Journal of Public Health Management and Practice最新文献

{"title":"Use and Characteristics of Clinical Coding for Post-COVID Conditions in a Retrospective US Cohort.","authors":"Nicole D Ford, Sarah Baca, Alexandra F Dalton, Emilia H Koumans, Julia Raykin, Priti R Patel, Sharon Saydah","doi":"10.1097/PHH.0000000000002137","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002137","url":null,"abstract":"<p><strong>Context: </strong>Little is known about when and how the ICD-10-CM diagnosis code for Post-COVID Conditions (PCC; U09.9) is being used to document PCC.</p><p><strong>Objectives: </strong>To examine the use and characteristics of clinical coding for PCC.</p><p><strong>Design: </strong>A retrospective cohort.</p><p><strong>Setting: </strong>Transaction-level medical encounters, laboratory testing results, pharmacy claims, and medical claims for inpatient and outpatient care from the HealthVerity database.</p><p><strong>Participants: </strong>382 400 US adults and children with private health insurance, Medicare, and Medicaid who had U09.9 code documented during October 1, 2021-June 30, 2023.</p><p><strong>Outcome measures: </strong>Count of first use of the U09.9 code, (a) overall, over time, and proportion by provider type; (b) prevalence of PCC-associated incident conditions co-documented with U09.9; (c) number of documented SARS-CoV-2 infections preceding U09.9; (d) timing between infection and U09.9; (e) encounters during the 6 months following first use of U09.9.</p><p><strong>Results: </strong>Overall, 0.6% of 65 556 068 patients had a PCC diagnosis code (64.6% female; 6 in 10 had ≥1 preexisting conditions). The highest count of new U09.9 codes occurred during Quarter 1 and Quarter 3 of 2022 and was documented by a variety of provider specialties. The most prevalent co-documented PCC-associated incident conditions were respiratory (13.4%) and malaise and fatigue (7.8%). Only 62% of patients had SARS-CoV-2 infection documented preceding U09.9; median time to PCC documentation was 17.0 days (interquartile range [IQR] = 5.0, 61.0). Patients with ≥1 encounters during which PCC was documented in the 6 months following their index encounter (n = 109 794) had, on average, 25.5 additional encounters (median = 14 [IQR = 7, 29]).</p><p><strong>Conclusions: </strong>Our study describes the sociodemographic characteristics, complex clinical manifestations, and high healthcare use of patients following a PCC diagnosis. These findings may inform efforts to identify and treat PCC, inform healthcare planning, and support efforts to educate clinicians about the definition of PCC and accurate application of the code.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active and Passive Vector Surveillance Systems in Lyme Endemic Minnesota and Their Correlation to Human Disease.","authors":"Kathleen E Angell, Janet Jarnefeld, Elizabeth K Schiffman, M Jana Broadhurst, Jianghu James Dong, Abraham Degarege, Roberto Cortinas, David M Brett-Major","doi":"10.1097/PHH.0000000000002140","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002140","url":null,"abstract":"<p><strong>Context: </strong>Vector surveillance is often used to predict tick-borne diseases in endemic regions. Active and passive vector surveillance systems offer differing benefits and limitations; understanding how the outputs of these systems differ and how they correlate to human disease is essential to public health decision-making. Active and passive vector surveillance systems in Minnesota between 2018 and 2023 present an opportunity for comparison between these surveillance methods.</p><p><strong>Objective: </strong>To (1) analyze, compare, and contrast the results of active vector surveillance with crowd-sourced approaches, and (2) explore how these sources predict risk of Lyme disease.</p><p><strong>Methods: </strong>In this ecological comparative analysis, descriptive statistics were performed to evaluate characteristics of each surveillance method to assess differences in seasonality, life stage, and species of ticks. Negative binomial regression was used to analyze correlation to Lyme disease.</p><p><strong>Results: </strong>There are differences between data sources in tick life stage, species, and seasonality. Active surveillance using small mammal trapping had a majority larval (85%) and I. scapularis (76%) ticks. In contrast, passive surveillance had a majority of adult (96%) and D. variabilis (75%) ticks. Observations in both data sources were skewed to the early third of the tick season, although this was more exaggerated in the passive surveillance data. Observations of ticks from both data sources positively correlated with cases of Lyme disease.</p><p><strong>Conclusions: </strong>Observed differences in tick characteristics between the 2 data sources may represent real differences between tick populations and human encounters. Some differences may be explained by observation, reporting, and sampling biases. Increased observations of ticks at the beginning of the season indicate potential utility of enhanced human Lyme disease surveillance at that time. These One Health findings signal an opportunity for early identification of high tick-borne disease years through integrated active and passive tick surveillance that informs the conduct of human disease surveillance.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Definition to Identify Severe Opioid Overdoses Treated in Emergency Departments, 2019-2022.","authors":"Stephen J Liu, Herschel Smith, Vikram Krishnasamy, R Matthew Gladden","doi":"10.1097/PHH.0000000000002045","DOIUrl":"10.1097/PHH.0000000000002045","url":null,"abstract":"<p><strong>Background: </strong>Existing surveillance systems monitor nonfatal and fatal opioid overdoses but do not monitor severe nonfatal overdoses that require intensive medical interventions.