final exploring social determinants of health through ... · public health law series webinar:...

Public Health Law Series Webinar

Exploring Social Determinants of Health through a Public Health Law Lens

Thursday, July 14, 2016

Public Health Law Series Webinar: Exploring Social Determinants of Health through Public Health Law Lens

How to Use Webex

Audio: If you can hear us through your computer, you do not need to use your phone. Just adjust your computer speakers as needed.

Support: If you need technical assistance, call Webex Technical Support at 1-866-863-3904.

Submitting Questions: All participants are muted. Type a question into the Q & A panel for our panelists to answer. Submit your questions at any time during webinar.

Recording: This webinar is being recorded. If you arrive late, miss details or would like to share it, we will post link to the recording at www.networkforphl.org/webinars after the session has ended.

Public Health Law Series Webinar: Exploring Social Determinants of Health through Public Health Law Lens

How to Use Webex

Accessing Network webinars from your mobile device: You can now access and fully participate in Network webinars on the go using the WebEx app for Apple or Android.

o Download the app.

o Register for a webinar on the Network website, then use the event number provided in your attendee email to connect via the mobile app.

Public Health Law Series Webinar: 4Shared-Use Agreements to Support Public Health

Public Health Law Series Webinar

Exploring Social Determinants of Health through a Public Health Law Lens

Thursday, July 14, 2016

Public Health Law Series Webinar:Taking on Tobacco RegulationPublic Health Law Series:

Moderator

Exploring Social Determinants of Health through Public Health Law Lens

Donna Levin, National Director, Network for Public Health Law

J.D., Northeastern University School of Law

Areas of expertise: Social determinants of health Health equity Newborn screening Health insurance consumer protections Emergency public health response Medical marijuana


Presenter Introduction

Scott Burris, Professor of Law and Public Health, Temple University; Director, Center for Health, Law, Policy, and Practice; Director, Public Health Law Research

J.D., Yale Law School

Research interests/areas of expertise: Social determinants of health HIV/AIDS Global health governance Health effects of criminal law and drug policy




Dawn Pepin, Public Health Analyst, Carter Consulting, Inc., Public Health Law Program, Centers for Disease Control and Prevention

J.D., Seton Hall University School of Law M.P.H., Johns Hopkins University

Research interests/areas of expertise: Health equity Health crisis and humanitarian assistance Vulnerable populations




Ellie Gladstone, Senior Staff Attorney, ChangeLab Solutions

J.D., University of California, Davis M.P.H., University of California, Berkeley

Areas of expertise: Social determinants of health Inequities in access to recreational space Engaging faith‐based organizations in community health

and wellness efforts


Click to edit Master title style

Social Determinants and LawyersWorking our Way Upstream

Scott BurrisProfessor of Law and Public Health, Temple UniversityDirector, Public Health Law Research Program

Bad News: Mortality

Bad News: Inequality

Piketty T, Saez E. Inequality in the long run. Science. 2014 May 23, 2014;344(6186):838‐43.

Social Determinants

Social Determinants

Social determinantsof health(e.g., inequality)

Particular pathologies(e.g., HIV)

Individual interventions: Helping people cope with current environment

Structural interventions: Changing the environment

Social Determinants

Social determinantsof health

Particular killers

Individual interventions

Changing the environment

CVD meds

Social Determinants


Particular killers



CVD medsStress‐reduction counseling

Social Determinants


Particular killers



CVD meds

No smoking laws

Stress‐reduction counseling

Social Determinants


Particular killers



CVD meds

No smoking laws

Greater equality at work and in the community

Stress‐reduction counseling

Social Determinants





Dignity – Equality ‐‐Cooperation – Security ‐‐Morality – Opportunity ‐‐ Care

Social Determinants






gReduce smoking

Social Determinants






gReduce smoking

ppSocial support

Social Determinants






gReduce smoking

Health care

ppSocial support

Ways law matters


Health

Criminal justice

School disciplineOSH and work lawHousingPublic safetyDrug policy

Ways law matters


Health

1. Laws shape contexts

Criminal justice


Ways law matters


Health

1. Laws shape contexts

2. Laws influence behavior

Criminal justice


Law: Missing in Action?

Law: Missing in Action?

Deaths attributable to:Racial segregation: 176,000Low education: 245,000

Kingdon Streams

Politics

Policy

Problem

A Long‐Term Perspective

Impact

Arguments that work now

Arguments that work in 20 years

Arguments that work in 10 years

Legal Scholarship

Transdisciplinary Health Law

Help Engaging Communities and Building Political Will

Help Engaging Communities and Building Political Will

Expertise in Designing Legal

Solutions

Expertise in Designing Legal

Solutions

Support for Enforcing and Defending Legal

Solutions

Support for Enforcing and Defending Legal

Solutions

Policy Surveillance

and Evaluation

Policy Surveillance

and Evaluation

Access to Evidence and Expertise

Access to Evidence and Expertise

Better Health Faster

Summary

ENGAGETIME

Summary

ENGAGETIME

ENGAGE

SCIENCE

PRACTICE

ADVOCACY

Centers for Disease Control and Prevention

New Tools to Achieve Health Equity: Section 1557 of the Affordable Care Act

Dawn Pepin, JD, MPHPublic Health AnalystCarter Consulting, Inc.Public Health Law ProgramOffice for State, Tribal, Local and Territorial SupportCenters for Disease Control and Prevention

CDC Public Health Law Program DisclaimerThe contents of this presentation have not been formally disseminated by the Centers for Disease Control and Prevention (CDC) and should not be construed to represent any agency determination or policy.

