Health Disparity Reduction Plan

The Health Disparity Reduction Plan in its entirety was approved on xx/xx/xxxx by the
following:

Eric Edwards, MPA, MCHES Date: _____________

Executive Director/Local Health Officer

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Table of Contents
1. Introduction..............................................................................................................................3
1.1. Purpose............................................................................................................................3
1.2. Background......................................................................................................................3
1.3. Evaluation and Enforcement............................................................................................4
2. Vision, Mission, and Values.....................................................................................................4
2.1 Utah County Health Department Vision, Mission and Values..............................................4
3. Key Terms................................................................................................................................5
4. Strategic Practices Framework for Reducing Health Disparities.............................................5
4.1. Strategic Practice #1 Build Internal Infrastructure..........................................................6
4.2. Strategic Practice #2 Work Across Agencies..................................................................8
4.3. Strategic Practice #3 Foster Community Partnerships....................................................9
4.4. Strategic Practice #4 Expand the Narrative of What Creates Health..............................9
5. Appendices.............................................................................................................................11
5.1. Appendix A: Evaluation and Outcomes Table..............................................................11
5.2. Appendix B: Diversity and Language Assessment Standard Operating Procedures....11
5.3. Appendix C: Planning and Outreach Committee Standard Operating Procedure.........16
6. References..............................................................................................................................22

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 Health Disparity Reduction Plan

1. Introduction

1.1. Purpose
Healthy People 2030’s top priorities include a goal to “eliminate health disparities, achieve
health equity, and attain health literacy to improve the health and well-being of all” i. To better
align with and track efforts to accomplish this goal, the Utah County Health Department
(UCHD) created the Health Disparities Reduction Plan. Efforts to address health gaps and
disparities have been ongoing but require more comprehensive action. The Health Disparities
Reduction Plan intends to help UCHD leadership make decisions and establish procedures and
best practices to increase health and wellness outcomes in Utah County. The plan’s purpose is to
build internal infrastructure, work across agencies, foster community partnerships, and expand
the narrative of what creates health.

1.2. Background
Utah County has a population of approximately 702,000ii.
Table 1. Race/Ethnicity in Utah Countyiii

White 80.2%

Latino/Hispanic 13.1%

Black/African American 0.9%

Asian 2%

Native Hawaiian/Pacific Islander 1%

American Indian/Alaskan Native 0.9%

Other 1.9%

Table 2. Languages Spoken in Utah Countyiv

English 84.88%

Spanish 10.62%

Portuguese 0.79%

Chinese (including Mandarin, Cantonese) 0.72%

Ilocano, Samoan, Hawaiian or other Austronesian 0.40%

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 Languages

Of those that speak Spanish in Utah County, 28.73% report that they speak English less than
very wellv.

The Utah Department of Health and Human Services: Office of Health Equity Utah Health
Improvement Index provides a ranking of Health Disparities from very low to very high for all
Utah small areas. According to the 2022 report, 6 of 18 small areas within Utah County fall
under the high or very high ranking for significant present health disparities. This report
identifies a very high health disparity area as a Utah Small Area where poor health outcomes are
considered to be closely linked to economic disadvantagesvi.
The small areas with very high health disparities are:
• Provo/BYU
• Provo (West City Center)
• Provo (East City Center).
The small areas with high health disparities are:
• Orem (North)
• Orem (West)
• Springville.
Understanding the level of current health disparities can help us understand what areas to target
programs and goals towards in order to increase health outcomes in Utah County.

1.3. Evaluation and Enforcement

The Quality Improvement Specialist will be responsible for reviewing and updating this plan
once a year in preparation for the next year. This update will be informed by the Diversity &
Language Assessment as well as the Community Health Assessment. The plan will be enforced
by the Health Department Executive Staff and will be reviewed by them at least quarterly during
Executive Staff meetings.
2. Vision, Mission, and Values

2.1 Utah County Health Department Vision, Mission and Values

Our Vision
Healthy People in Healthy Communities.
Our Mission

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Promote health and prevent avoidable disease and injury by monitoring the health of our
community, responding to public health emergencies, and assuring conditions in which all
people can be healthy.
Our Values
• Careful, open, and fair consideration of the concerns and cultural values of all people.
• Excellence in science, communications, collaboration, and operations.
• Timely, effective, consistent, and professional customer service.
• Wellness, healthy lifestyles, and a safe and healthful environment.
• Partnerships with private and other public organizations within our community.

