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Part of the SS/HS Framework Implementation Toolkit 1. Plan2. Implement3. Sustain and ExpandDisparities Impact Statement Worksheets 1: Develop Local DIS CommitteeDevelop an inclusive local committee
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To fill out the disparities impact statement worksheet, follow these steps:
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Begin by gathering relevant data and information regarding the subject of the disparities impact statement.
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Open the worksheet template and review the provided sections and prompts.
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Start with the first section of the worksheet and enter the necessary details as requested. Be sure to provide accurate and specific information.
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Who needs disparities impact statement worksheet?

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The disparities impact statement worksheet may be required by various organizations, institutions, or agencies that are conducting assessments, evaluations, or audits related to disparities in certain areas.
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These can include governmental bodies, research institutions, social impact organizations, healthcare providers, educational institutions, or any entity that aims to measure and address disparities in areas such as healthcare, education, employment, housing, justice, or civil rights.
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The specific need for the disparities impact statement worksheet will depend on the objectives and requirements of the organization or agency requesting it.
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Disparities impact statement worksheet is a tool used to assess the impact of disparities in different areas such as education, healthcare, and employment.
Government agencies, organizations, and companies that receive federal funding or contracts are required to file disparities impact statement worksheet.
Disparities impact statement worksheet should be filled out by providing data and analysis on disparities in various areas, as well as proposed strategies to address them.
The purpose of disparities impact statement worksheet is to identify and address disparities in different aspects of society, and to ensure that resources are allocated equitably.
Information such as demographics, outcomes, trends, and proposed interventions must be reported on disparities impact statement worksheet.
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