These course materials are for instructional use only and are not intended as a substitute for professional legal or other advice. Always seek the advice of an attorney or other qualified professional with any questions you may have regarding a legal matter.

Health Disparities in the United States

Healthcare disparity – “Differences in group in access to care, quality, and coverage”

Health disparity– “Higher burden of illness, injury, disability, or mortality experienced by

one population group relative to another group.” Disparities in Health and Health Care: Five Key Questions and Answers, Kaiser Family Foundation, last accessed May 9, 2016.Image: Equity and social justice, Kingcounty.gov, Last Updated October 27, 2015

Health Disparities and Discrimination in the United States

Proposed 45 CFR Part 92

“Discrimination in the healthcare context can often lead to poor andinadequate health care or health insurance or other coverage forindividuals and exacerbate existing health disparities in underservedcommunities.”

– Why?• Postponing or not seeking care• Being denied the opportunity to get care to begin with

– What is the result?• Care is not getting to those who need it most• Higher costs from more complicated care, lost wages, lost productivity

What Section 1557 of the ACA does Prohibits discrimination on the basis of

– Race, color, and national origin– Sex – Age – Disability

Prohibits discrimination by– Any health program or activity that received federal

• Credits • Subsidies• Contracts of insurance• Executive agency programs• Programs under this title 1 (or amendments)

42 U.S.C.A. § 18116; Proposed 45 CFR 92

What Section 1557 of the ACA does Prohibits discrimination on the basis of

– Race, color, and national origin – Sex – Age – Disability

Prohibits discrimination by– Any health program or activity that received federal

• Credits • Subsidies• Contracts of insurance• Executive agency programs• Programs under this title 1 (or amendments)

42 U.S.C.A. § 18116; Proposed 45 CFR 92

Enforcement

• Federal• HHS Office for Civil Rights

• Federal courts

What is missing?

Sexual Orientation Chronic Disease Etc.

States

For more information, contact CDC1‐800‐CDC‐INFO (232‐4636)TTY: 1‐888‐232‐6348 www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Dawn [email protected]

• Presented by• Ellie Gladstone, Senior Staff Attorney

Beyond Statutes & Regulations:Increasing Recreational Access with

Shared Use Agreements & Policies

July 14, 2016

• Healthier communities for all through better laws and policies.

Disclaimer

The information provided in this discussion is for informational purposes only, and does not constitute legal advice. ChangeLab Solutions does not enter into attorney-client relationships.

ChangeLab Solutions is a non-partisan, nonprofit organization that educates and informs the public through objective, non-partisan analysis, study, and/or research. The primary purpose of this discussion is to address legal and/or policy options to improve public health. There is no intent to reflect a view on specific legislation.

© 2016 ChangeLab Solutions

Public Health Law and Policyare more than just

legislation

Hospital policyLocal ordinances Zoning language Resolutions

School/agency policy language

Contracts/agreements State/federal laws

University policy Organization policy Hospital policy

How do you build ahealthy community?

Shared Use Occurs When…

• government entities or nonprofit organizations

• agree to open or broaden access

• to facilities • for community use

Increase opportunities for physical activity

Getting from here…

…to here

Low-income communities and communities of color are more likely to lack safe, well-maintained parks and other recreational spaces


School district policy language



Formalizing Shared Use

Creative Commons Flickr: jk5854

1) Shared Use Agreements

2) School District Policies

Shared Use Agreements

• Formal contract• Between > 2 parties• With terms and

conditions • For use of the

property

Shared Use Agreement: Lemon Grove, CA

Photo credit: Lemon Grove HEAL Zone

School District Policies

• Community Use of Facilities

• Open Use

Community Use of Facilities

Open Use Policies

• Community access• For individual play

and recreation• For free• Without formal

partnership or agreement

Open Use Policy: Hamilton County, TN


School district policy language




School/agency policy language



can depend on state law

Feasibility and success

AuthorityLiabilityFunding

Shared Use Resources

www.ChangeLabSolutions.org/shared-use

ChangeLabSolutions.org

Thank [email protected]

Public Health Law Series Webinar:

Q&A

Please type your questions in the Q&A panel.

Shared-Use Agreements to Support Public HealthExploring Social Determinants of Health through Public Health Law Lens

Public Health Law Series Webinar:

Thank you for attending

Please join us for this upcoming webinar:

Combating the Zika Virus: Mosquito‐Control and the Law

Thursday, July 21| 2:30 – 4:00 p.m. (ET)

Learn more at: networkforphl.org/webinars


final exploring social determinants of health through ... · public health law series webinar:...

Documents