Understanding Health Through a Life Course Perspective. WIC Conference April 28, 2015

Transcription

1 Understanding Health Through a Life Course Perspective WIC Conference April 28, 2015

2 Overview 1 CityMatCH Life Course Game & Discussion 2 Equity Resources 3 Practices to Reduce Infant Mortality through Equity Initiative 2

3 The Life Course Game: A Simulation Experience

4 Life Course Game Instructions 5 players If less than 5 players, choose either 1) BLUE or YELLOW; 2) RED; or 3) GREEN or PURPLE/BLACK Have one person read the instructions Each player will read their profile card OUT LOUD to all of the players Each player must read their GREEN or RED cards OUT LOUD to all of the players

5 Life Course Game Instructions Note the two STOP squares 20 Each player must stop at 20 and complete the instructions on the back of the card 67 Each player must stop at 67 and complete the instructions on the back of the card Read the 2 nd TIP

6 Discussion

7 What is the Life Course Perspective? A complex interplay of biological, behavioral, psychological, and social protective and risk factors contributes to health outcomes across the span of a person s life.

8 Social Determinants of Health The economic and social conditions that influence the health of individuals, communities, and jurisdictions as a whole. They include, but are not limited to: Safe Affordable Housing Quality Education Job Security Social Connection & Safety Living Wage Access to Transportation Availability of Food Dennis Raphael, Social Determinants of Health; Toronto: Scholars Press, 2004

9 Institutional Racism Root Causes of Health Inequity Class Oppression Gender Discrimination and Exploitation LABOR MARKETS Power and Wealth Imbalance TAX POLICY HOUSING POLICY EDUCATION SYSTEMS GLOBALIZATION & DEREGULATION SOCIAL SAFETY NET SOCIAL NETWORKS Safe Affordable Housing Social Determinants of Health Job Security Living Wage Quality Education Transportation Availability of Food Social Connection & Safety Psychosocial Stress / Unhealthy Behaviors Disparity in the Distribution of Disease, Illness, and Wellbeing Adapted from R. Hofrichter, Tackling Health Inequities Through Public Health Practice.

10 Health Equity Health equity, as defined by Health People 2020, is the "attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities".

11 With Equity, inputs may need to be different to achieve equal outcomes This is Equity 11 MDCH, Health Equity Learning Labs 2013, provided by Hogan, V., Rowley, D., Berthiaume, R. and Thompson, Y, University of North Carolina at Chapel Hill. Adapted from

12 Reports, Articles & Films Unnatural Causes When the Bough Breaks 12

13 Reports CDC Health Disparities and Inequities Reports 2011 & 2013 Levels of Racism: A Theoretical Framework and a Gardner s Tale IS RECONCILIATION POSSIBLE? LESSONS FROM COMBATING MODERN RACISM RWJF Place & Heath: Why Conditions Where We live, Work & Play Matter May,

14 Holes in the Mitten Videos We are where we eat Stress: An unlikely culprit One size does not fit all (culture &healthcare access) Education inequity: It hurts Fact Sheets PowerPoint Activities MDCH - Health Disparities Reduction/Minority Health Section 14

15 Achieving Health Equity In MI Michigan Public Act 653 (2006) Charges the state to develop and implement a structure to address racial and ethnic health disparities Michigan Department of Community Health (MDCH) Mission To protect, preserve, and promote the health and safety of the people of Michigan with particular attention to providing for the needs of vulnerable and under-served populations 15

16 Achieving Health Equity In MI MDCH Strategic Priorities: Use MI s Infant Mortality Reduction Plan to address disparities and save babies Promote & Protect Health, Wellness, and Safety - Reduce disparities in health outcomes Ensure access to culturally and linguistically appropriate services for all MI residents 16

17 Michigan vs. US rates of infant mortality per 1,000 live births United States Michigan 17

18 Infant Mortality Rates Three-Year Moving Averages Michigan American Indian African American 20 White Per 1,000 live births Years 18

19 Top 11 MI Counties with Racial Disparities in Infant Mortality:

20 PRIME Goal is to create a training and practice model that promotes health equity practices within MCH programs, policies and resource distribution PRIME focuses on improving equity in maternal and infant health for African Americans and Native Americans 20

21 HOW TO INCORPORATE EQUITY INTO THE WORK Equity training Standardize data collection process/analysis Allocate resources to support equity Program standards and protocols 21

22 PRACTICES TO REDUCE INFANT MORTALITY THROUGH EQUITY: A GUIDE FOR PUBLIC HEALTH PROFESSIONALS An informational resource for transforming public health through equity education and action 22

23 PRIME Guide Organizational Assessment Workshops Health Equity & Social Justice Ingham County Health Department Undoing Racism TM The People s Institute for Survival & Beyond Native American History, Culture and Core Values Health Equity Learning Labs 23

24 WIC Health Equity Plans Awareness and support for breastfeeding from men, focusing on young Native and African American men Outreach and referral, focus on Native Americans Data & system management Access to fresh fruits and vegetables in food deserts 24

25 Standardize Data Collection Department wide efforts to collect race, ethnicity, language, sex & disability data Native American Pregnancy Risk Assessment Monitoring System (PRAMS) Survey Nurse Family Partnership (Kitagawa Analysis) Health Equity Status Report 25

26 Program Standards and Protocols Use of Kitagawa analysis to align program activities with the highest need population by communities Race-specific mortality is highest among American Indian/Alaska Native Percent Contribution to the Difference in Excess Mortality Rate 100% 50% 0% Multiracial Other Asian Am. Indian Hispanic Black White -50% Excess mortality is highest among Hispanic infants Michigan Reference = Women 20 years and older with more than 13 years education. 26

27 Information & Dissemination 27

28 BRENDA JEGEDE, MPH, MSW