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Health Equity Considerations For Virginia's African American Children
- 1. Prepared by Cheza Garvin, PhD, MPH, MSW Assistant Professor and Academic Director, Consortium for Infant and Child Health (CINCH) Presented by Keisha Cutler, MPH, Assistant Director, CINCH Department of Pediatrics, Division of Community Health & Research, Eastern Virginia Medical School
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- 12. Cohen & Swift, 1998
- 16. Is that a mirage, or is it a light at the end of the tunnel? Long, lonely road ahead or are there many sources of expertise and support for these efforts?
- 27. Would a round table be more inclusive, more inviting, more effective for communication? Who gets a vote? Civic engagement is more than the voting booth. Can community-based organizations be included? What about parents and children/youth?
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- 29. Safe Routes to School in Walkable Built Environments Easy access to Healthy Food Options Equal access and support for high Educational Achievement Greater Economic Opportunity Physical Fitness for Life, Safe Play Places Elimination of Racism & Discrimination Full access to High Quality Health Care Ease of Transportation Housing (e)quality
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Editor's Notes
- CINCH is a coalition of over 200 agencies and individuals working in partnership with the mission of engaging the community to improve children’s health in Hampton Roads. Founded in 1993, CINCH has initiated, coordinated and/or participated in several successful health initiatives, has received national recognition for its work and has a focus on policy and systems change rather than individual services.
- Data are from various studies and surveillance sources, e.g. CDC, NIH, the Prevention Institute, census (2000), others.
- But this talk is not really about the data. VDH does a good job of tracking data for the Commonwealth, although we are always looking for more regional data for Hampton Roads. I really want to talk more about impacts on children and efforts to create solutions.
- Individual lifestyle change is an important component, but “….”. We must create a social/political/economic and physical environment in which people can readily make healthy lifestyle choices.
- These determinants are important for the health of all groups, yet it is in these categories that African Americans are disproportionately subject to poor, inadequate or substandard conditions that are by and large beyond individual control. Societal infrastructure, i.e. policies, systems and environments must be improved to assure equity in these factors for our African American families. The GOOD NEWS is that more and more, these complex issues are being understood and gradually being incorporated into planning and policy development.
- These determinants are important for the health of all groups, yet it is in these categories that African Americans are disproportionately subject to poor, inadequate or substandard conditions that are by and large beyond individual control. Societal infrastructure, i.e. policies, systems and environments must be improved to assure equity in these factors for our African American families. The GOOD NEWS is that more and more, these complex issues are being understood and gradually being incorporated into planning and policy development.
- The social ecological model provides a theoretical “framework to examine the multiple effects and interrelatedness of social elements in an environment” and helps to define the multiple levels from which to view and seek solutions for societal problems. We need to work on all levels toward the same goals in order to improve health for everyone and to pay special attention to cultural impacts to reduce health disparities and inequities.
- Similarly to the social ecological model, the spectrum of prevention illustrates multiple levels upon which actions can and should be taken to effect the primary prevention of health-related problems and conditions. It can be an approach to eliminating health disparities and inequities. Strengthening Individual Knowledge and Skills  Enhancing an individual's capability of preventing injury or illness and promoting safety Promoting Community Education  Reaching groups of people with information and resources to promote health and safety Educating Providers  Informing providers who will transmit skills and knowledge to others Fostering Coalitions and Networks  Bringing together groups and individuals for broader goals and greater impact Changing Organizational Practices Adopting regulations and shaping norms to improve health and safety Influencing Policy Legislation Developing strategies to change laws and policies to influence outcomes
- These are examples of common types of experiences of African American families in medical settings in these locations. What are the likely outcomes of these types of scenarios? What are some of the likely social determinants at play in these cases? Such as, economics/income, provider bias, access and quality of care issues. When you look beyond the medical setting to other community settings, other determinants of health, the issues grow exponentially.
- The road to health equity may seem endless, but it doesn’t have to be lonely. I believe there is a light at the end of this long tunnel and many who will invest their time, energy and expertise toward creating a social/environmental infrastructure supportive of healthy communities and healthy people. Some examples of efforts follow.
- These national programs either seek to establish best practices or are already putting evidence-based best practices to work, or both. I will only address a few of these. All are designed to be inclusive of African Americans and other communities of color, with specific, mandated focus from REACH, CCHE and Place Matters. CCHE and Champion have a mandated focus specifically on child health.
- This slide provides examples following the spectrum of prevention using a social ecological model approach and incorporates some of the solutions suggested by the Prevention Institute.
- Traditionally we think only of high level officials and decision makers – extremely important stakeholders who can make policy happen and pave the way for its implementation. What about community-based organizations? What about community residents? What about the children themselves? What about other non-traditional sectors? Is everyone heard? Does everyone understand what is happening? Who gets a vote? Who needs to buy in to assure successful implementation? Does everyone understand their value, their responsibility, their pride of participation? Ponder and plan how to engage people within the African American community so they can have a voice. Civic engagement beyond the voting booth….
- Superimposed on a map of Virginia, these pictures illustrate what it might look like for African American children, adults and families to have a healthy environment sustained by strong policies, regulations and programs and where the health equity gap is eliminated. Such a community would ultimately be healthy for all Virginians of any race, ethnicity or cultural background.
- We need to remember to celebrate our successes along the way. Incremental steps lead to big leaps over time.