3. Key Terms
A. Community Health Worker (CHW): A frontline public health worker who serves
the community in culturally appropriate ways. A CHW attends outreach events,
connects individuals with resources, helps with translation needs, and provides health
education. Doing this, they act as a liaison between health and social services and the
community to facilitate access to services and improve the quality and cultural
competence of service deliveryvii.
B. Health Disparity: A preventable health difference that adversely affects
disadvantaged groups. Health disparities are closely linked with social, economic,
environmental and/or geographic disadvantageviii.
C. Social Determinants of Health: The conditions in which people are born, live, learn,
work, play, worship, and age that affect a wide range of health outcomes and risksix.
D. Underserved Populations: Groups that have limited or no access to resources.
These groups may include people who are socioeconomically disadvantaged, have
low English proficiency, are geographically isolated, lack access to education, or are
elderly, disabled, or of racial/ethnic minoritiesx.

4. Strategic Practices Framework for Reducing Health Disparities

The Utah Department of Health and Human Services created the Health Equity Strategic
Practices Framework as a tool for state, county, and local health leaders to reduce health
disparitiesxi. The framework is meant to provide guidance on implementing disparity reduction
strategies to better serve marginalized communities.
The Health Equity Strategic Practices Framework consists of four strategic practices that are
used to evaluate and implement Health Equity activities.
The first strategy, Building Internal Infrastructure, focuses on building internal capacity within
the agency. This includes expanding the capacity of agency services and establishing plans to
monitor and evaluate progress.

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The second strategy, Work Across Agencies, emphasizes collaborating with state, local, and
tribal leaders as well as healthcare systems. Building these partnerships with diverse stakeholders
leads to improving population outcomes and builds sustainability.
The third strategy, Foster Community Partnerships, involves supporting and engaging with
community groups as well as establishing transparent communication with the community.
The fourth strategy, Expand the Narrative of What Creates Health, is focused on creating a
shared vision with all staff of reducing health disparities. All services, programs, and
communications will be in line with and promote this vision.

Image 1

4.1. Strategic Practice #1 Build Internal Infrastructure

 Goal 1: Improve language accessibility in all programs and services
o UCHD should strive to improve language accessibility in all programs and
services. This can be achieved through one or more of the following proposed
strategies:
 Strategy 1: Hire a Spanish-speaking Public Information Officer
 Strategy 2: Hire a Spanish-speaking communications employee
 Strategy 3: Utilize an existing employee with time and experience to
complete translation for the communications team
 Strategy 4: Utilize several existing employees with time and experience to
form a translation consulting team to complete translation requests sent to
the communications team
 Strategy 5: Pursue funding to fill one of the above language accessibility
positions
 Strategy 6: Pursue funding to compensate employees that are certified
medical interpreters or speak a high demand language

