Developing State Health Improvement Plans: Exploring States' Use of Healthy People

Abstract

Background: While Healthy People outlines a national framework for improving the health of the nation, many states develop State Health Improvement Plans (SHIPs) to set priorities to improve the health of their residents. The purpose of this study was to understand the processes that states use to develop their SHIPs, how states align their SHIPs with Healthy People, and challenges that states face using Healthy People. Methods: NORC conducted semistructured interviews with 9 state health department representatives who were responsible for SHIPs. The responses were analyzed using qualitative thematic analysis. Results: State health departments used similar approaches to develop their SHIPs. Generally, states began the SHIP development process by performing community health assessments and then assembling diverse stakeholders to recommend key priority areas that should be addressed in the SHIP. States used a similar framework for their SHIPs, outlining priority areas, indicators, and targets. All respondents reported that they referenced Healthy People during the development of their SHIPs. Some states reported aligning their state plans with the Healthy People Framework, while others focused more on the specific Healthy People objectives or target setting guidance. Conclusions: Both the federal government and state public health agencies rely on input from stakeholders and cross-sector collaboration to ensure their initiatives reflect the diverse needs of their population. Stakeholder engagement is increasingly important as public health professionals are shifting toward a health equity approach that considers social determinants outside of the health care sector. Healthy People continues to strengthen this perspective by outlining national priorities on well-being while incorporating language around health equity issues. Reinforcing relationships between the federal government and state public health can help states better understand the role of Healthy People as well as encourage further dissemination of creative strategies and best practices.

Using Healthy People as a Tool to Identify Health Disparities and Advance Health Equity

“…Federal agencies often align grant funding opportunities with Healthy People priority areas, including the SDOH and health equity. Locally, states often use Healthy People as a resource for their state health improvement plans 11. In addition, Healthy People is used broadly as a resource to explore priority populations for specific areas of interest and find evidence-based resources to help address these priorities.…”

“…Locally, states often use Healthy People as a resource for their state health improvement plans. 11 In addition, Healthy People is used broadly as a resource to explore priority populations for specific areas of interest and find evidence-based resources to help address these priorities. As we build on the knowledge from Healthy People 2020, Healthy People 2030 can be leveraged to advance health equity and respond to identified health disparities and inequities that emerge throughout the decade (Figure 3 ).…”

Moving the needle on health inequities: principles and tactics for effective cross-sector population health networks

“…Many healthcare providers, public agencies, and service- and community-based organizations across sectors are committed to helping communities reduce health disparities that stem from widespread inequality. However, they cannot effectively promote population health and reduce health inequities without aligning and coordinating with stakeholders outside their own sector [ 4 ▪ , 5 ]. Pediatric healthcare providers have historically been limited to using clinical interventions to influence the health of individual children [ 6 ].…”

The Ever-Evolving Nature of Health Literacy in Organizations: A Commentary on the 2021 JPHMP Article “Updating Health Literacy for Healthy People 2030”

“…H ealthy People is a data-driven policy framework that public health managers and practitioners use to guide their work (eg, collaborations, logic models). 1 In 2021, JPHMP published the article by Santana et al, titled “Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health.” 2 Their article informs public health managers and practitioners that, henceforth with Healthy People 2030 , 2 definitions of health literacy—that is, individual and organizational—will be used to appraise how well health promotion efforts align with the framework's objectives. 3 Santana et al relay that organizational health literacy is defined as “the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.” 2 (pS259) This formal definition of organizational health literacy is new to the framework, though efforts to promote something to its effect have been around for some time (eg, training manuals and workshops teaching health care providers how to be clear and effective in their communication with patients).…”