TFAH Webinar Series on Achieving Health Equity through Collaborations, Innovative Funding and Leadership.

TFAH’s Fall 2018 4-part webinar series, Taking Action to Promote Health Equity – Using the Lessons from Cutting-Edge Practices to Improve Health and Well Being, features national public health practitioners and community leaders sharing their experiences shaping and executing programs to increase health equity in their communities.  The webinar series is designed to inform a broad, national audience about compelling and replicable health equity initiatives and how to address the grass roots issues that will impact their success.  The programs you will learn about via this series are transferable to diverse communities – large or small, urban or rural, with substantial or minimal resources.

The series is made possible through funding from The California Endowment, the W.K. Kellogg Foundation, and the Robert Wood Johnson Foundation.  TFAH Executive Vice President and COO, Dr. J. Nadine Gracia, is the series moderator.

Segment 1 – Lessons Learned from The California Endowment’s Building Healthy Communities Project

Segment 2 – Show Me the Money – Innovative Funding

Segment 3 – Breaking Out of the Box – Innovative Collaborations

Segment 4 – Creating Change Through Leadership: Two Extraordinary Leaders, a Mother and Daughter, Share their Experiences Promoting Racial Equity

 

 

 

Taking Action to Promote Health Equity Series: Breaking Out the Box – Innovative Collaborations

This is the third installment of TFAH’s 4-part Web Forum series: Taking Action to Promote Health Equity—Using the Lessons from Cutting-Edge Practices to Improve Health and Well Being.

Ensuring lasting community health and equity calls for innovation, collaboration, and a multifaceted approach that addresses underlying determinants of health, including discrimination and poverty. By adopting strategies that include criminal justice reform, local purchasing, job training, community investment, and other endeavors, W.K. Kellogg-funded organizations are contributing to efforts that create equitable opportunity and better meet broader community needs, priorities, and challenges. Please join us for an engaging Dialogue4Health discussion during which leaders and partners describe why they have taken this approach and how it benefits not just their organizations, but the surrounding areas they serve, and ultimately improves health equity.

This event is recommended for anyone working in public health, advocacy, community-based systems, education, faith-based organizations, hospitals/health systems, insurers, local and state health officials, and housing.

Taking Action to Promote Health Equity Series: Show Me The Money – Innovative Funding Approaches to Promote Health Equity

This is the second installment of TFAH’s 4-part Web Forum series: Taking Action to Promote Health Equity—Using the Lessons from Cutting-Edge Practices to Improve Health and Well Being.

Public health organizations often are frustrated by the lack of specialized funding to promote equity. Categorical funding by disease may restrict the types of interventions needed to tackle the complex causes of health disparities. Please join us for this Dialogue4Health Web Forum which will feature place-based initiatives that are leveraging diverse funding, assets, and commitments of multiple sectors, while at the same time involving the community members in meaningful ways to advance health equity. Included in that session will be information on the successful Health Equity Zones in Rhode Island, which has managed the seemingly impossible task of converting categorical funding into community-driven equity work.

This event is recommended for anyone working in public health, advocacy, community-based systems, education, faith-based organizations, hospitals/health systems, insurers, local and state health officials, and housing.

Learn more: dialogue4health.org/web-forums/detail/show-me-the-money

Taking Action to Promote Health Equity Series: Lessons Learned from California Endowment’s Building Healthy Communities

The promotion of health equity is central to Trust for America’s Health’s (TFAH) work to support optimal health for every person and community.

As a part of this effort, TFAH is launching a four-part Web Forum series called Taking Action to Promote Health Equity—Using the Lessons from Cutting-Edge Practices to Improve Health and Well Being. Our goal is to shine a bright light on some of the most compelling and replicable activities that help advance health equity. Program speakers will share their lessons learned through practice and experiences that are transferable to diverse community settings—large or small, urban or rural—and with substantial or minimal resources. And while a few of the examples may be familiar, the Web Forum series will feature excellent work that has not received much national attention.

TFAH designed the series so you can participate in all four Web Forums or any that you want to attend. And when the series is over, they will be available online. Each segment is being planned with substantial time for questions and answers. Furthermore, if the participants identify topics of further interest, TFAH will use that information to plan future Web Forums.

