A Multisectoral Approach to Advance Health Equity in Northern Arizona: County-level Leaders’ Perspectives on Health Equity

Abstract Background Multisectoral and public-private partnerships are critical in building the necessary infrastructure, policy, and political will to ameliorate health inequity. By focusing on health equity, researchers, practitioners, and decision-makers make explicit the systematic, avoidable, unfair, and unjust differences in health status across population groups sustained over time and generations, beyond the control of individuals. Health equity requires a collective process in shaping the health and wellbeing of the communities in which we live, learn, work, play, move, and grow. Methods Data are drawn from the Southwest Health Equity Research Collaborative Regional Health Equity Survey (RHES). RHES is a community-informed, cross-sectional online survey comprised of 31 quantitative and 17 qualitative questions. Generated to elicit an interdisciplinary body of knowledge and guide future multisectoral action for improving community health and well-being, the RHES targeted leaders representing five large rural northern Arizona counties and 13 distinct sectors. To explore, multisectoral leaders’ knowledge, attitudes, and actions to address the social, environmental, and economic conditions that produce and sustain health inequity were analyzed using a priori coding scheme and emergent coding with thematic analysis. Results Although leaders were provided the definition and asked to describe the root causes of inequities, the majority of leaders described social determinants of health (SDoH). When leaders described root causes of health inequity, they articulated systemic factors affecting their communities and described discrimination and unequal allocation of power and resources. Most leaders described the SDoH of their communities by discussing compounding factors of poverty, transportation, and housing among others, that together exacerbate inequity. Leaders also identified specific strategies to address SDoH and advance health equity in their communities, ranging from providing direct services, to activating partnerships across organizations and sectors in advocacy for policy change. Conclusion Our findings indicate that community leaders in the northern Arizona region acknowledge the importance of multisectoral partnerships and collaborations in improving health equity for the populations that they serve. However, a common understanding of health equity remains to be widely established, which is essential for conducting effective multisectoral work with the goal of advancing health equity.