Electronic Thesis/Dissertation
 

Development of Domains and Novel Assessment Metrics to Advance Health Equity

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Examining the Social Mission of Academic Public Health

This dissertation aimed to define and develop domains for understanding and measuring how academic public health institutions advance health equity and social justice by

Underscores the necessity of bidirectional engagement and localized responsiveness, ensuring that academic public health institutions are rooted in and guided by the needs of the communities they serve. Across each domain, panelists generated a series of indicators – both quantitative and qualitative– that schools of public health could adopt to assess their progress toward equity-centered transformation. The indicators were organized as process-based metrics rather than outcomes-based, reflecting the study’s focus on institutional actionability rather than direct attribution to population-level health improvements. Conclusions

Highlights the importance of diverse representation and inclusive institutional culture, supported by shared governance that empowers all stakeholders in shaping public health education and policy. 5. Accountability, Transparency, and Measurable Performance

and (3) developing process-based indicators for assessing the implementation of practices within those domains. The study purpose is to support development of accountability structures and benchmarking tools that move schools beyond only compliance-based metrics and towards comprehensive indicators of institutional transformation centered on equity and justice. Aims and Methods

Reflects an institution’s explicit mission and policies aimed at advancing the health and well-being of all communities through a demonstrable commitment to societal benefit. 3. Foundation in Social Justice Principles

The Delphi process yielded six final domains of social mission in academic public health, which both overlap with and diverge from frameworks developed in medical and nursing education. The domains are

Emphasizes equipping current and future public health professionals with the skills and knowledge necessary to implement effective, equity-focused interventions and policies. 2. Institutional Commitment to the Greater Good

(2) identifying domains that characterize a public health school’s contribution to advancing equity and justice

This applied, mixed-methods study uses a modified Delphi approach to generate consensus from an expert panel composed of educators, researchers, practitioners, and policymakers in academic public health and social mission work. The study began with a scoping review of existing literature on health equity, accreditation standards, and frameworks from public health associations. The literature informed the design of a novel conceptual framework illustrating how academic public health's three core functions – education, research, and practice – interface with institutional equity commitments.The study produced a working definition and domains of social mission for academic public health and a set of novel assessment metrics. Results

Calls for institutions to track and report progress toward equity goals through transparent metrics, while holding themselves accountable to communities through socially responsive research and practice. 6. Community-Centric Operations

Background

Centers ethical obligations to advance health justice by actively dismantling structural inequities and promoting the equitable distribution of health resources. 4. Diversity, Inclusivity, and Shareholder Engagement

This dissertation provides a foundational framework for defining, assessing, and advancing the social mission of academic public health institutions. By establishing expert-informed domains and developing prototype metrics for institutional self-assessment, the study fills a critical gap in the field’s ability to move from rhetorical support of health equity to demonstrable progress. The social mission framework presented may be used by schools of public health to benchmark their own practices, by accreditors to refine equity-oriented standards, and by professional associations to build collective capacity for transformation. While this study focuses on U.S.-based institutions, the methodological approach and conceptual framework have potential for adaptation in global contexts and domestically for other health professions. Future research is needed to validate the proposed metrics through field testing, explore associations between domain engagement and public health outcomes, and evaluate the influence of institutional structure and policy on social mission performance.

(1) defining “social mission” within the unique context of public health schools

1. Empowerment and Training of Practitioners

Health inequities remain entrenched across racial, socioeconomic, and geographic lines in the United States, often exacerbated by unequal access to resources and social determinants of health. Academic institutions – particularly schools of public health – hold significant power not only through workforce training and development but also through their own institutional policies, research, and community engagement. Despite the potential to be distributors of critical resources to the community, there is a disconnect between the aspirational equity values of academic public health and the tools and standards by which they define, implement, and measure their actual contributions to health equity and social justice. While prior research has explored the concept of social mission in medical and nursing education, there remains a critical gap in defining and operationalizing social mission within public health education. Objectives

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