how do you operationalize health equity? · 2019-05-31 · foundational definitions . health...
TRANSCRIPT
How Do You Operationalize Health Equity?
How Do We Tip The Scale?
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Why Look Through A Health Equity Lens:
• A large body of research has been well a established. This research has lead us to understand that there are complex interplay going on that impacts one’s health aside from a person’s genetics, or individual behavior. This leads researchers to a strategic focus on population health.
• Health disparities are growing, particularly with chronic diseases and infectious disease; these disparities are disproportionately impacting communities of color. Women of child bearing age are getting chronic illnesses at an earlier age, such as diabetes and high blood pressure.
• It is arguably that the current health care system favors the better
off, and may set up health inequalities. • To improve the health outcomes of the population, it is vital to
focus on ensuring everyone has an opportunity to achieve their optimal level health.
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Foundational Definitions Health Disparities-closely linked to social economic status for those who have been historically discriminated against due to race, ethnicity, social economic status, gender, or other marginalized characteristics. Health Inequalities –Differences in health that is seen as unjust, unfair, and avoidable. Health Equity –the obtainment of the highest level of health for everyone. Social Determinants of Health-conditions where a person is born, live, work, age, go to school and these conditions are shaped by policies, structures, systems, and political powers. Health In All Policies –Is an approach working across multiple sectors to address health equity.
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A Different Directions
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Focus on Five Strategies
1. Implementing Culturally and Linguistic Appropriate Services
2. Utilization of quantitative and qualitative data to guide
transformative interventions 3. A commitment to not just stopping at transactional
strategies, a having a broader transformational change in mind from the start.
4. Community driven, community lead interventions 5. Internal reflection
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Culturally & Linguistic Appropriate Services
• Ensuring there is representation of the community served at the table
• Language barriers perpetuate quality of services • Materials in the preferred language • Access to interpreting services • Having a language access plan in place • Addressing Health Literacy
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Data
In an effort to meet the needs of the diverse populations, hospitals and health systems will need to use data to bridge the gap, between collecting meaningful patient data and reviewing the data to identify inequities in health care provisions and utilization, and to implement simple yet effective interventions to improve care for patients.
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Commitment To Policy & System Changes Using Collective Impact
Collective Impact is the
commitment of a group of actors from different sectors forming a common agenda for solving a specific social problem, using a structured form of collaboration
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Community Engagement 16 Week Program Free to your community partners Subject areas from: importance of using and
collecting quantitative and qualitative data, clinical trails, photo voice, grant writing workshops, looking at social determinants of health
Faculty from universities, health department, and community health centers.
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Reflecting Internally
• Conducting Health Equity Assessment • Health Equity Policy • Checklist for developing policies looking through
a health equity lens • Language Access Plan • Assurance Statement for sub grants, etc. • Health Equity Plan for the organizations
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Resources Black and Minority Health-The Heckler Report 1985 Crossing The Quality Chasm: A New Health System for The 21st Century Unequal Treatment Confronting Racial and Ethnic
Disparities Health Care, 2002 HHS Action Plan to Address Health Disparities, 2011 Health In All Policies: A Guide for State and Local Government, 2003
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Conclusion
Change will not come if we wait for some other person, for some other time. We are the ones we’ve been waiting for. We are the change that we seek. Barrack Obama
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Dr. Tanya Funchess Mississippi State Department of Health Director, Health Equity [email protected].
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Operationalizing Health Equity Strategy and Sharing
Michael L. Jones, PhD(c), RN, MSN, MBA Associate Director, Medical & Clinical Operations
Optum Population Health Management Mississippi & California
Healthy Start Regional Meeting June 13, 2017
Videos
What is Health Equity? https://www.youtube.com/watch?v=ZPVwgnp3dAc
Social Determinants of Health https://www.youtube.com/watch?v=_11xLlwKgWc
Social Determinants of Health (Clinical) https://www.youtube.com/watch?v=I7iSYi3ziTI
Health Equity
Health equity is achieved when every person has the opportunity to “attain his or her full health potential” and no one is “disadvantaged from achieving this potential because of
social position or other socially determined circumstances.”
(Centers for Disease Control and Prevention, 2014)
Achieving Health Equity
Social Determinants of Health (as defined by the CDC)
“Social determinants of health are economic and social conditions that influence the health of
people and communities. These conditions are shaped by the amount of money, power, and resources that people have, all of which are
influenced by policy choices.”
(Centers for Disease Control and Prevention, 2014)
Social Determinants of Health (as defined by the WHO)
“Social determinants of health are conditions in which people are born, grow up, live, work and
age, including their health. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics.”
(World Health Organization, 2010)
Social Determinants of Health (as defined by the WHO)
There are Ten (10) Components:
The Social Gradient Stress Early Life Social Exclusion
Work Unemployment Social Support Addiction
Food Transport
(World Health Organization, 2010)
Social Determinants of Health Ten Components
Component Explanation
1. The Social Gradient Life expectancy is shorter and most diseases are more common further down the social ladder in each society.
