Shah Gulzar H, Mase William A, Waterfield Kristie C
Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia.
J Public Health Manag Pract. 2019 Mar/Apr;25(2):171-180. doi: 10.1097/PHH.0000000000000842.
Health disparities and health inequities can lead to poor health outcomes. However, health disparities continue to persist in communities across the United States, presenting a crucial public health challenge. Persisting budget cuts and workforce challenges tend to hinder local health departments' (LHDs') ability to assess and address health disparities.
To examine the extent to which LHDs' use of informatics effects their engagement in strategies and activities addressing health disparities.
Data from the 2016 Profile of LHDs were used in examining the association of informatics with 9 activities addressing health disparities/inequities.
Fifty-nine percent of LHDs used data and described health disparities in their jurisdiction, and 12% conducted original research to link health disparities to differences in social or environmental conditions. Less than 40% of LHDs prioritized resources for the reduction of health disparities. LHDs that implemented information systems had increased odds of describing the disparities in their jurisdiction (P < .01) and having prioritized resources for the reduction of disparities (P < .01). Per capita expenditures, participation in a national accreditation program process, and a larger LHD population were also positively associated with 7 of 9 activities for addressing health disparities/inequities.
As LHDs advance efforts to reduce health disparities and inequities, leadership will find informatics a useful strategy. National initiatives aimed to boost LHDs' engagement in the reduction of disparities might benefit from our findings, positing a positive influence of informatics.
健康差异和健康不平等会导致不良的健康结果。然而，美国各地社区的健康差异依然存在，这是一项严峻的公共卫生挑战。持续的预算削减和劳动力挑战往往会阻碍地方卫生部门（LHDs）评估和解决健康差异的能力。
研究地方卫生部门对信息学的使用在多大程度上影响其参与解决健康差异的策略和活动。
使用2016年地方卫生部门概况的数据来研究信息学与9项解决健康差异/不平等问题的活动之间的关联。
59%的地方卫生部门使用数据并描述其辖区内的健康差异，12%进行了原创研究以将健康差异与社会或环境条件的差异联系起来。不到40%的地方卫生部门将资源优先用于减少健康差异。实施信息系统的地方卫生部门描述其辖区内差异的几率增加（P < 0.01），并且将资源优先用于减少差异的几率也增加（P < 0.01）。人均支出、参与国家认证计划过程以及规模较大的地方卫生部门人口也与9项解决健康差异/不平等问题的活动中的7项呈正相关。
随着地方卫生部门加大减少健康差异和不平等的努力，领导层会发现信息学是一种有用的策略。旨在促进地方卫生部门参与减少差异的国家倡议可能会从我们的研究结果中受益，这些结果表明信息学具有积极影响。
