance of health equity in framing public health efforts has grown substantially within the past few years at the [health department]. Through the use of improved data analysis and sharing, the agency has begun partnering with other organizations on how to best address the barriers and gaps in obtaining optimal health. Quote from an annual report submitted to PHAB by an accredited health department. Accreditation is one of the best leverage points to improve the public health system and success on objective health measures. Statement from a focus group participant in NORC evaluation conducted about PHAB, 2016.

Peer Interaction and Sharing in the Field Health equity as a key topic of interest at major performance improvement meetings Popular query for learning community and performance improvement network exchanges Activities from national partner organizations supporting accreditation readiness and related efforts Health equity resources (e.g., health equity supplement to MAPP) Trainings Issue briefs and stories from the field Health equity-focused workgroups

Selected Resources Accreditation PHAB: www.phaboard.org CDC accreditation web page: www.cdc.gov/stltpublichealth/accreditation Partner accreditation web pages: State: www.astho.org/programs/accreditation-and-performance/ Local: www.naccho.org/topics/infrastructure/accreditation/index.cfm Tribal: www.nihb.org/public_health/accreditation.php; www.nihb.org/tribalasi and http://redstar1.org/resources/ Journal of Public Health Management and Practice January/February 2014 Issue on Accreditation (open access): http://journals.lww.com/jphmp/toc/2014/01000

Thank you! Discussion and Questions For more information, contact CDC 1-800-CDC-INFO (232-4636) TTY: 1-888-232-6348 www.cdc.gov Liza Corso LCorso@cdc.gov 404-498-0313 The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.