The series will be hosted by J. Nadine Gracia, MD, MSCE, TFAH’s Executive Vice President and Chief Operating Officer, and presented through the Dialogue4Health platform. The first Web Forum of the series will analyze the impact of The California Endowment’s unprecedented Building Healthy Communities initiative. This $1 billion, multi-year effort in 14 communities across California has shown what can be achieved with long-term, community-led, place-based campaigns. The panelists will provide a broad overview of the initiative, highlight two community examples, and equip audience members with strategies and tools they can use to advance health equity in their work and communities.

Learn More: dialogue4health.org/web-forums/detail/taking-action-to-promote-health-equity-lessons

Health Equity/Social Determinants of Health

Research shows that a person’s health is strongly impacted by where they live. In fact, some data suggest that the difference in life expectancy between rich and poor neighborhoods can be as much as 20 years.

Disease rates vary dramatically from neighborhood to neighborhood, county to county.  Evidence-based programs need to be employed to improve the health of all Americans and achieve health equity for all regardless of where a person lives, their race, ethnicity or socioeconomic status.

Building a Community Roadmap to Health and Equity in Jackson, Mississippi

By Beneta D. Burt, Executive Director, Mississippi Roadmap to Health Equity

The Mississippi Roadmap to Health Equity, a community-run organization that seeks to generate and mobilize resources, utilizes our expertise to improve how community institutions operate and, at the same time, protect and promote the health of community members.

By working with everyday institutions that touch everyone’s life, we can advocate for changes that are good for the bottom line and promote better health equity in Jackson. By building important relationships, we can ensure community institutions support the community’s efforts to be healthy—and are true partners in making the healthy choice the easy choice.

How we started

With primary support from the W.K. Kellogg Foundation, Mississippi Roadmap’s work began in 2003 with a series of sessions aimed at addressing why African-Americans are sicker and die sooner than their peers.

Through concept mapping, we identified the many factors that contribute to poor health. And, just one year later, nearly 200 community residents, members of the Mississippi Roadmap Community Steering Committee (CSC) and National Advisory Board members created ideas to improve community health outcomes. Participants laid out a “roadmap” for a healthy present and an even healthier future, especially for the economically-disadvantaged citizens of Jackson. While the state of affairs regarding the health of African-Americans was central to the purpose of the conference, the overall goal was to develop a community-driven health movement that fostered equity, justice and respect for all people.

Initially we set out to improve access to fresh and affordable produce and safe and affordable places for people to exercise – there were simply no grocery stores or farmers’ markets in the area and no price-conscious fitness centers.

To solve these problems, we re-purposed a shuttered grocery store to include:

  • A state-of-the-art adult fitness center;
  • An indoor farmers’ market;
  • A children’ fitness area that accommodates pre-school through teens;
  • Space for healthy cooking classes, in partnership with dietitians from The University of Mississippi Medical Center;
  • A venue for senior citizens to congregate;
  • An affordable rental facility for community events and a venue to convene community conversations; and
  • A Technology Learning Lab that serves 4th and 5th grade students who participate in our afterschool program.

Additionally—in an effort to promote healthy eating habits, to demonstrate to city kids where good food comes from, and to encourage them to eat more fruits and vegetables—we developed 15 garden-based projects in elementary/middle schools in the Mississippi Delta, in Jackson, and on the Gulf Coast.

How we do it

A Community Steering Committee guides our work. An executive director, together with a staff of six, provides day-to-day management. CSC members each have their own “community constituents” who they work with and/or advocate for. These community constituents range from neighborhood associations to church groups to social justice and advocacy organizations—they run the full gamut of the community.

The diversity of ages, backgrounds, interests, professions, and community connections of the CSC members provide access to the pulse of each segment of Jackson and provides a voice for their issues, ideas, needs and concerns.

Going Forward

We are scaling up our work to focus even more on promoting the health and well-being of children by creating job training programs targeted to non-college bound high school graduates and other out of- school youth.

To do so, we began the process of becoming an affiliate of the National Urban League—this vital partnership, which was fully formed in February 2018, will promote employment equity.

