Local health departments (LHDs) play a critical role in advancing health equity by addressing health threats, collaborating with community partners, and embedding equity considerations into decision-making. However, research highlights gaps in workforce competencies, particularly in the confidence and skills needed to address social determinants of equity, structural racism, and environmental justice.

This article examines the associations of various individual, community, and organizational factors with key competencies, beliefs, and activities reported by LHD staff that are important for advancing health equity.