Degree Name
DrPH (Doctor of Public Health)
Program
Public Health
Date of Award
5-2025
Committee Chair or Co-Chairs
Casey Balio
Committee Members
Kate Beatty, Dawn Rowe, Thomas Quade
Abstract
Introduction: Local health departments (LHDs) use community health assessments (CHAs) and community health improvement plans (CHIPs) to identify and address health needs of the populations they serve. People with disabilities experience health disparities, and there is limited information about how the health needs of people with disabilities are included in CHAs and CHIPs. The purpose of this study was to describe and quantify disability inclusion in LHD CHAs and CHIPs.
Methods: This cross-sectional, mixed methods study used the CHAs and CHIPs of accredited local health departments, data about LHDs and populations served, and interviews with LHD staff and community partners engaged in CHA and CHIP processes that considered disability. Characteristics of disability inclusion in the CHAs and CHIPs were assessed through bivariate and multivariate analyses. A qualitative analysis of the interviews was conducted to describe factors that influenced disability inclusion in the CHIP.
Results: Less than one-quarter of CHIPs included a goal, objective, or activity that specifically included people with disabilities. In the multivariate regression, CHAs and CHIPs that were conducted by a mixed group of community partners were associated with greater odds of having a CHIP goal, objective, or activity that included people with disabilities (adjusted odd ratio (aOR)= 5.40, CI: 1.53-19.14) as well as CHA and CHIP steering committees that included at least one disability partner (aOR=5.65, CI: 1.96-16.32). In the qualitative analysis of the CHA free-text, disability was commonly written as a negative outcome focused on preventing disabilities. The two most common interview themes for building disability inclusion into CHAs and CHIPs were including disability partners throughout the CHA and CHIP process and using disability-inclusive data.
Discussion: Disability inclusion in LHD CHAs and CHIPs is limited. Factors such as who conducts the CHA and CHIP and who participates on the steering committee are correlated with disability inclusion in the CHIP. Understanding the characteristics that support disability inclusion in CHAs and CHIPs and the perspectives of those engaged in disability-inclusive CHAs and CHIPs may help to inform more inclusive CHAs and CHIPs in the future and ultimately to address the health disparities experienced by people with disabilities.
Document Type
Dissertation - embargo
Recommended Citation
Leslie, Haleigh, "Disability Inclusion in Local Public Health Community Health Assessments and Community Health Improvement Plans" (2025). Electronic Theses and Dissertations. Paper 4504. https://dc.etsu.edu/etd/4504
Copyright
Copyright by the authors.