</p><p><strong>Methods: </strong>The Centers for Disease Control and Prevention's Drug Overdose Surveillance and Epidemiology system was used to query emergency department data from local syndromic systems and the National Syndromic Surveillance Program from January 2019 to August 2022. Opioid overdoses were classified as not severe or severe using a definition from the patient's chief complaint terms and discharge diagnosis codes. The percentage of opioid overdoses treated in emergency departments classified as severe was described by patient demographics, US Census region, and month.</p><p><strong>Results: </strong>Among 503 156 opioid overdoses in 29 states and Washington, DC, from January 2019 to August 2022, 17.4% were classified as severe. Common key terms found among severe opioid overdoses were hypoxia (34.8%), unresponsive (32.9%), and naloxone/Narcan (20.9%). The largest severity percentage was in the South Census region (19.6%). The trends of severe opioid overdoses remained stable during the study period.</p><p><strong>Discussion: </strong>Based on the severe opioid overdose definition, there was minimal change in the severity of opioid overdoses during the study period. This definition can help monitor trends of severe opioid overdoses, guiding public health action such as focusing on naloxone and fentanyl test strip distribution to areas of need.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"252-262"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reaccreditation and Pathways Recognition Experiences of Small Local and Tribal Health Departments.","authors":"Peg Allen, Matthew Fifolt, Andrew N Crenshaw, Paul C Erwin, Britt Lang, Amy Belflower Thomas, Paul Kuehnert, Ross C Brownson","doi":"10.1097/PHH.0000000000002084","DOIUrl":"10.1097/PHH.0000000000002084","url":null,"abstract":"<p><strong>Context: </strong>This paper describes experiences and views of leadership teams from 4 small local health departments (LHDs) seeking Public Health Accreditation Board (PHAB) reaccreditation or Pathways Recognition using PHAB Standards & Measures Version 2022. The Pathways program launched in 2022 provides additional supports for improvement of public health practice.</p><p><strong>Objective: </strong>Given the need to accelerate accreditation among small health departments, the purpose of this study is to share small health departments' strategies for overcoming accreditation challenges and actionable advice for use by other health departments.</p><p><strong>Design: </strong>In this descriptive qualitative study, the study team conducted 22 individual interviews with 4 small LHDs from January to March 2024.</p><p><strong>Setting: </strong>Participating small health departments were located in the Midwestern and Western United States with staff sizes ranging from 3 to 47.</p><p><strong>Participants: </strong>Interview participants included small health department leadership teams, a local board of health member, and a contracted external accreditation consultant.</p><p><strong>Main outcome measures: </strong>We used a semi-structured interview guide to elicit participant experiences and views on accreditation processes, benefits, facilitators, strategies for overcoming challenges, and advice for other small health departments.</p><p><strong>Results: </strong>Participants suggested that accreditation benefits far outweighed the challenges. Perceived benefits included improved organizational procedures, equitable delivery of needed effective programs and services, and enhanced public perception. Key strategies to overcome staff capacity challenges were establishing a team approach and orienting and mentoring new staff in the \"why\" and \"how\" of accreditation. Advice included learning what is involved, taking the time to lay a foundation beforehand, and not waiting for a perfect time as accreditation is about improvement, not perfection.</p><p><strong>Conclusions: </strong>Small health departments can achieve and maintain PHAB accreditation by strategically implementing strategies to overcome staff capacity and other challenges. The Pathways Recognition program is a supportive option for small health departments wanting to improve public health practice.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"173-182"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modernizing Public Health Data Systems and Workforce Capacity: The Centers for Disease Control and Prevention's Public Health Informatics Fellowship Program.","authors":"Robert D Kirkcaldy, Bradley Biggers, Wilfred Bonney, Jeffrey Gordon, Brianne Yassine, Brandi Crawford, Sridhar Papagari Sangareddy, Laura Franzke, Kyle T Bernstein","doi":"10.1097/PHH.0000000000002048","DOIUrl":"10.1097/PHH.0000000000002048","url":null,"abstract":"<p><strong>Context: </strong>The COVID-19 pandemic exposed governmental public health's outdated information technology and insufficient data science and informatics workforce capacity. The Centers for Disease Control and Prevention's Public Health Informatics Fellowship Program (PHIFP) is well positioned to strengthen public health data science and informatics workforce capacity.</p><p><strong>Program: </strong>Established in 1996, PHIFP is a 2-year, full-time, on-the-job training program. PHIFP includes a didactic curriculum, applied learning through informatics projects completed at the assigned host site, short-term technical assistance projects, and a final capstone project.