IDEAS home Printed from https://ideas.repec.org/a/plo/pgph00/0004068.html
   My bibliography  Save this article

Individual and organizational factors associated with public health workforce competencies to advance health equity

Author

Listed:
  • Paula M Kett
  • Shahida Shahrir
  • Betty Bekemeier
  • Kay Schaffer
  • Danielle J Zemmel
  • Davis G Patterson

Abstract

Little is known about how to develop public health workforce capacity for health equity work. We explored associations of individual and organizational characteristics of local public health departments (LHDs) with competencies essential for advancing health equity. Data included responses of 29,751 staff from 742 LHDs in 48 states to the 2021 Public Health Workforce Interests and Needs Survey, plus LHD characteristics and county demographics. Logistic regression assessed associations between key factors and staff-reported “knowledge of” and “confidence in addressing” structural racism, health equity, social determinants of equity (SDoE), social determinants of health (SDOH), and environmental justice, as well as belief and involvement in addressing racism through one’s work. Staff with a master’s degree or higher compared to others had greater odds of reporting confidence in addressing structural racism (adjusted odds ratio [AOR] = 1.23) and health equity (AOR = 1.56), agreeing that addressing racism should be a part of their work (AOR = 2.45) and being involved in such efforts (AOR = 1.57). Staff identifying as Black, compared to white, had greater odds of reporting confidence in addressing all concepts: structural racism (AOR = 1.98), health equity (AOR = 1.34), SDoE (AOR = 1.53), SDOH (AOR = 1.21), and environmental justice (AOR = 1.72) and agreeing that addressing racism should be a part of their work (AOR = 2.11). Patterns were similar among staff identifying as Hispanic/Latino and other persons of color. Black (AOR = 0.68) and Hispanic/Latino (AOR = 0.83) staff had lower odds, however, of reporting engagement in activities to address racism. Finally, competencies positively associated with nearly all outcomes included cross-sector collaboration, ability to incorporate health equity into programming, and policy advocacy. LHD workforce development should include training that involves explicitly naming structural racism’s effects and complementary skills, such as policy development and cross-sector partnership building. Further exploration is needed into how best to grow commitment among white staff and to support staff of color in health equity work.

Suggested Citation

  • Paula M Kett & Shahida Shahrir & Betty Bekemeier & Kay Schaffer & Danielle J Zemmel & Davis G Patterson, 2025. "Individual and organizational factors associated with public health workforce competencies to advance health equity," PLOS Global Public Health, Public Library of Science, vol. 5(1), pages 1-19, January.
    • Handle: RePEc:plo:pgph00:0004068
    DOI: 10.1371/journal.pgph.0004068
    as