Unemployment among teenagers and young adults are major issues in Jackson, especially during the summer, while unemployment among out-of-school youth is equally concerning. In 2016, approximately 600 Jackson high school graduates did not attend college and most had no plans or employment prospects.

In an effort to close this gap, Roadmap entered into a Memorandum of Understanding (MOU) with the City of Jackson in to acquire a city-owned, soon-to-be-shuttered golf course and club house that we will now use to develop a job training program in golf course management designed to develop landscaping-related employment opportunities.

Out-of-school youth will be recruited during the course of the year and enrolled in a GED program provided by Hinds Community College prior to enrolling in the job training program. We will incentivize participant training to encourage consistent attendance and attainment of GEDs prior to transitioning to the program. Additionally, a job developer will work with non-college bound high school seniors in March of each year to prepare them for entering the training program.

Upon completion of classroom and on-the-job training activities, and with Roadmap’s oversight, some participants will bid on landscaping management contracts with local public school districts. Successful bids will result in permanent, unsubsidized employment for participants.

To leverage these relationships and also improve physical fitness, golf pros will develop a program for integration into the curriculum of the local elementary school, which is located next to the golf course. And, a concurrent physical fitness program will be incorporated into the program. Eventually, we hope these plans and resources can benefit the health of the entire community.

Partnerships are Vital

Any measure of success that we have achieved can be attributed to the long-term support from the W. K. Kellogg Foundation, and to the large group of public and private sector members whose actions demonstrate that community partnerships play an integral part in achieving improved health outcomes.  We have the good fortune to have local chefs, hospitals and health professionals, church ministries, and community-academic partners involved.

Just one partnership example: we are the grant recipient in partnership with the Mississippi State Department of Health and the University of Mississippi Medical Center (UMMC). For this grant, the Department of Health provides staff resources and UMMC provides the required match for the project, which allows us to create a culture of breastfeeding among young women in Jackson.                                                                                              

TFAH Releases Special Issue Brief: Racial Healing and Achieving Health Equity in the United States

TFAH Calls for Increased Focus on Addressing Health Inequities and Releases Priority Recommendations to Achieve this Goal

Washington, D.C., January 16, 2018 – Today, Trust for America’s Health (TFAH) released Racial Healing and Achieving Health Equity in the United States, which highlights and acknowledges health inequities, the factors that influences them and highlights policy recommendations that can help the nation achieve health equity.

TFAH issued the brief in conjunction with The Truth, Racial Healing & Transformation’s second annual National Day of Racial Healing, which is intended to identify key steps that will help take collective action to promote positive and lasting change across issues.

“As we mark the annual Martin Luther King Day, we are reminded he said that ‘of all the forms of inequality, injustice in health care is the most shocking and inhumane’,” said John Auerbach, president and CEO, TFAH. “TFAH is proud to be joining the National Day of Racial Healing to acknowledge health inequities in the country and to focus on building a pathway forward toward an equitable and socially just future.”

TFAH has issued the following set of recommendation to help the nation to achieve health equity:

  • Create strategies to optimize the health of all Americans, regardless of race, ethnicity, income or where they live.  All levels of government must invest in analyzing needs and increasing effective policies and programs to address the systematic inequities that exist and the factors that contribute to these differences, including poverty, income, racism and environmental factors. Solutions should feature community-driven tactics, including using place-based approaches to target programs, policies and support effectively.
  • Expand cross-sector collaborations.  Improving equity in health will require supporting and expanding cross-sector efforts to make communities healthy and safe.  Efforts should engage a wide range of partners, such as schools and businesses, to focus on improving health through better access to high-quality education, jobs, housing, transportation and economic opportunities.
  • Fully fund and implement health equity, health promotion and prevention programs in communities. And, partner with a diverse range of community members to develop and implement health improvement strategies.  Federal, state, local and tribal governments must engage communities in efforts to address both ongoing and critical health threats.  The views, concerns and needs of community stakeholders, such as volunteer organizations, religious organizations and schools and universities, must be taken into account in this process.  Proven, effective programs, such as the U.S. Centers for Disease Control and Prevention’s REACH (Racial and Ethnic Approaches to Community Health) program should be fully-funded and expanded.
  • Collect data on health and related equity factors – including social determinants of health – by neighborhood.  There should be a priority on improving data collection at a very local level to understand connections between health status and the factors that impact health to help identify concerns and inform the development of strategies to address them.
  • Support Medicaid coverage and reimbursement of clinical-community programs to connect people to services that can help improve health.  Medicaid should reimburse efforts that support improved health beyond the doctor’s office – for example asthma and diabetes prevention programs and other community-based initiatives can help address the root causes that contribute to inequities.
  • Communicate effectively with diverse community groups.  Federal, state, local and tribal officials must design culturally competent, inclusive and linguistically appropriate communication campaigns that use respected, trusted and culturally competent messengers to communicate their message. Communication channels should reflect the media habits of the target audience.
  • Prioritize resiliency in health emergency preparedness efforts.  Federal, state, local and tribal government officials must work with communities and make a concerted effort to address the needs of low-income, minority and other vulnerable groups during health emergencies. Public health leaders must develop and sustain relationships with trusted organizations and stakeholders in diverse communities on an ongoing basis—including working to improve the underlying health of at-risk individuals, sub-population groups and communities, so these relationships are in place before a disaster strikes.  Communication and community engagement must be ongoing to understand the needs of various populations.
  • Eliminate racial and ethnic bias in healthcare.  Policies should incentivize equity and penalize unequal treatment in healthcare, and there should be increased support for programs to increase diversity in and across health professions.  In addition, efforts should be increased to train more healthcare professionals from under-represented populations so that the workforce reflects the diversity of the patient population.
  • Incorporate strategies that foster community agency—or a community’s collective ability and opportunity to make purposeful choices—into the design, implementation and governance of multi-sector collaborations. Building community agency can contribute to improved community health by yielding a deeper understanding of the challenges and opportunities influencing a community, and relies on an asset-based approach to leverage existing community strengths and resources. Multi-sector collaborations should include dedicated resources for fostering and measuring community agency. Efforts should maximize and bolster community voice and power as a means to influencing larger policy- and systems-level changes (including those within and outside of the traditional health sector).

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.  Twitter: @HealthyAmerica1

Ready or Not? 2017

«state» Achieved «score_num» of 10 Indicators in Report on Health Emergency Preparedness

«state»’s Flu Vaccination Rate is «fvr_num» Percent, «flu_rank_upper»

Washington, D.C., December 19, 2017 – In Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism, «state» achieved «score_lower» of 10 key indicators of public health preparedness.

In total, 25 states scored a 5 or lower—Alaska scored lowest at 2 out of 10, and Massachusetts and Rhode Island scored the highest at 9 out of 10.

The report, issued today by the Trust for America’s Health (TFAH), found the country does not invest enough to maintain strong, basic core capabilities for health security readiness and, instead, is in a continued state of inefficiently reacting with federal emergency supplemental funding packages each time a disaster strikes.

According to Ready or Not?, federal funding to support the base level of preparedness has been cut by more than half since 2002, which has eroded advancements and reduced the country’s capabilities.

“While we’ve seen great public health preparedness advances, often at the state and community level, progress is continually stilted, halted and uneven,” said John Auerbach, president and CEO of TFAH.  “As a nation, we—year after year—fail to fully support public health and preparedness. If we don’t improve our baseline funding and capabilities, we’ll continue to be caught completely off-guard when hurricanes, wildfires and infectious disease outbreaks hit.”

No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Public Health Funding Commitment: State increased or maintained funding for public health from FY 2015 to FY 2016 and FY 2016 to FY 2017. «phfc» 19 + D.C.
2 National Health Security Preparedness Index: State increased their overall preparedness scores based on the National Health Security Preparedness Index™ between 2015 and 2016. «nhspi» 33
3 Public Health Accreditation: The state public health department is accredited. «pha» 30 + D.C.
4 Antibiotic Stewardship Program for Hospitals:  State has 70 percent or more of hospitals reporting meeting Antibiotic Stewardship Program core elements in 2016. «asp» 20 + D.C.
5 Flu Vaccination Rate: State vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2016 to Spring 2017.* «fvr» 20
6 Enhanced Nurse Licensure Compact (eNLC): State participates in an eNLC. «enlc» 26
7 United States Climate Alliance: State has joined the U.S. Climate Alliance to reduce greenhouse gas emissions consistent with the goals of the Paris Agreement. «usca» 14
8 Public Health Laboratories: State laboratory provided biosafety training and/or provided information about biosafety training courses (July 1, 2016 to June 30, 2017). «lab_safety» 47 + D.C.
9 Public Health Laboratories: State laboratory has a Biosafety Professional (July 1, 2016 to June 30, 2017). «phl_staff» 47 + D.C.
10 Paid Sick Leave: State has paid sick leave law. «sick_leave» 8 + D.C.
Total «score_num»

