Title: HEALTH EQUITY THROUGH SOCIAL JUSTICE
1HEALTH EQUITY THROUGH SOCIAL JUSTICE
- RE-ENGAGING LOCAL PUBLIC HEALTH
- Connecticut Association of
- Directors of Health, Inc
- 2005
2What is Health Equity?
- Is this reducing health disparities or is it
something different? - Health equity points to the elimination of
disparities in adverse health status and outcomes
through social, economic, environmental and
political processes
3BACKGROUND
- CADH HEALTH DISPARITIES
- CADH/NACCHO PARTNERSHIP
- UNIVERSAL HEALTH CARE FOUNDATION OF CT
4Anthem Foundation
- Health Equity Project Year One
- Asking Public Health Four questions
5OBJECTIVES-YEAR ONE
- 1--Assess the views of local public health
directors on public healths role in achieving
health equity - 2--Identify and convene critical
- stakeholders (HEAT)
- 3--Delineate what local health departments could
do to address the issues of inequality,
discrimination, unequal distribution of resources
and opportunities - 4--Develop an RFP for pilot sites
6HEALTH EQUITY ACTION TEAM(HEAT)
- Statewide, Multidisciplinary, Diverse
- Provide Consultation
- Prod and Provoke Process
- Engage Non-traditional Collaborators
7Survey local health directors
- Role of local public health practitioners in
addressing health equity - Barriers associated with achieving health equity
- Current program addressing the reduction of
health disparities
8Survey Findings
- 74 respondents believe that public health
workforce resources should be devoted to health
equity - 82 respondents reported that academic education
in principles, objectives and practice of health
equity through social justice was important - 74 of respondents felt they could collaborate
with other sectors or disciplines
9Survey FindingsBarriers to Achieve HEtSJ
HEtSJ is an issue for social
12.8
workers, not PH workers
HEtSJ is not a core function
48.7
of PH
No political will in this country
53.8
to address HEtSJ and no
resources made available
84.6
PH is already overextended
Political / Economic forces
30.8
impeding ability to address
health inequities
Social justice is a huge issue
56.4
for our society, far larger than
anything PH can address
0
10
20
30
40
50
60
70
80
90
()
10Survey FindingsActions to Prompt HEtSJ
Changes to the legal
51.3
mandate for PH
64.1
Financial incentives
Guidance about what to do
79.5
to achieve HEtSJ
64.1
Public support
Support among colleagues
33.3
Training in schools on
48.7
social justice
0
10
20
30
40
50
60
70
80
90
()
11What Can Local Public Health Do?
- Educate
- Public Health Workforce
- Leaders
- Community
- Advocate
- Social Change
- Community Well-being
- Tax Code
- Living Wage
- Health Equity Index
- Equity in Education
- Affordable Housing
- Collaborations
- ID Name Inequities
- Link Inequities to Health
- Frame in larger social issues context
12RFPDemonstration Projects
- Proposal Requirements
- Emphasis on Social and Economic Root Causes of
Health Inequities - Advocacy
- Change in Health Practice
- Community Collaboration
- Targeting Socially Disadvantaged Populations
- Communications Strategy
- Sign off by Political Leadership
13 14What is a Health Equity Index?
- A way to conceptualize and measure community
contextual influences on population health and
health disparities. - Uses traditional and non traditional domains,
both quantitative and qualitative data sources to
measure - Triggers actions to reduce inequities
- Evaluates
15Prerequisites for an effective index
- Assessment and monitoring to analyze, understand,
measure, and document inequities - Advocacy to promote changes in policy, programs,
and planning - Community collaboration to support the
marginalized and vulnerable as active
participants in change
16Contextual Dimensions Plausibly linked to Health
Status
17Issues Involved in Constructing an Equity Index
- What we chose to measure, how we choose to
measure it and the significance we attach to the
results have more to do with philosophy, values
and politics than science. - Trevor Hancock
- Indicators that Count. Measuring Population
Health at the Community Level
18Issues, Contd
- How do we measure health and well-being at the
community level? - To what extent are data available at the
neighborhood level to support the indicators?
19Issues, Contd
- What information influences policymakers,
empowers the community and is of interest to the
media? - What are the political implications of using a
Health Equity Index at the local health
department level? Health district level?
20Next Steps
- HEAT Team
- Expand and diversify membership at the community
level - Engage on the issues affecting the development of
the Health Equity Index - Continue to dialogue with local health districts
about Health Equity Index
21Next Steps Cont.d
- Index Development
- Continue to research existing index models and
indicator projects (US and international) - Identify potential community dimensions and
indicators
22Next Steps Contd.
- Cultivate support among funders for the
demonstration pilot testing phase