2. Stress Stress is damaging to health and may lead to premature death.
3. Early Life The health impact of early development and education lasts a lifetime.
4. Social Exclusion Hardship and resentment, poverty, social exclusion, and discrimination costs lives.
(World Health Organization, 2010)
Social Determinants of Health Ten Components (continued)
Component Explanation 5. Work Stress in the workplace increases the
risk of disease. People who have more control over their work have better health.
6. Unemployment Job security increases health, well-being, and job satisfaction. Higher rates of unemployment causes more illness and premature death.
7. Social Support Friendship, good social relations, and strong, supportive networks improve health at home, at work, and in the community.
(World Health Organization, 2010)
Social Determinants of Health Ten Components (continued)
Component Explanation 5. Work Stress in the workplace increases the
risk of disease. People who have more control over their work have better health.
6. Unemployment Job security increases health, well-being, and job satisfaction. Higher rates of unemployment causes more illness and premature death.
7. Social Support Friendship, good social relations, and strong, supportive networks improve health at home, at work, and in the community.
(World Health Organization, 2010)
Social Determinants of Health Ten Components (continued)
Component Explanation 8. Addiction Individuals turn to alcohol, drugs, and
tobacco, and suffer from their use, but use is influenced by the wider social setting.
9. Food Because the global market forces control the food supply, healthy food is a political issue.
10. Transport Healthy transport means less driving and more walking and cycling, backed up by better public transport.
(World Health Organization, 2010)
Partnerships
Partnerships
Faith-Based Community
Community-Based Organizations Trust building Community engagement Community empowerment
Policy Makers State, Local, and National
Partnerships
Clinical-Community Delivery Systems Academic/Community-Based Organization Managed Care Organizations Others
Education
Education
Policy Makers
Community-based Education Health Advocates Lifestyle Coaches Community Health Workers
Social Determinants of Health Healthcare Professionals
Disease Self-Management
Chronic Diseases Diabetes Hypertension Congestive Heart Failure Arthritis
Patient Empowerment
Community Empowerment
Improved Health Outcomes
Summary
Addressing the Social Determinants of Health is essential to improving health outcomes.
The engagement of community partners is essential to addressing the many health care issues facing Mississippians.
The health care environment of Mississippi heavily depends upon it.
Contact Information
Michael L. Jones, PhD(c), RN, MSN, MBA
Email: [email protected]
Phone: 601-594-2387
Charlene Collier MD, MPH, MHS Perinatal Health Policy & Research Consultant
Mississippi State Department of Health
Disparities in Birth Outcomes Preterm Birth Infant Mortality
Sleep Related Infant Deaths Low Birth weight Maternal Mortality
Mississippi Infant Mortality
Achieving The Highest Level of Health For All Moms And Babies
Image Adapted from: https://www.google.com/search?q=road+with+obstacles&safe=active&rls=com.microsoft:en-US:IE-Address&source=lnms&tbm=isch&sa=X&ved=0ahUKEwio-_rlubjUAhVs4YMKHbh-AFsQ_AUICigB&biw=1920&bih=911#imgrc=CtbQlBd15aYpkM:&spf=1497275483098
• Stress •Poverty •Poor Nutrition •Reduced Education •Chronic Health Problems •Environment/Pollution •Racism
• Adequate prenatal care •Adequate obstetric and newborn care
MSDH Initiatives Sisters United Fetal Infant Mortality Review Program
Sisters United African American Sorority Graduate Chapters Adapted from Arkansas Program for Mississippi Train-the-Trainer Model Trainers returned to train their chapters & host
community based education events
Sisters United- Focus Areas Folic Acid Safe Sleep Breastfeeding Healthy Weight Before Pregnancy YouTube Video with MS Doctors
Sisters United Events 12 Train the Trainer Sessions 121 Sorority Members Trained by Team Leads Year 1: 6 community Events, 199 attendees Year 2: 16 community Events, 560 attendees Year 3 ( June 2017) 8 community Events, 425 attendees
Fetal Infant Mortality Review Program Action-oriented community process Continually assesses, monitors, and works to improve
Service systems Community resources
Local Review of Fetal and Infant Deaths Case Review Team Maternal/Family Interview Community Action Team
Focus on Psychosocial/Systems Issues
Three Active State Reviews District IX- Coast, Cheryl Doyle, RN District VIII, Hattiesburg, Gail Jones, RN Delta- Healthy Start/Tougaloo College,
Arletha Howard, MSN, RN Carol Mack, LCSW Glennis Patton, RN, Jodi Bailey, RN
Successes Coast Hospitals Showing Safe Sleep Video to Parents Coast Hospitals Display Safe Sleep Poster in Patient Rooms Safe Sleep Conferences on Coast, Open to Community Grandparent Education Classes Expanded Prenatal Education Infant CPR Classes Cahoma County Church Outreach- Letter
Healthy Start- Maternal Interview Beyond medical record review Simultaneously gather information & provide support Prevention & ‘Treatment’ Understand current needs & share resources
Summary Empower communities to drive change Use DATA and PERSONAL STORIES Be comfortable with differences
Doing the SAME for every group won’t close the gap
Thank You [email protected]