State and Territorial Infrastructure for Health Equity and Minority Health.

Objective: With support from the National Partnership for Action to End Health Disparities, the Association of State and Territorial Health Officials conducted a survey of state and territorial health agencies (STHAs) to identify agencies' infrastructure and capacity for addressing health equity and improving minority health outcomes.

Design: The Minority Health Infrastructure Survey was a census design survey distributed to STHAs in 2007, 2010, and 2014. Both cross-sectional and select longitudinal data are presented.

Methods: Descriptive data from the Association of State and Territorial Health Officials' Minority Health Infrastructure Survey were recorded, and χ tests were performed on selected variables.

Results: In 2007, 95.7% of jurisdictions had a primary contact person for health equity initiatives. That number rose to 98.0% in 2010 and to 100% in 2014. In STHAs with a primary contact person, that individual worked full-time on health equity initiatives in 63.6% of STHAs in 2007, 82.0% of STHAs in 2010, and 81.1% of STHAs in 2014. The proportion of STHAs with an organizational unit devoted to minority health was 78.3% in 2007, 90.2% in 2010, and 84.9% in 2014. In 2014, 92.6% of STHAs had included minority health in an agencywide or dedicated strategic plan. The most common strategies for addressing health equity included in strategic plans were collecting and tracking disparities data (91.8%), leveraging and engaging public/private partners in solutions for health disparities (87.8%), and increasing cultural competency or health literacy (87.8%). All respondents collaborated with external partners on health equity initiatives in some way.

Conclusions: STHAs increased their organizational resources to address minority health between 2007 and 2010, but resources leveled off or decreased in some areas between 2010 and 2014. Closing the disparities gap will require substantial nationwide investment and implementing strategies with the potential to make a lasting impact.