Assessing Local Public Health Agency Alignment With Public Health 3.0: A Content Analysis of Illinois Community Health Improvement Plans

Abstract

Context: Public Health 3.0 described the need for public health agencies and the public health workforce to transform and obtain new skills and approaches to address the social determinants of health (SDOH) through cross-sectoral partnerships and collective action. Objective: To assess the current state of local health departments' Public Health 3.0 alignment through interventions and initiatives documented in community health improvement plans (CHIPs). Method: We conducted a content analysis of Illinois CHIPs from July to November 2020. A coding framework aligned with Public Health 3.0 concepts was developed on the basis of constructs from the literature, faculty expertise, and preliminary reviews of the CHIPs. Two researchers deductively coded for health priorities and interventions in Microsoft Excel 2016 and calculated the number of CHIPs in which each code appeared. Results: Ninety CHIPs representing 98 counties across the state were analyzed; 2 CHIPs were excluded because of a lack of strategies. Our content analysis found that 13% (n = 12) of CHIPs had explicit priorities related to SDOH and 12% (n = 11) included interventions that addressed socioeconomic factors. Ten percent (n = 9) of CHIPs proposed multilevel multicomponent interventions. Eighty-nine percent (n = 80) of CHIPs included community-level interventions, and 53% (n = 48) of CHIPs included policy, systems, and environmental strategies focused on specific health content. The majority of CHIPs (96%; n = 86) had at least 1 partnership strategy. Thirty-two percent (n = 29) of CHIPs mentioned the use of an evidence-based strategy. Conclusions: Our content analysis found opportunities to improve Illinois public health agencies' Public Health 3.0 capacities and capability. Findings are limited to this data source and definitions of the Public Health 3.0 attributes, leaving room for practice and research opportunities to develop operational definitions of Public Health 3.0; capacity building to improve the public health workforce readiness; and research and evaluation to measure improvements.

Inclusive and intersectoral: community health improvement planning opportunities to advance the social determinants of health and health equity

“…In addition, a recent nationwide assessment of CHIPs from over 30 states found that plans generally contain few objectives related to addressing health disparities, particularly for racial, ethnic, and sexual minorities, suggesting that CHIPs can do more to address health disparities [ 26 ]. Similarly, an assessment of CHIPs in Illinois found that very few plans had priorities and interventions related to the SDoH [ 27 ].…”

“…Although some research has reviewed the inclusion of SDoH objectives in CHIPs, a more comprehensive assessment of the specific SDoH present and missing from CHIPs can reveal social determinants that need increased attention to alleviate health disparities [ 27 , 28 ]. Furthermore, to our knowledge, there are unanswered questions regarding the challenges and facilitators of including the SDoH and health equity in CHIPs.…”