</p><p><strong>Evaluation: </strong>Fellows have learned from and bolstered host site informatics capacity through the development or enhancement of information systems, evaluations, data integration, data visualization, and analysis. Among recent graduates, 54% are employed at Centers for Disease Control and Prevention and 16% are employed at other public health organizations, including local health departments.</p><p><strong>Discussion: </strong>Fellowships such as PHIFP, which recruit and train promising scientists in public health informatics, are important components of efforts to strengthen public health workforce capacity.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"263-269"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on Public Health Department Accreditation: Lessons Learned From Ohio's Accreditation Mandate.","authors":"Tonni Oberly, Simone R Singh, Amy Bush Stevens, Robin Blair-Ackison, Anna Sheeran, Britt Lang","doi":"10.1097/PHH.0000000000002094","DOIUrl":"10.1097/PHH.0000000000002094","url":null,"abstract":"<p><strong>Context: </strong>Ohio is the only state that requires local health departments (LHDs) to be accredited by the Public Health Accreditation Board (PHAB). As of May 2024, 80% of Ohio's 111 LHDs achieved accreditation, making Ohio the state with the highest proportion of accredited LHDs in the country.</p><p><strong>Objectives: </strong>This study examined the experience of public health accreditation in Ohio including the perceived value of PHAB accreditation for LHDs. It also explored the extent to which perspectives on the value of mandatory accreditation differed between state and local health officials.</p><p><strong>Design: </strong>Data for this study was obtained from 5 focus group interviews with 41 participants, representing state and local perspectives on PHAB accreditation in Ohio. Interviews were recorded, transcribed, and coded using inductive and deductive coding for a thematic analysis.</p><p><strong>Results: </strong>Focus group participants outlined numerous advantages that accreditation has brought to their organizations. Commonly cited benefits include enhancements in quality improvement and performance management, strengthened collaborations and partnerships, improved communications, and optimized resource use. Challenges in achieving accreditation involved the financial expenses associated with the process and constraints on staffing resources. State officials generally expressed positive views on the accreditation mandate, perceiving it as a pathway to modernize the public health system and ensure consistency in service delivery across communities. In contrast, local stakeholders offered more nuanced perspectives and voiced concerns about the intentions behind the mandate.</p><p><strong>Conclusions: </strong>The experience of health officials in Ohio offers lessons for both PHAB and officials in other states working to increase public health department accreditation levels. Successful implementation of accreditation mandates requires trust between state and local partners, open communication, and clarity of purpose. Moreover, attaining accreditation necessitates substantial resources, including technical assistance, financial support, and a robust workforce.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"165-172"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noah Webster's A Brief History of Epidemics and Pestilential Diseases: A Review of His Book With Lessons for Today.","authors":"John S Marr","doi":"10.1097/PHH.0000000000002047","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002047","url":null,"abstract":"","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":"31 2","pages":"213-216"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Los Angeles County Health Survey Outcomes After Transitioning From Telephone to a Primarily Web-Based, Self-Administration Data Collection Mode.","authors":"Taylor Lewis, Naomi Freedner, Nicole Lee, Yan Cui, Monica Rosales, Megha Shah","doi":"10.1097/PHH.0000000000002054","DOIUrl":"10.1097/PHH.0000000000002054","url":null,"abstract":"<p><strong>Context: </strong>As response rates to health surveys conducted by telephone continue to fall while data collection costs rise, practitioners are increasingly transitioning to address-based sample (ABS) designs with a self-administered, mail contact data collection mode.</p><p><strong>Objective: </strong>To compare differences in key health indicators produced from both the Adult Survey and Child Survey of the Los Angeles County Health Survey (LACHS), which transitioned from a telephone to primarily self-administered mode in the 2022-2023 administration.</p><p><strong>Design: </strong>Weighted survey estimates from the 2015, 2018, and 2022-2023 LACHS administrations are compared to investigate differences that may be attributable to LACHS' recent mode transition.</p><p><strong>Setting: </strong>All survey data were collected of residents of Los Angeles County between 2015 and 2023.</p><p><strong>Main outcome measures: </strong>Response rates and key health indicators produced from the Los Angeles County Health Survey.</p><p><strong>Results: </strong>Introducing the self-administration mode led to modest response rate increases of approximately 10% to 16% for the Adult Survey and from 10% to 14% in the Child Survey. Key health indicator differences are mixed, but generally larger in magnitude across the mode transition, and also generally larger for the Adult Survey relative to the Child Survey.</p><p><strong>Conclusions: </strong>Transitioning a population health survey from a telephone mode to a primarily self-administration mode using an ABS design comes with tradeoffs. Increased response rates and a greater ability to target lower-level geographies and other population domains of interest may be offset by mode effects that cannot be compensated for by weighting adjustments.