Characterizing Organizational Health Equity Capacity Assessments for Public Health Organizations: A Scoping Review

Abstract

Objective: Organizational health equity capacity assessments (OCAs) provide a valuable starting point to understand and strengthen an organization’s readiness and capacity for health equity. We conducted a scoping review to identify and characterize existing OCAs. Methods: We searched the PubMed, Embase, and Cochrane databases and practitioner websites to identify peer-reviewed and gray literature articles and tools that measure or assess health equity–related capacity in public health organizations. Seventeen OCAs met the inclusion criteria. We organized primary OCA characteristics and implementation evidence and described them thematically according to key categories. Results: All identified OCAs assessed organizational readiness or capacity for health equity, and many aimed to guide health equity capacity development. The OCAs differed in regard to thematic focus, structure, and intended audience. Implementation evidence was limited. Conclusions: By providing a synthesis of OCAs, these findings can assist public health organizations in selecting and implementing OCAs to assess, strengthen, and monitor their internal organizational capacity for health equity. This synthesis also fills a knowledge gap for those who may be considering developing similar tools in the future.

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

“…Several studies have described how equity in planning, broadly, is consequential for the distribution of resources and opportunities towards systematically disadvantaged and marginalized populations [ 43 , 58 ], and equity in community health planning is no exception. One way to build capacity for centering health equity in CHIPs is by encouraging local health departments and CHIP developers to complete an organizational health equity capacity assessment upfront, to help them assess their understanding of and readiness for health equity [ 59 ]. This exercise could not only promote a greater understanding of equity but also use of a health equity lens when completing the CHIP.…”

A Scoping Review of Health Equity Interventions in Governmental Public Health

“…Previous systematic and scoping reviews on health interventions also yielded a low number of articles (n = 17 and n = 15) where interventions were provided by governmental entities. 15,16 Studies in this literature set focused on: (1) individual-tailored strategies, (2) provider-tailored interventions, and (3) structural or policy changes. Individual-tailored strategies often focused on testing and prevention, while provider-tailored interventions often focused on how to change care practices or provide health education to individuals.…”

“…This evidence map focuses on existing health equity interventions that were implemented by health departments identified in 39 studies published since 2017. Previous systematic and scoping reviews on health interventions also yielded a low number of articles (n = 17 and n = 15) where interventions were provided by governmental entities 15,16…”

“…12 Other national frameworks including Healthy People 2030, the Foundational Public Health Services, and CDC's 10 Essential Public Health Services have also centered equity [12][13][14] and has been a significant increase in the number of governmental entities focusing on health equity and an increase in the proportion of agencies engaging in health equity activities. 15 However, the focus on health equity in health departments may still be emerging and developing; a 2018 study of more than 500 state health department employees across the United States found that nearly 90% of employees reported "not" working on health equity matters. 4 Despite the recent interest and increase in activity related to health equity, there is a lack of available peer-reviewed literature on health equity interventions/programs within health departments either due to limited publication or limited engagement of health equity programming.…”

“…In 2022, equity was added as a Foundational Public Health Service, elevating its importance as a cross-cutting skill and capacity and reinforcing its critical role in ensuring community health and well-being 12. Other national frameworks including Healthy People 2030, the Foundational Public Health Services, and CDC’s 10 Essential Public Health Services have also centered equity12-14 and has been a significant increase in the number of governmental entities focusing on health equity and an increase in the proportion of agencies engaging in health equity activities 15. However, the focus on health equity in health departments may still be emerging and developing; a 2018 study of more than 500 state health department employees across the United States found that nearly 90% of employees reported “not” working on health equity matters 4…”