    Download full text from publisher

    File URL: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0004068
    Download Restriction: no
    File URL: https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0004068&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pgph.0004068?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Ford, C.L. & Airhihenbuwa, C.O., 2010. "Critical race theory, race equity, and public health: Toward antiracism praxis," American Journal of Public Health, American Public Health Association, vol. 100(S1), pages 30-35.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Layland, Eric K. & Maggs, Jennifer L. & Kipke, Michele D. & Bray, Bethany C., 2022. "Intersecting racism and homonegativism among sexual minority men of color: Latent class analysis of multidimensional stigma with subgroup differences in health and sociostructural burdens," Social Science & Medicine, Elsevier, vol. 293(C).
    2. Slaughter-Acey, Jaime C. & Brown, Tony N. & Keith, Verna M. & Dailey, Rhonda & Misra, Dawn P., 2020. "A tale of two generations: Maternal skin color and adverse birth outcomes in Black/African American women," Social Science & Medicine, Elsevier, vol. 265(C).
    3. Came, Heather, 2014. "Sites of institutional racism in public health policy making in New Zealand," Social Science & Medicine, Elsevier, vol. 106(C), pages 214-220.
    4. Scott, Darius, 2022. "Uncaring landscapes and HIV peer support in the rural Southern United States," Social Science & Medicine, Elsevier, vol. 292(C).
    5. Hicken, Margaret T. & Kravitz-Wirtz, Nicole & Durkee, Myles & Jackson, James S., 2018. "Racial inequalities in health: Framing future research," Social Science & Medicine, Elsevier, vol. 199(C), pages 11-18.
    6. Smith-Morris, Carolyn, 2017. "Epidemiological placism in public health emergencies: Ebola in two Dallas neighborhoods," Social Science & Medicine, Elsevier, vol. 179(C), pages 106-114.
    7. Chandra L. Ford & Bita Amani & Nina T. Harawa & Randall Akee & Gilbert C. Gee & Majid Sarrafzadeh & Consuela Abotsi-Kowu & Shayan Fazeli & Cindy Le & Ezinne Nwankwo & Davina Zamanzadeh & Anaelia Ovall, 2021. "Adequacy of Existing Surveillance Systems to Monitor Racism, Social Stigma and COVID Inequities: A Detailed Assessment and Recommendations," IJERPH, MDPI, vol. 18(24), pages 1-18, December.
    8. Paris Ekeke & Dara D. Mendez & Toby D. Yanowitz & Janet M. Catov, 2020. "Racial Differences in the Biochemical Effects of Stress in Pregnancy," IJERPH, MDPI, vol. 17(19), pages 1-15, September.
    9. Jason L. Cummings, 2023. "Entangled Inequalities: U.S. Trends in Self-Rated Health at the Intersection of Gender and Race, 1972–2018," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 169(3), pages 759-774, October.
    10. San Juanita García & Taylor Trummel & Monica Cornejo & Katherine Maldonado & Ana Ojeda & Humberto Flores & Bruce G. Link, 2021. "Immigrant Health Inequities: Exposing Diversions and White Supremacy," Social Sciences, MDPI, vol. 10(9), pages 1-22, September.
    11. Pichardo, Catherine M. & Chambers, Earle C. & Sanchez-Johnsen, Lisa A.P. & Pichardo, Margaret S. & Gallo, Linda & Talavera, Gregory A. & Pirzada, Amber & Roy, Amanda & Castañeda, Sheila F. & Durazo-Ar, 2023. "Association of census-tract level gentrification and income inequality with 6-year incidence of metabolic syndrome in the Hispanic Community Health Study/Study of Latinos, an epidemiologic cohort stud," Social Science & Medicine, Elsevier, vol. 336(C).
    12. Ryan J. Petteway & Lourdes A. González, 2022. "Engaging Public Health Critical Race Praxis in Local Social Determinants of Health Research: The Youth Health Equity and Action Research Training Program in Portland, OR—yHEART PDX," IJERPH, MDPI, vol. 19(13), pages 1-16, July.
    13. Jeffrey Olivet & Catriona Wilkey & Molly Richard & Marc Dones & Julia Tripp & Maya Beit-Arie & Svetlana Yampolskaya & Regina Cannon, 2021. "Racial Inequity and Homelessness: Findings from the SPARC Study," The ANNALS of the American Academy of Political and Social Science, , vol. 693(1), pages 82-100, January.
    14. Came, H. & Doole, C. & McKenna, B. & McCreanor, T., 2018. "Institutional racism in public health contracting: Findings of a nationwide survey from New Zealand," Social Science & Medicine, Elsevier, vol. 199(C), pages 132-139.
    15. Kathomi Gatwiri & Leticia Anderson, 2020. "Boundaries of Belonging: Theorizing Black African Migrant Experiences in Australia," IJERPH, MDPI, vol. 18(1), pages 1-13, December.
    16. Came, Heather & Griffith, Derek, 2018. "Tackling racism as a “wicked” public health problem: Enabling allies in anti-racism praxis," Social Science & Medicine, Elsevier, vol. 199(C), pages 181-188.
    17. Kathomi Gatwiri & Darlene Rotumah & Elizabeth Rix, 2021. "BlackLivesMatter in Healthcare: Racism and Implications for Health Inequity among Aboriginal and Torres Strait Islander Peoples in Australia," IJERPH, MDPI, vol. 18(9), pages 1-11, April.
    18. Ford, Chandra L. & Airhihenbuwa, Collins O., 2010. "The public health critical race methodology: Praxis for antiracism research," Social Science & Medicine, Elsevier, vol. 71(8), pages 1390-1398, October.
    19. Lynn N. Ibekwe & Maria Eugenia Fernández-Esquer & Sandi L. Pruitt & Nalini Ranjit & Maria E. Fernández, 2021. "Racism and Cancer Screening among Low-Income, African American Women: A Multilevel, Longitudinal Analysis of 2-1-1 Texas Callers," IJERPH, MDPI, vol. 18(21), pages 1-19, October.
    20. Belak, Andrej & Filakovska Bobakova, Daniela & Madarasova Geckova, Andrea & van Dijk, Jitse P. & Reijneveld, Sijmen A., 2020. "Why don't health care frontline professionals do more for segregated Roma? Exploring mechanisms supporting unequal care practices," Social Science & Medicine, Elsevier, vol. 246(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pgph00:0004068. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: globalpubhealth (email available below). General contact details of provider: https://journals.plos.org/globalpublichealth .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.