HEALTH EQUITY THROUGH SOCIAL JUSTICE

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HEALTH EQUITY THROUGH SOCIAL JUSTICE

• RE-ENGAGING LOCAL PUBLIC HEALTH
• Connecticut Association of
• Directors of Health, Inc
• 2005

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What 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

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BACKGROUND

• CADH HEALTH DISPARITIES
• CADH/NACCHO PARTNERSHIP
• UNIVERSAL HEALTH CARE FOUNDATION OF CT

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Anthem Foundation

• Health Equity Project Year One
• Asking Public Health Four questions

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OBJECTIVES-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

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HEALTH EQUITY ACTION TEAM(HEAT)

• Statewide, Multidisciplinary, Diverse
• Provide Consultation
• Prod and Provoke Process
• Engage Non-traditional Collaborators

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Survey 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

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Survey 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

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Survey 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
()
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Survey 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
()
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What 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

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RFPDemonstration 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

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• Pause for a moment

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What 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

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Prerequisites 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

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Contextual Dimensions Plausibly linked to Health
Status
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Issues 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

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Issues, 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?

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Issues, 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?

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Next 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

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Next Steps Cont.d

• Index Development
• Continue to research existing index models and
  indicator projects (US and international)
• Identify potential community dimensions and
  indicators

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Next Steps Contd.

• Cultivate support among funders for the
  demonstration pilot testing phase