A DRA Project “State of the Health Equity Movement” Memo 09-01

Prepared by Jerusha Haasenritter and Stella Han, Institute for Alternative Futures
September 17, 2009

“The growth of the Health Equity Movement is reflected by a rising number of government entities (local, state, federal) and organizations explicitly recommending and pursuing health equity. This memo compiles the recommendations for 28 of these efforts and provides a table to illustrate the recommendations from nine of these.”

The introduction of this memo can be found below. To read the report in its entirety, you can download it here:

Introduction

In 2005 Michael Marmot stated, “If you catch the metro train in downtown Washington, D.C., to suburbs in Maryland, life expectancy is 57 years at beginning of the journey. At the end of the journey, it is 77 years. This means that there is 20‐year life expectancy in the nation’s capital, between the poor and predominantly African American people who live downtown, and the richer and predominantly non‐African American people who live in the suburbs … The social determinants of these two individual’s lives are different, and we must acknowledge this and think of poverty in a different way. It is about opportunities in life and control over one’s life, in addition to social conditions that shape the physical environment one lives in1.” The differences in these two individual’s lives reflect health inequities as they exist in the United States. However, a growing movement towards acknowledging and taking steps to reduce these inequities exists and is referred to as the health equity movement. This movement focuses on prevention and addressing the social determinants of health which include “income and social status (income inequality and social class), social support networks (social exclusion and social isolation), education, employment and working conditions (unemployment), physical environments (food and transportation), social environments, community norms, healthy child development, health services, and gender and culture2.” This movement advocates for health reform, not just health care reform.

Currently, health equity advocates are moving beyond solely identifying the inequities, to focus on what actions will create health equity. The following document compiles 28 reports (including memos and briefs) that serve as indicators of the health equity movement and its growth. All of these reports offer recommendations, strategies, and/or priorities for health equity, specific to the subject area of the report. The reports presents an examination of a variety of recommendations, representing different subject areas, and delivering a diverse focus.

The purpose of this document is to disseminate information by presenting varying strategies and recommendations for those who are interested to get a better idea of possible means to bring about an end result. This document has two components:

1. An illustrative chart of ten reports, giving an overview of certain themed recommendations; and
2. A list of 28 significant reports regarding health disparities, health equity, prevention, and the social determinants of health. The list details recommendations, priorities, and/or strategies, with links to each report included.

The reports included illustrate the growing activity in the health equity field. We acknowledge there are others and will gather these for subsequent inclusion in DRA Project reviews of activity. In considering the range of policies recommended, the advice from the Multnomah County Health Initiative (2009) is relevant to share. The effort recognized three emergent themes:

1. There is no single “magic bullet” policy or short list of policies that will eliminate the inequities that result in health disparities, solutions need to come from the coordinated effort of policy makers, bureaucrats and community members,
2. local efforts at eliminating inequities should be driven by local data on existing health disparities, and
3. local governments should look at their own policies that perpetuate inequities.

If you would like to request that any information be edited or added, or have other examples please email Jerusha Haasenritter at jhaasenritter@altfutures.com. This document is part of a larger DRA Project effort to identify “The State of the Health Equity Movement”. For more information, please email jhaasenritter@altfutures.com. To find out more about the DRA Project, please visit http://www.altfutures.com/draproject/ .

In order to build support for health reform and inform congressional Members and staff about health and health care disparities, the National Working Group on Health Disparities and Health Reform will be coordinating a congressional briefing on Tuesday, September 22 in the Senate from 12:00 pm to 1:30 pm in room SVC 208 and 209. The focus of this briefing will be to highlight the costs associated with health disparities in our country as well as the cost-savings we would realize from reducing these critical disparities. Within that context, the briefing will include discussions such as why data collection is critical, as well as issues regarding workforce development, language access, health coverage, quality, prevention, and the economic costs & savings.

Speakers include:
Norman Anderson, PhD (CEO – American Psychological Association),
Tom Bornemann, EdD (Director – The Carter Center Mental Health Program),
Carolyn Clancy, MD (Invited) (Director – AHRQ),
Kavita Patel, MD, M.Sc. (Invited) (Director of Policy – White House),
Marcos Pesquera, R.Ph., MPH (Director – Center on Health Disparities at Adventist HealthCare),
Brian Smedley, Ph.D. (VP and Director – Health Policy Institute at the Joint Center for Economic & Political Studies)

The bill bows to hateful sentiments by preventing undocumented immigrants from using the national exchange to purchase, even at full price, health insurance for themselves or their families. It also sets up new paperwork requirements that might keep some citizens from accessing coverage. This is not what our country stands for. The House and Senate HELP Committee health reform bills are ones we can build upon. But this is one we can’t. Tell our senators TODAY to stand for what is right and pass a health reform bill that helps everyone!