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  Strategy 7: Provide Medical Interpretation Certification training, such as
Bridging the Gap, for current UCHD employees who speak another
language
 Strategy 8: Create a Spanish Terms Guide of preferred language options
for Spanish media materials
 Strategy 9: Alter the communications request form to include a section
that provides the option to receive approval for English and Spanish media
or request Spanish translation of media
 Strategy 10: Using data from the Diversity & Language Assessment,
compile a list of UCHD employees who have the skill and time to
translate and distribute the list to Division Directors
 Strategy 11: Allocate funding from each division for language translation
o Evaluation: Within one year, at least one of the proposed strategies will be
implemented. This will be evaluated by Executive Staff.
 Goal 2: Have an internal Planning & Outreach Committee
o Strategy: Assigned to Health Promotion & Prevention
 Hold monthly Planning and Outreach Committee meetings to improve
department communication and collaboration across divisions.
Additionally, these meetings will provide cultural competency and health
disparity reduction trainings to increase UCHD’s effectiveness in reaching
high-risk populations.
o Evaluation: Within one year, at least 10 Planning and Outreach Committee
meetings will be held. This will be evaluated by Health Promotion & Prevention
Staff.
 Goal 3: Conduct a yearly Diversity & Language Assessment (DLA)
o Strategy: Assigned to Quality Improvement Specialist
 Each year the DLA will be conducted department-wide to assess the status
and capacity of health equity strategic practices. This data will be used to
inform program and division improvements as well as the revision of this
Health Disparity Reduction Plan.
o Evaluation: Within one year, conduct the DLA. This will be evaluated by the
Quality Improvement Specialist.
 Goal 4: Promote diversity within UCHD
o Strategy: Assigned to Program and Division Managers
 UCHD will strive to hire qualified employees with diverse
races/ethnicities, experiences, and backgrounds. UCHD will also strive to
hire employees who speak multiple languages.
o Evaluation: In the results of the DLA, increase the percentage of employees with
diverse races/ethnicities, experiences, and backgrounds to reflect the current
population demographics of Utah County. This will be evaluated by the Quality
Improvement Specialist.

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 Goal 5: Utilize data gathered from the Community Health Assessment to address health
disparities
o Strategy: Assigned to Quality Improvement Specialist
 The Community Health Assessment (CHA) for Utah County will be open
continuously for responses from the community. The data gathered from
this assessment will be analyzed on a yearly basis and used to inform
UCHD programs and services. This data will also be used to update this
plan and assist in ongoing disparity reduction efforts.
o Evaluation: Within one year, gather baseline data of health disparities present in
the community through the CHA to prepare for implementation. This will be
evaluated by the Quality Improvement Specialist.
 Goal 6: Continue to expand UCHD service hours outside of 8am–5pm
o Strategy: Assigned to Executive Staff
 Consider offering alternative office and clinic hours for programs and
services utilized by the community to accommodate clients’ availability.
o Evaluation: Within one year, at least one program has expanded their hours
outside of 8am-5pm. This will be evaluated by Executive Staff.

4.2. Strategic Practice #2 Work Across Agencies

 Goal 1: Utilize partners to reach disparate populations
o Strategy: Assigned to Program and Division Managers
 UCHD should continue to foster and utilize community partnerships to
better reach disparate populations and spread awareness of UCHD
programs and services.
o Evaluation: Within one year, conduct the UCHD Partner Participation Survey and
gather baseline data of employees who agree or strongly agree that their
committees, coalitions and partnerships improve their ability to reach target
populations. This will be evaluated by the Quality Improvement Specialist.
 Goal 2: Consider populations who experience health disparities when developing,
implementing, and evaluating programs and services
o UCHD should strive to address the health disparities that exist in the populations
they serve. This can be achieved through one or more of the following strategies:
 Strategy 1: Executive Staff will provide an annual training for UCHD
employees on developing, implementing, and evaluating programs and
services with disparate populations in mind
 Strategy 2: Executive Staff will create or assign a team to create a best
practice lens for developing, implementing, and evaluating programs and
services with disparate populations in mind
o Evaluation: Within one year, at least one of the proposed strategies will be
implemented. This will be evaluated by Executive Staff.
 Goal 3: Engage with Utah County Health Equity Coalition partners
o Strategy: Assigned to Health Promotion & Prevention Staff

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  Health Promotion & Prevention Staff should strive to maintain Utah
County Health Equity Coalition partnerships to increase UCHD’s reach to
address health disparities.
o Evaluation: Within one year, hold 6 coalition meetings and maintain meeting
attendance at approximately 20 members per meeting. This will be evaluated by
Health Promotion & Prevention Staff as coalition leadership responsibilities are
transitioning to staff in this division.

