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Voices for Health Equity

Voices for Health Equity

The latest issue of our Health Equity Forum newsletter came out today and it includes several great articles and dozens of resources. You'll be glad you have an extra hour because of the end of daylight savings this weekend because you want to make sure you have enough time to read it.

CPEHN’s Executive Director, Sarah de Guia, opens the newsletter by discussing some positive developments from the recently concluded 2015 legislative session, including all three of CPEHN’s bills being signed into law. She also talks about the fiscal challenges the state will have to address in 2016.

Our Ethnic Partner Spotlight features an article from the California Rural Indian Health Board (CRIHB) and it talks about all of the new initiatives they are working on to improve the health of the state’s rural Indians.

Causa Justa :: Just Cause contributed an article on the health impacts of gentrification and displacement. This is particularly timely as we are seeing dramatic changes in neighborhoods across the state. The Nile Sisters Development Initiative also discussed their new project, Type 2, Not You! to educate refugee populations in San Diego about diabetes.

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has issued proposed regulations to implement Section 1557 of the Affordable Care Act (ACA). Section 1557 prohibits discrimination on the basis of race, color, national origin (including immigration status and language), sex (including sex stereotyping and gender identity), age, or disability in health programs. These protections apply to consumers in all federally funded state health programs, including Covered California and Medi-Cal.

The proposed regulations are a good first step, but the rule could be made stronger to better protect people at risk of discrimination in health coverage or care, including communities of color, Limited English Proficient, women, LGBTQ populations, and persons with disabilities.
 
Public comments are needed to strengthen these proposed regulations. While comments submitted by organizations are important, it also is very important for individual members of the public to submit personalized comments.
 
Please submit your comments online no later than 2 pm PT on November 9, 2015. Click on the blue "Comment Now!" button on the top right of the page. You can either type in your comments or upload a file from your computer.
 
You can use these sample messages to guide your comments. The National Health Law Program (NHeLP) also has a great sample letter you can use.

Submit your comments today!

Welcome to This Week in Equity Engagement on Twitter (TWEET) for the week of October 19, 2015. Another eventful week comes to a close, and we have some great social media resources for you. Check it out:

Another report that shows that soda taxes can be effective at reducing consumption of sugar-sweetened beverages.

Most Americans understand the importance of access to healthy foods.

Here are some tax policy solutions to help alleviate poverty across the country.

There was good news this week in the effort to raise awareness of the diabetes epidemic confronting San Francisco's Asian community. This past Tuesday during San Francisco's Public Health Commission meeting, the "Screen at 23" Resolution was passed, and this national campaign has officially kicked off in San Francisco. The Campaign was initiated and endorsed by the American Diabetes Association (ADA), the National Council of Asian and Pacific Islander Physicians (NCAPIP), the AANHPI Diabetes Coalition, and the Joslin Diabetes Center. For the Asian community in the city, this is arguably the second most important public health campaign since the HepBFree campaign

What is "Screen at 23"?

"Screen at 23" is part of the ADA's 2015 Guidelines designed to specifically to address the disproportionately heavier disease burden of diabetes experienced by Asians. The initiative recognizes that diabetes occurs in many Asians with a body mass index (BMI) lower than 25. Instead of starting screening for diabetes in those with a BMI of 25 or more as was previously the standard, ADA now recommends a lower BMI of 23 to start screening for diabetes in Asians.

A new Prevention Institute (PI) report, Moving From Understanding to Action on Health Equity: Social Determinants of Health Frameworks and THRIVE, presents an overview of social determinants of health (SDOH) frameworks and discusses how our updated Tool for Health and Resilience in Vulnerable Environments (THRIVE) has incorporated the field’s collective knowledge on SDOH. This work builds off our U.S. Office of Minority Health (OMH)-funded cooperative agreement with the National Network of Public Health Institutes.  

PI first developed THRIVE in 2002, with funding from the OMH and The California Endowment. Since then, the public health community has created many more frameworks on the factors that shape health outcomes outside the healthcare system – i.e., SDOH.

According to the World Health Organization (WHO), SDOHs are largely understood as the broad set of factors that influence health outcomes directly and shape community environments. These factors reach far beyond the healthcare system, and include structural drivers, such as racism, and the conditions of daily living – the community determinants of health. PI is working with WHO's SDOH team to explore the use of our equity tools and updated THRIVE approach as a resource for advancing community efforts in other countries. 