Calls needed TODAY to:

Senator Dianne Feinstein
(202) 224-3841

Senator Barbara Boxer
(202) 224-3553

Key messages:
.    All Americans, including immigrants, need better access to culturally competent, quality health care.
.    Taxpayer dollars should not be spent on complex verification schemes aimed solely at appeasing groups that are not negotiating in good faith.
.    Reform must move forward and provide coverage we can afford, benefits we can count on, and the choice of a national public option!

Your call really does matter. Please take a moment and make that call!
More information on the health reform bills now in Congress can be found at www.cpehn.org.

Let us know if you took action by emailing Marty Martinez at mmartinez@cpehn.org.

OMO believes that health reform MUST reduce health disparities and promote prevention. Reducing and eliminating health disparities will result in cost-savings and increased quality of care.

Call members of the House of Representatives today and tell them to pass health reform as soon as they return from August recess!

Let them know that meaningful reform needs to be affordable for every resident, address primary prevention, and ensure language access.

You can find the phone number for your Representative by going to: www.healthcareforamericanow.orghttps://writerep.house.gov/writerep/welcome.shtml. or

Meeting with your Representative or his or her staff during August is also a very helpful step you can take to make your voice heard. If you could use assistance with setting up such a visit, contact Marty Martinez at (510) 832-1160 or mmartinez@cpehn.org.

You can follow the status of national health reform and priority issues for communities of color at CPEHN’s newly revised Policy Center.

Let us know if you took action by emailing Marty Martinez at mmartinez@cpehn.org.

We wrote a letter in support of this legislation to Chairmen Miller, Rangel, and Waxman. It is available for download here: Note: There is a file embedded within this post, please visit this post to download the file.Note: There is a file embedded within this post, please visit this post to download the file.

Additionally, Out of Many, One is also a part of a large health disparities workgroup, which also issued its own letter in support of this legislation. Out of Many, One and several of its members have signed on, and their signatures are highlighted in blue. The letter is availble for download here: Note: There is a file embedded within this post, please visit this post to download the file.

HEALTHCARE REFORM:

“COVERAGE IS NOT ENOUGH!”

(Washington DC) – The Congressional TriCaucus – comprised of the Congressional Black Caucus, the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus – will hold a news conference on Tuesday, June 9 at 10 am regarding their priorities for healthcare reform–particularly the need to address racial and ethnic health disparities.

The TriCaucus is committed to healthcare reform that expands coverage to all Americans while also reducing the serious health disparities that disproportionately affect racial and ethnic minorities.

Among the other elements of healthcare reform members of the TriCaucus have identified as priorities are:

• A public health insurance option that is universal and includes mental, dental and oral health services.

• Elevating the National Center on Minority Health and Health Disparities at the National Institutes of Health and strengthening the Office of Minority Health within the Department of Health and Human Services.

• Addressing cultural and linguistic concerns such as credentialing for medical translators and ensuring adequate reimbursement for language and translation services.

• Healthcare provisions regarding clinical trials must also – whenever possible – include racial and ethnic, as well as gender diversity to better determine effects on a broad range of groups.

WHO: Members of the Congressional TriCaucus and healthcare professionals.

Congressman Michael Honda, Chair of the Congressional Asian Pacific American Caucus
Congresswoman Barbara Lee, Chair of the Congressional Black Caucus
Congresswoman Nydia Velazquez, Chair of the Congressional Hispanic Caucus
Congresswoman Donna Christensen and Congressman Danny K. Davis, Co-Chair’s of the CBC Health and Wellness Taskforce
Congresswoman Madeleine Bordallo, Chair of the CAPAC Health Taskforce
Congresswoman Lucille Roybal-Allard, Chair of the CHC Health and the Environment Task Force
Special remarks by Dr. Brian Smedley, Vice President and Director, Health Policy Institute at the Joint Center for Political and Economic Studies.

WHAT: Congressional TriCaucus Health Equity News Conference

WHEN: Tuesday, June 9 at 10:00 a.m.

WHERE: The House Triangle, which is located at the base of the East Capitol steps