4.3. Strategic Practice #3 Foster Community Partnerships

 Goal 1: Build community trust
o Strategy: Assigned to all UCHD employees
 UCHD should strive to build trust between UCHD and the Utah County
population by working in the community to create tailored programs that
address populations needs.
o Evaluation: Within one year, gather baseline data through the DLA of employees
who agree or strongly agree that their division tailors programs to population
needs. This will be evaluated by the Quality Improvement Specialist.
 Goal 2: Engage with the community
o A significant part of reducing disparities includes improving accessibility to
services and facilitating means for the community to engage with UCHD services.
This can be achieved through one or more of the following proposed strategies:
 Strategy 1: Ensuring forms, online material, and signage are in English
and Spanish
 Strategy 2: Offering digital and physical copies of surveys and community
health assessments for community involvement
 Strategy 3: Focus outreach at community centers and gathering places of
target populations
o Evaluation: Within one year, at least one of the proposed strategies will be
implemented. This will be evaluated by the Executive Staff.

4.4. Strategic Practice #4 Expand the Narrative of What Creates Health

 Goal 1: All UCHD employees know the UCHD vision and mission statements
o Strategy: Assigned to Executive Staff
 UCHD should strive to keep its vision and mission at the center of all
services. This can be accomplished by including the vision and mission
statements in staff training meetings as well as ensuring it is visible on the
Hub.
o Evaluation: Within one year, gather baseline data through the DLA of employees
who agree or strongly agree they know the UCHD vision and mission statements.
This will be evaluated by the Quality Improvement Specialist.
 Goal 2: Utilize the UCHD Hub for training and onboarding

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 o Strategy: Assigned to Program and Division Managers/Quality Improvement
Specialist
 The UCHD Hub should be used by all programs and divisions during the
onboarding process and throughout employment to receive additional
training. On the Hub, trainings to improve cultural competency, language
accessibility, and disparity reduction efforts will be posted.
o Evaluation: Within one year, gather baseline data through the DLA of employees
who report they refer back to the UCHD Hub often or very often or used the Hub
during their onboarding process. This will be evaluated by the Quality
Improvement Specialist.
 Goal 3: Use communication and promotional materials to address health disparities
o Strategy: Assigned to Communications Team
 Address health disparities in UCHD branding, media, and other materials.
The CHA and Healthy Places Index can be used to determine which
factors to address in these materials.
o Evaluation: Within one year, at least 10 social media posts posted by UCHD will
address health disparities. This will be evaluated by the communications team.

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5. Appendices

5.1. Appendix A: Evaluation and Outcomes Table

Goal/Objective Indicator Method/Activity Responsible/Reporting Target
Party Outcome/Output

1.1 Improve language Number of strategies Log of strategy Executive staff/ Within one year, at least
accessibility in all implemented implementation Executive Director & one of the proposed
programs and services Deputy Director strategies will be
implemented.
1.2 Have an internal Number of Planning & Log of meeting agendas Health Promotion & Within one year, at least
Planning & Outreach Outreach Committee Prevention staff 10 planning and
Committee meetings held each year outreach committee
meetings will be held.
1.3 Conduct a yearly Number of Diversity & Assessment distributed Quality Improvement Within one year,
Diversity & Language Language Assessments Specialist conduct the DLA.
Assessment conducted
1.4 Promote diversity Percentage of Diversity & Language Quality Improvement In the results of the
within UCHD employees with diverse Assessment data Specialist DLA, increase the
races/ethnicities, collection percentage of
experiences, and employees with diverse
backgrounds races/ethnicities,
experiences, and
backgrounds to reflect
the current population
demographics of Utah
County.
1.5 Utilize data gathered Number of times Data collected, Quality Improvement Within one year, gather
from the Community Community Health analyzed, and Specialist baseline data on health
Health Assessment to Assessment data is distributed disparities present in the

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address health distributed to Executive community through the
disparities Staff CHA to prepare for
implementation.
1.6 Expand UCHD Number of programs Log of program and Executive Staff Within one year, at least
service hours outside of and services that offer service hours one program has
8am–5pm extended hours expanded their hours
outside of 8am-5pm.
2.1 Utilize partners to Number of community Community Partner Quality Improvement Within one year,
reach disparate partnerships mobilized Survey Specialist conduct the UCHD
populations Partner Participation
Survey and gather
baseline data of
employees who agree or
strongly agree that their
committees, coalitions
and partnerships
improve their ability to
reach target
populations.
2.2 Consider Number of strategies Log of strategy Executive staff Within one year, at least
populations who implemented implementation one of the proposed
experience health strategies will be
disparities when implemented.
developing,
implementing, and
evaluating programs and
services
2.3 Engage with Utah Number of Utah County Coalition meeting Health Promotion & Within one year, hold 6
County Health Equity Health Equity Coalition attendance record Prevention staff Coalition meetings and
Coalition partners partnerships mobilized maintain meeting
attendance at
approximately 20
members per meeting.

