Seminole County is in east Central Florida just north of Orlando. With an estimated population of 470,093 (as of July 1, 2021), according to the U.S. Census Bureau. Seminole County is also the most densely populated county in Central Florida with a total land area of 309.5 square miles. The county is comprised of seven cities and six unincorporated areas represented by 26 zip codes and 86 census tracts as of the 2010 Decennial Census. 52% of the population is female, 80% Caucasian and 78% non-Hispanic. The Florida Department of Health in Seminole County (DOH-Seminole) serves the community with a mission to protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts.
The Robert Wood Johnson Foundation defines health equity as everyone having a fair and just opportunity to be as healthy as possible. Over the past decades, health equity has become a framework and lens that public health at the local, regional, state, and national level has used to address health disparities, the disproportionate impact in health outcomes and disease, like COVID-19, and systemic barriers impacting the social determinants of health for at-risk, high-need, and priority populations. The Florida Department of Health in Seminole County has been a local leader in health equity through collaboration with grassroots community organizations like the East Goldsboro Council, through the advent of our Community Mobile Health Integrated Services, and through the legacy of systems-change work with our Health Equity Advisory Board.
In alignment with the Florida Department of Health's Office of Minority Health and Health Equity mandated Section 381.735 of Florida Statute, the Florida Department of Health in Seminole County is making health equity more actionable in practice through built capacity for an internal Health Equity team of Minority Health and Health Equity Liaisons, expanded partnership of the Health Equity Advisory Board to a Health Equity Taskforce, the creation of a county health equity plan, health equity training through Equit[y]-easer: A Card Game to Demonstrate Health Equity, and by creating a culture of health equity through operationalizing health equity awareness and implementation as a core employee performance expectation metric.
In April 2022, Equit[y]-easer: A Card Game to Demonstrate Health Equity was offered from the Office of Health Promotion and Education to all DOH-Seminole staff as a training exercise during our mandatory quarterly town hall for all programs. In November 2022, the card game was presented in the Ethics Roundtable format section at the American Public Health Association Annual Conference as a training tool for public health professionals to experience the ethical principles that help shape a culture and system of equitable service delivery to the communities we serve.
To measure the application of equity principles in daily activities, the Office of Health Promotion and Education in collaboration with the Office of Performance and Quality Improvement quantified health equity awareness and implementation through the creation and implementation of a health equity performance metric. The following measurement scale was created as part of employee performance expectations.
5 = Report activities addressing social determinants to achieve health equity related to Community Health Improvement Plan (CHIP) objectives; discuss at meetings on the inequities facing the community and the health department's role in health equity, participates in a health equity basic training provided by DOH-Seminole, and create a health equity profile for their program(s).
4 = Discuss at meetings on the inequities facing the community and the health department's role in health equity, participates in a health equity basic training provided by DOH-Seminole, and create a health equity profile for their program(s).
3 = Participate in a health equity basic training provided by DOH-Seminole and create a health equity profile for their program(s) shared on any internal DOH-Seminole committee meeting.
2 = Participate in creation of program(s) health equity profile(s).
1 = No documentation on health equity activities.
DOH-Seminole is making health equity more actionable in practice through training all staff on equity through an easy-to-understand family card game format, and then measuring the application of this tool's effectiveness in practice through standardizing health equity implementation in every department program. This internal cultural shift in infusing health equity across the board will allow DOH-Seminole to better acknowledge, understand, and address social determinant of health barriers that priority populations in Seminole County face through the integration of more lived experience perspectives, expanding partnerships, and the development of more systems thinking solutions.