Going Above and Beyond: Bridging the Gap Between Equitable Outcomes and Procedural Fairness in Health Policy Administration.

Abstract

Background/objectives: Public health administrators are entrusted to oversee the fair and efficient implementation of public health policy. Professional standards rooted in social justice add an additional ethical standard beyond what is required by procedural equality, reinforcing a service culture of creativity and doing more with less when resources are restrictive. This study explores this phenomenon within the context of government-subsidized opioid use disorder programming in Pennsylvania.

Methods: Twenty-three agencies responsible for opioid treatment referrals in Pennsylvania were surveyed about the effects of meeting social equity needs on their operational and procedural outcomes. Univariate frequencies, cross-tabulations, and percentage comparisons were employed in a descriptive-analytic induction approach to analyze the online survey responses.

Results: The survey results showed that 91.4% of administrators identified transportation equity as an important programmatic concern, with 91.3% developing transportation support for their clients although not required or funded by the grant program.

Conclusions: Equity-focused interventions necessitated operational creativity and sacrifice to maintain compliance while meeting the unique needs of populations, especially when taking geographical differences into account.