How Do You Operationalize Health Equity? How Do We Tip The Scale?

Transcription

1 1 How Do You Operationalize Health Equity? How Do We Tip The Scale?

2 2 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.

3 3 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.

4 A Different Directions 4

5 5 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

6 Culturally & Linguistic Appropriate Services 6 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

7 7 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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9 9 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

10 10 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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12 12 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

13 13 Resources Black and Minority Health-The Heckler Report 1985 Crossing The Quality Chasm: A New Health System for The 21 st 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

14 14 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

15 15 Dr. Tanya Funchess Mississippi State Department of Health Director, Health Equity

16 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

17 Videos What is Health Equity? Social Determinants of Health Social Determinants of Health (Clinical)

18 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)

19 Achieving Health Equity

20 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)

21 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)

22 Social Determinants of Health (as defined by the WHO) There are Ten (10) Components: The Social Gradient Early Life Work Social Support Food Stress Social Exclusion Unemployment Addiction Transport (World Health Organization, 2010)

23 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)

24 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, wellbeing, 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)

25 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, wellbeing, 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)

26 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)

27 Partnerships

28 Partnerships Faith-Based Community Community-Based Organizations Trust building Community engagement Community empowerment Policy Makers State, Local, and National

29 Partnerships Clinical-Community Delivery Systems Academic/Community-Based Organization Managed Care Organizations Others

30 Education

31 Education Policy Makers Community-based Education Health Advocates Lifestyle Coaches Community Health Workers Social Determinants of Health Healthcare Professionals

32 Disease Self-Management Chronic Diseases Diabetes Hypertension Congestive Heart Failure Arthritis Patient Empowerment Community Empowerment Improved Health Outcomes

33 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.

34 Contact Information Michael L. Jones, PhD(c), RN, MSN, MBA Phone:

35 Charlene Collier MD, MPH, MHS Perinatal Health Policy & Research Consultant Mississippi State Department of Health

36 Disparities in Birth Outcomes Preterm Birth Infant Mortality Sleep Related Infant Deaths Low Birth weight Maternal Mortality

37 Mississippi Infant Mortality

38 Achieving The Highest Level of Health For All Moms And Babies Adequate prenatal care Adequate obstetric and newborn care Stress Poverty Poor Nutrition Reduced Education Chronic Health Problems Environment/Pollution Racism Image Adapted from: AFsQ_AUICigB&biw=1920&bih=911#imgrc=CtbQlBd15aYpkM:&spf=

39 MSDH Initiatives Sisters United Fetal Infant Mortality Review Program

40 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

41 Sisters United- Focus Areas Folic Acid Safe Sleep Breastfeeding Healthy Weight Before Pregnancy YouTube Video with MS Doctors

42 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

43 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

44 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

45 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

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47 Healthy Start- Maternal Interview Beyond medical record review Simultaneously gather information & provide support Prevention & Treatment Understand current needs & share resources

48 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

49 Thank You