Ready or Not? features six expert commentaries from public health officials who share perspectives on and experiences from the historic hurricanes, wildfires and other events of 2017, including from California, Florida, Louisiana and Texas.

The report also examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies. Some key findings include:

  • Just 19 states and Washington, D.C. increased or maintained funding for public health from Fiscal Year (FY) 2015-2016 to FY 2016-2017.
  • The primary source for state and local preparedness for health emergencies has been cut by about one-third (from $940 million in FY 2002 to $667 million in FY 2017) and hospital emergency preparedness funds have been cut in half ($514 million in FY 2003 to $254 million in FY 2017).
  • In 20 states and Washington, D.C. 70 percent or more of hospitals reported meeting Antibiotic Stewardship Program core elements in 2016.
  • Just 20 states vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2016 to Spring 2017—and no state was above 56 percent.
  • 47 state labs and Washington, D.C. provided biosafety training and/or provided information about biosafety training courses (July 1, 2016 to June 30, 2017).

The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:

  • Communities should maintain a key set of foundational capabilities and focus on performance outcomes in exchange for increased flexibility and reduced bureaucracy.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of core capabilities so they are ready when needed. In addition, a complementary Public Health Emergency Fund is needed to provide immediate surge funding for specific action for major emerging threats.
  • Strengthening and maintaining consistent support for global health security as an effective strategy for preventing and controlling health crises. Germs know no borders.
  • Innovating and modernizing infrastructure needs – including a more focused investment strategy to support science and technology upgrades that leverage recent breakthroughs and hold the promise of transforming the nation’s ability to promptly detect and contain disease outbreaks and respond to other health emergencies.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks.  Develop stronger coalitions and partnerships among providers, hospitals and healthcare facilities, insurance providers, pharmaceutical and health equipment businesses, emergency management and public health agencies.
  • Preventing the negative health consequences of climate change and weather-related threats. It is essential to build the capacity to anticipate, plan for and respond to climate-related events.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop superbugs and antibiotic resistance.
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.
  • Supporting a culture of resilience so all communities are better prepared to cope with and recover from emergencies, particularly focusing on those who are most vulnerable.   Sometimes the aftermath of an emergency situation may be more harmful than the initial event.  This must also include support for local organizations and small businesses to prepare for and to respond to emergencies.

The report was supported by a grant from the Robert Wood Johnson Foundation (RWJF) and is available on TFAH’s website at www.healthyamericans.org.

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’s website.  For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator.  Zero is the lowest possible overall score, 10 is the highest.  The data for the indicators are from publicly available sources or were provided from public officials.

  • 9 out of 10: Massachusetts and Rhode Island
  • 8 out of 10: Delaware, North Carolina and Virginia
  • 7 out of 10: Arizona, Colorado, Connecticut, Hawaii, Minnesota, New York, Oregon and Washington
  • 6 out of 10: California, District of Columbia, Florida, Illinois, Maryland, Nebraska, New Jersey, North Dakota, South Carolina, South Dakota, Utah, Vermont and West Virginia
  • 5 out of 10: Georgia, Idaho, Maine, Mississippi, Montana and Tennessee
  • 4 out of 10: Alabama, Arkansas, Iowa, Louisiana, Missouri, New Hampshire, Oklahoma and Pennsylvania
  • 3 out of 10: Indiana, Kansas, Kentucky, Michigan, Nevada, New Mexico, Ohio, Texas, Wisconsin and Wyoming
  • 2 out of 10: Alaska

 Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. www.healthyamericans.org