How local health departments work towards health equity.

BACKGROUND: Health inequities are exacerbated when health promotion programs and resources do not reach selected populations. Local health departments (LHDs)1 have the potential to address health equity via engaging priority populations in their work. However, we do not have an understanding of what local agencies are doing on this front. METHODS: In the summer of 2016, we collaborated with informants from thirteen LHDs across North Carolina. Via semi-structured interviews, the research team asked informants about their LHD's understanding of health equity and engaging priority populations in program planning, implementation, and evaluation. FINDINGS: All informants discussed that a key function of their LHD was to improve the health of all residents. LHDs with a more comprehensive understanding of health equity engaged members of priority populations in their organizations' efforts to a greater extent than LHDs with a more limited understanding. Additionally, while all LHDs identified similar barriers to engaging priority populations, LHDs that identified facilitators more comprehensively engaged members of the priority population in program planning, implementation, and evaluation. CONCLUSIONS: LHDs are ideally situated between the research and practice worlds to address health equity locally. To promote this work, we should ensure LHDs hold an understanding of health equity, have the means to realize facilitators of health equity work, and recognize the complex context in which health equity work exists.

Improving Population Health by Incorporating Chronic Disease and Injury Prevention Into Value-Based Care Models.

Today's health system transformation provides a prime opportunity to leverage the capacity of public health to reduce the burden of chronic disease and injury, improve population health, and contain health care costs. Health care settings and organizations should support public health capacity as a key investment in population health.

Assessing Preliminary Impact of the North Carolina Community Transformation Grant Project Farmers' Market Initiatives Among Rural Residents.

OBJECTIVE: Using the Social Determinants of Health as the study's theoretical underpinning, the authors examined the impact of the North Carolina Community Transformation Grant Project farmers' market initiatives on changes in awareness and use of farmers' markets, and fruit and vegetable consumption. METHODS: During the farmers' market season, the researchers conducted a random digit-dial telephone survey among residents in 3 rural North Carolina counties to examine changes in farmers' market awareness, shopping, and fruit and vegetable consumption. They examined change over 1 year using t tests, chi-square tests, and propensity score matching. RESULTS: In 1 county there were increases in farmers' market shopping and fruit and vegetable consumption, and in 1 county there were decreases in farmers' market shopping and fruit and vegetable consumption. CONCLUSIONS AND IMPLICATIONS: The impact of farmers' market initiatives may be affected by county-specific socioeconomic contexts.