This week, Southern California Public Radio (SCPR) had a terrific report on student hydration in California. The story highlighted one of the state’s more distressing inequities – the lack of access to and consumption of clean drinking water.

The report focuses primarily on schools in Los Angeles, but does reference a national study that found that more than half of all children and adolescents in the U.S. experience chronic dehydration. While rates are high across all races and ethnicities, they are particularly high among African Americans and Latinos. This is especially evident in LA’s public schools, where a majority of students are from communities of color.

The article has some good quotes from health advocates, including our friends at California Food Policy Advocates, on the challenges of increasing access to and consumption of clean water.

"When you look at water it’s zero calories but yet you need it to survive and to live a fruitful life," says Hector Gutierrez, a nutrition policy analyst who works on water access for the California Food Policy Advocates. "So we are trying to change the paradigm and make water the beverage of choice."

Experts say school is a natural target for efforts to make water more attractive, since kids spend so much of their time there. But there's a lot of work to do...

“A lot of these schools [in California] are very old and have old infrastructure," says Gutierrez. "The water might be hot, or the drinking fountain might be kind of decrepit."

California’s Office of the Patient Advocate (OPA) released its 2015-16 Health Care Quality Report Cards last week. The new report cards shed light on the quality of care under a variety of health care providers and plans, including California’s 10 largest HMOs, the six biggest PPOs, and more than 200 large medical groups covering 16 million consumers in California. The data is drawn from claims data and patient surveys.

The report cards are timely as consumers gear up for 2016 open enrollment, which begins Nov. 1, 2015, and continues through Jan. 31, 2016. With the release of the report cards, consumers should have an easier time shopping for coverage. Each HMO and PPO is evaluated on their overall medical care and for how it treats certain conditions like asthma and cancer as well as its behavior and mental health care. Further, the report card provides a deeper evaluation on how a health plan treats certain conditions through specific clinical indicators of good care. This helps consumers understand what they should expect from their coverage.

Welcome to This Week in Equity Engagement on Twitter (TWEET) for the week of October 12, 2015. Yet again, there’s so much great work being done it’s hard to capture all of it, but I think we have a bunch of interesting topics this week. Check it out:

Public policy efforts are working to improve access to healthy food!

New report shows that more than half of California’s remaining uninsured are eligible for public health programs.

As Covered California’s third open enrollment period fast approaches, a new report sheds some light on the state’s remaining uninsured and finds that roughly half are eligible for either Medi-Cal or subsidized coverage through Covered California. Earlier this week, the Kaiser Family Foundation released New Estimates of Eligibility for ACA Coverage among the Uninsured, which looks at the over 32 million remaining uninsured across the country after the first two years of the Affordable Care Act (ACA) coverage expansions.

Nationally, the report shows the devastating impact of many states’ refusals to expand Medicaid. Roughly one-tenth of the remaining uninsured in the U.S. – over 3 million individuals – would fall into the coverage gap and could have been covered had their states decided to expand Medicaid as stipulated in the ACA.

But the report also looks at the remaining uninsured at a state-by-state level, and with this analysis we see that over half (53%) of California’s more than 3.8 million uninsured are eligible for either Medi-Cal (37%) or for subsidized coverage in Covered California (16%). These numbers show that while we have cut our state’s uninsured population nearly in half over the past three years, we still have an opportunity to continue this dramatic improvement. With another open enrollment period on the horizon, it is imperative that there are sufficient outreach and enrollment efforts, particularly in low-income areas, communities of color, and Limited English Proficient populations to maximize participation by the eligible population.

Welcome to This Week in Equity Engagement on Twitter (TWEET) for the week of October 5, 2015. There was so much bill-signing excitement last week that we’re a couple days late for this anxiously anticipated edition of TWEET. Don’t worry, we still have a lot of great stuff in here, including:

Great feature in the New York Times about how soda consumption is decreasing.

While most people drive to work, alternative forms of transportation (walking, biking, etc.) are becoming more popular.

There are more sobering statistics about mass incarceration in America, particularly among African American young men.

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