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Voices for Health Equity

Voices for Health Equity

This post originally appeared on the Safe Routes to School National Partnerhip's blog.

The Safe Routes to School movement has evolved in recent years.  Inspired by many factors – changing demographics in America, more professionals of color involved in the Safe Routes to School movement, strong research that sets out the extent and nature of transportation inequities, and deepening organizational, professional, and personal commitments to creating fair communities that support health for everyone – there’s been a real change not only in how the Safe Routes to School movement is talking about equity, but also in what is playing out on the ground. The movement has recognized that to successfully achieve core goals around increasing the number and safety of kids walking and bicycling to school, it is vital to direct resources and craft programs and policies in ways that address the needs of low-income kids and kids of color.

One key sign of these changes is the move by many Safe Routes to School programs to add an E for equity to the traditional 5 E’s of Safe Routes to School. Let’s not kid ourselves – outside of the Safe Routes to School movement, no one has heard of the 5 E’s of Safe Routes to School. But inside the movement, the 5 E’s act as a fairly universal checklist and framework that practitioners use to define a comprehensive Safe Routes to School initiative, making sure that they are covering all the bases necessary to effectively get more kids to school in a healthier and safer manner. And so, it’s been a welcome development over the past several years to see equity becoming an increasingly established part of the framework, leading to 6 E’s – education, encouragement, engineering, enforcement, evaluation, and equity. 

On Saturday, the California Department of Health Care Services (DHCS) and the Centers for Medicare and Medicaid Services (CMS) agreed in principle to a five-year, $6.2 billion waiver for California’s Medicaid program. The new waiver, or “Medi-Cal 2020,” is good news for California as it will provide the state with much needed funds to begin the next phase of Affordable Care Act (ACA) implementation – equitably improving health care quality and reforming delivery so that it is more targeted and efficient.

The waiver agreement, while a significant achievement, is lower than California’s original request for $17 billion in funding and is almost $1 billion lower than the state’s revised waiver request of $7.25 billion. CMS has granted the state a temporary two-month extension of the current waiver until December 31st while state and federal officials work out the remaining details of the new waiver.

The conceptual agreement includes the following core elements:

We're one week away from the start of our exciting fall convening series, A Blueprint for Health: Planning Communities that Promote Equity! We will be focusing on the NEWLY revised draft General Plan Guidelines, which direct cities and counties to consider key issues including housing, complete streets, and open space as they plan and develop their communities.
 
The long-awaited revised general plan guidelines include new sections on how cities and counties can promote health communities and social equity in future development. The guidelines can potentially impact health in many ways, and your input is vital to ensuring community voices are part of the process.

Register today to hear about the draft guidelines from the Governor’s Office of Research and Planning, discuss with fellow advocates about the potential impacts of the revisions, and share your feedback on the new health and equity components of the draft guidelines.
 
Fresno – November 10, 2015
9:00 am to 1:30 pm
First Five Fresno County
2405 Tulare Street
Co-hosts: CA4Health, California Bicycle Coalition, California Rural Legal Assistance Foundation, Centro Binacional para el Desarrollo Indígena Oaxaqueño, Centro La Familia, Cultiva La Salud, Housing California, Leadership Counsel for Justice and Accountability, Raimi + Associates
 
Register for Fresno
 
Oakland – November 12, 2015
9:00 am to 1:30 pm
The California Endowment
1111 Broadway, 7th Floor

Welcome to This Week in Equity Engagement on Twitter (TWEET) for the week of October 26, 2015. It’s been a great week leading up to what should be a spooky weekend. But before you endure the tricks and enjoy the treats, check out what’s been up on social media:

Covered California open enrollment starts this Sunday! Enroll early!

Greenlining takes a look at diversity in the tech industry.

This past week, CPEHN was one of a number of organizations represented at the Oral Health 2020 National Network Gathering in New Orleans. We’re excited to be a part of this project and we think it could have a lasting impact on the oral health landscape in California. Our focus has always been on improving health in communities of color, and through this project, we can highlight an especially important health topic for diverse populations across our state. We are proud partners in this network that is working to achieve these bold goals by 2020 and we made even more great strides last week at the convening.

These goals were originally established to expand the impact of and unify the national network of change agents working to improve oral health across the country while allowing us to launch a system-change strategy that has inspired collective action across the country. Due to the network’s exciting success, the DentaQuest Foundation and its partners unveiled the recently-updated Oral Health 2020 goals:

Goal 1: Eradicate dental disease in children. 

  • Target: With the closing of disparity gaps, 85% of children reach age 5 without a cavity.

Goal 2: Incorporate oral health into the primary education system.

  • Target: The 10 largest school districts have incorporated oral health into their systems.

Goal 3: Include an adult dental benefit in publicly-funded health coverage.

  • Target: At least 30 states have an extensive Medicaid adult dental benefit.
  • Target: Medicare includes an extensive dental benefit.

Goal 4: Build a comprehensive national oral health measurement system.

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.

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. 

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