Philadelphia Health Department pursues national accreditation

After months of work, the Philadelphia Health Department is preparing an application for national accreditation. The process has been a rigorous one, with leaders reviewing hundreds of health measures across the city.

Accreditation is new for health departments, but the Centers for Disease Control and Prevention backs it and has indicated that some future funding will likely depend on it. A private nonprofit organization developed the standards, which local health officials say are aimed at advancing the quality and performance of U.S. health departments.

So far, 31 departments nationwide have been accredited, but none is in Pennsylvania, Delaware or New Jersey. Officials with Philadelphia’s department say they plan to submit their application in the next few weeks, with the hope of becoming accredited next year.

“It’s a long and complex process, particularly for a big city health department,” says Dr. Donald Schwarz, director of Philadelphia’s health department.

The assessment

As part of the application, the department conducted a citywide health assessment, looking at more than 300 health measures and indicators. Using that information, the department and community stakeholders then separately defined their health priorities for Philadelphia. The idea was that both plans could help shape future efforts to improve the city’s health.

Schwarz recently went over these health measures and priorities with students at Drexel University School of Public Health. He found that some measures have improved, such as life expectancy. Infant mortality, he said, is at its lowest rate since Philadelphia started tracking those numbers.

Far less encouraging and even “ridiculous,” he said, is the rate of hospitalization for children with asthma. For every 100,000 kids, about a thousand were hospitalized in Philadelphia, based on 2010 data from the Pennsylvania Health Care Cost Containment Council. That’s compared with about 473 asthma hospitalizations per 100,000 kids in 2000.

Schwarz also stressed how health disparities emerge, even amid improvements, when looking more deeply at zip code, race and ethnicity.

“People who live just a mile or so apart live very different lives, different quality of lives, here in Philadelphia,” he said.

The priorities

After reviewing these measures, the department established four main priorities moving forward: women and infant health, sexual health, chronic diseases related to tobacco and environmental health.

A group of about 150 hospital, academic, nonprofit and community representatives also met several times between May and November of last year, examining those same health measures and establishing their own priorities for the city.

Jennifer Kolker, associate dean at Drexel’s School of Public Health, led that effort. Recurring themes included “the realization that there’s a huge backdrop of social determinants around poverty and education and poor housing that’s going to influence health, the need to close the gap on health disparities and a real desire to change the context and do things that will really make an impact on the largest number of people,” she said.

The group identified access to care, behavioral health, and reducing chronic disease that’s associated with unhealthy eating and physical activities as their main priorities.

Kolker and Schwarz expected that city and community priorities would differ. Access to care and behavioral health, for example, extend beyond the health department’s role and scope, says Kolker. Even so, Schwarz said, the differences provide a good teaching moment for how the department communicates its priorities.

“The biggest things that surprised me was what people weren’t interested in,” says Schwarz. “Everyone’s interested in obesity, behavioral health issues. People were less interested in smoking than I thought, less interested in environmental health. I don’t think we’ve done a good job to show what can be done to improve the whole city’s health.”