Date of Submission


Document Type


Degree Name

Doctor of Health Science


Health Sciences

First Advisor

Marquita A. Taylor, Ph.D.

Second Advisor

Mary V. Lamothe, Ph.D.

Third Advisor

De`Anna Z. Bond, Ph.D.


Health Equity, Health Inequities


Health care reform, Health services accessibility


Health equity refers to the opportunity for every person to be as healthy as possible. Unfortunately, people of color continue to face differences in health outcomes and are negatively impacted by health inequities. Local health departments (LHDs) are positioned to address health equity as these departments provide core services that improve community health. The Connecticut Department of Public Health created the Healthy Connecticut 2025 framework, which outlines strategies that address the social determinants of health (SDOH) that in turn influence health inequities. However, it is unclear what LHDs in Connecticut are doing to address the SDOH. Therefore, this study investigated how LHDs are utilizing the Healthy Connecticut 2025 framework to achieve health equity, as well as their successes and challenges in doing so. This study also explored whether differences in health equity efforts exist among LHDs in low- and high-income cities.

To gain insight into the health equity work being done in Connecticut, eight LHD key informants were interviewed. Each interview was transcribed and coded for themes. The four themes that were identified include: initiatives and programs that address the Healthy Connecticut 2025 priority areas vary; external resources contribute to successful health equity initiatives and programs; LHDs have the desire to do more despite barriers; and the COVID-19 pandemic emphasized the need to lead with a health equity lens.

The results indicate that most LHDs are working to address health equity in their communities through collaboration with community partners, grant funding, and community health improvement plans. Yet, it is evident that some LHDs want to do more to guarantee that they are meeting the needs of their community by incorporating a health equity lens. Future research should continue to examine how to address the barriers that LHDs continue to encounter when working on health equity initiatives and how LHDs can successfully build capacity to take on health equity work.

Available for download on Friday, September 19, 2025