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"E80-E87"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, Evaluation, and Initial Findings of New York State Department of Health Community Drug Checking Pilot Programs.","authors":"Emily R Payne, Guy J Thomas, Matthew Fallico, Allan Clear, Maka Gogia, Lucila Zamboni","doi":"10.1097/PHH.0000000000002061","DOIUrl":"10.1097/PHH.0000000000002061","url":null,"abstract":"<p><strong>Context: </strong>The illicit drug landscape in the United States is dynamic, featuring a risky and erratic drug supply. Drug checking programs (DCP) have been successfully implemented and studied extensively in Canada and Europe but are scarce in the United States. Integrating DCP at harm reduction programs provides an opportunity to engage people at the point-of-care and deliver a combination of harm reduction services, access to healthcare services, and linkages to treatment.</p><p><strong>Program: </strong>The New York State Department of Health (NYSDOH) developed and supports operation of 8 pilot community DCP sites throughout the state. The DCP were trained to utilize Fourier-transform infrared spectroscopy (FTIR) technology to deliver real-time results to participants.</p><p><strong>Implementation: </strong>The NYSDOH community DCP pilot began development in 2022. Partnerships were formed across multiple domains including other DCP, universities, forensic laboratories, syringe service and harm reduction programs, and legal and regulatory offices within the NYSDOH. The first pilot sites began operating in mid-2023 and program expansion is on-going.</p><p><strong>Evaluation: </strong>Evaluation staff were extensively engaged in development and implementation phases. Qualitative evaluation focused on barriers, facilitators, and lessons learned from program staff and technicians. Quantitative evidence was gathered to assess the reach of the DCP and accuracy of results attained by drug checking technicians during their training periods. Drug checking results helped characterize the illicit drug supply.</p><p><strong>Discussion: </strong>Development and implementation of DCP in NYS was facilitated by strong partnerships across sectors including public health and harm reduction. DCP may involve diverse partners who do not regularly collaborate, and health departments are positioned to build relationships and convene partners for program implementation. Evaluation findings highlight the importance of facilitating on-going training and technical assistance to DCP for quality assurance. The initial successes and lessons learned from the NYSDOH DCP demonstrate state public health departments' ability to successfully deploy this innovative harm reduction strategy.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"317-327"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Supports for Implementing Health Equity During National Accreditation Among Small Local Health Departments in the United States.","authors":"Andrew N Crenshaw, Peg Allen, Matthew Fifolt, Britt Lang, Amy Belflower Thomas, Paul C Erwin, Ross C Brownson","doi":"10.1097/PHH.0000000000002096","DOIUrl":"10.1097/PHH.0000000000002096","url":null,"abstract":"<p><strong>Objective: </strong>This article focuses on supports and challenges to health equity that small local health departments (LHDs) experienced while working toward national reaccreditation or Pathways Recognition with the Public Health Accreditation Board's Standards & Measures Version 2022 (PHAB S&M v2022).</p><p><strong>Design: </strong>The study team conducted 22 qualitative interview sessions with members of health department leadership teams.</p><p><strong>Setting: </strong>In the spring of 2024, participants from 4 small LHDs in the western and midwestern regions of the United States participated in individual remote interview sessions.</p><p><strong>Participants: </strong>Participants were members of leadership teams in LHDs with population jurisdictions less than 50 000.</p><p><strong>Main outcome measures: </strong>Common challenges relating to the health equity measures in the PHAB S&M v2022 included external influences on equity language; lack of small population data; and racially and ethnically homogeneous populations and staff. The main support was the national equity standards provided justification for pursuing equity work.</p><p><strong>Results: </strong>Strategies to overcome challenges associated with the equity measures included staff training, seeking alternative equity language, and examining socioeconomic inequities in addition to race and ethnicity. Internal workforce understanding of health equity was improved through department-wide training initiatives. When working under restrictive language requirements for state agencies, grants, and other funding sources, staff suggested using alternative phrases and keywords such as level playing field and equal access . When addressing racially and ethnically homogenous populations, staff pursued equity in terms of income and focused on those living with pre-existing conditions (ie, diabetes).</p><p><strong>Conclusions: </strong>Ensuring that LHDs can work toward health equity is crucial for reducing health inequities. While the equity focus of PHAB S&M v2022 proved challenging, for this selection of LHDs, participants affirmed that PHAB accreditation allowed them to solidify their equity work to better serve their communities.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"196-203"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}