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3.1 Build Community Percentage of Diversity & Language Quality Improvement Within one year, gather
Trust employees that agree of Assessment data Specialist baseline data through
strongly agree their collection the DLA of employees
division tailors who agree or strongly
programs to population agree that their division
needs tailors programs to
population needs.
3.2 Engage with the Number of assessments, Log of English and Communications team Within one year, gather
Community: Assigned forms, online materials, Spanish materials baseline data through
to All UCHD and signage available in distributed the communications
Employees English and Spanish request form regarding
forms, online materials,
and signage that is made
available in English and
Spanish.
4.1 All UCHD Percentage of Diversity & Language Quality Improvement Within one year, gather
employees know the employees that know Assessment data Specialist baseline data through
UCHD vision and UCHD vision and collection the DLA of employees
mission statement mission statements who agree or strongly
agree they know the
UCHD vision and
mission statement.
4.2 Utilize the UCHD Percentage of Diversity & Language Quality Improvement Within one year, gather
Hub for training and employees using the Assessment data Specialist baseline data through
onboarding UCHD Hub collection the DLA of employees
who report they refer
back to the UCHD Hub
often or very often or
used the Hub during
their onboarding
process. .
4.3 Address health Number of UCHD Log of communication Communications team Within one year, at least
disparities in UCHD materials that address materials 10 social media posts

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branding, media, and health disparities posted by UCHD will
other materials address health
disparities.

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5.2. Appendix B: Diversity and Language Assessment Standard Operating
Procedures

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5.3. Appendix C: Planning and Outreach Committee Standard Operating
Procedure

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5.4. Appendix D: Health Equity Strategic Practices Framework

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6. References

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 i
“Health Equity in Healthy People 2030.” Health Equity in Healthy People 2030 - Healthy
People 2030, health.gov/healthypeople/priority-areas/health-equity-healthy-people-2030.
“U.S. Census Bureau Quickfacts: Utah County, Utah.” U.S. Census Bureau,
ii

www.census.gov/quickfacts/fact/table/utahcountyutah/PST045223.
“U.S. Census Bureau Quickfacts: Utah County, Utah.” U.S. Census Bureau,
iii

www.census.gov/quickfacts/fact/table/utahcountyutah/PST045223. .
“Utah Language Data Report.” Utah Department of Health and Human Services,
iv

healthequity.utah.gov/wp-content/uploads/Language-data-report.pdf.
v
“Utah Language Data Report.” Utah Department of Health and Human Services,
healthequity.utah.gov/wp-content/uploads/Language-data-report.pdf.
vi
“Utah Health Improvement Index 2022 Update.” Utah Department of Health and Human
Services, healthequity.utah.gov/wp-content/uploads/Utah-HII-2022-Update.pdf.
“Community health worker resources.” (2022, February 18). Centers for Disease Control and
vii

Prevention. https://www.cdc.gov/chronicdisease/center/community-health-worker-resources.html
“Health Equity and Health Disparities Environmental Scan. Rockville, MD” (2022). U.S.
viii

Department of Health and Human Services, Office of the Assistant Secretary for Health, Office of
Disease Prevention and Health Promotion. https://health.gov/sites/default/files/2022-04/HP2030-
HealthEquityEnvironmentalScan.pdf
ix
“Social Determinants of Health.” Social Determinants of Health - Healthy People 2030,
health.gov/healthypeople/priority-areas/social-determinants-health.
x
“Glossary.” Glossary | FEMA.Gov, www.fema.gov/about/glossary.
“Health Equity Strategic Practices Framework.” (2024). Utah Department of Health and
xi

Human Services, Office of Health Equity.