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Voices for Health Equity

Voices for Health Equity

The Governor’s budget includes a $16.2 billion plan for the state’s transportation needs, with $3.2 billion in proposed new revenue. Unfortunately, the Governor’s transportation plan is business as usual, at the expense of public health and reducing greenhouse gas (GHG) emissions. The $3.2 billion in proposed new funding replicates the Governor’s plan introduced in August last year during the transportation special session. The majority of those funds will go towards repaving roads and expanding trade corridors, doing little to expand active transportation and advance transportation mode shift. Details of the proposal include:

CPEHN applauds the Governor’s renewed commitment to expand health care to California’s undocumented children but urges greater investment in the health of communities of color broadly given the projected $3.6 billion surplus.

On Thursday, January 7th, Governor Jerry Brown released his proposed FY 2016-17 state budget, which includes modest increases in Medi-Cal and other safety-net programs. We are elated to see that the Governor’s proposal maintains the state’s prior commitment to expand full-scope Medi-Cal to undocumented children starting on May 1, 2016. Additionally, we applaud the Governor’s tax revenue proposal to extend the Managed Care Tax (MCO), which is set to expire in 2016. The tax proposal, pending negotiations between the Governor and health plans, will provide $1.1 billion in state funding to help defray the cost of the In-Home Supportive Services program (IHSS) and other health care services. The 2016-17 budget also includes a small increase in SSI/SSP grants for seniors and persons with disabilities, the first increase since 2006.

With a large projected revenue surplus, however, the budget proposal misses important opportunities to invest in the health of California’s new majority, communities of color. The budget, for example, does not seek to restore dental benefits or concretely address the lack of comprehensive health care coverage for undocumented adults. Further, the $3.2 billion in additional revenues for transportation will primarily fund repaving roads and expanding trade corridors rather than expanding funding for active transportation to positively impact climate change and public health. We also urge the elimination of the Maximum Family Grant (MFG) in the CalWORKs program, which unfairly denies financial support to babies born while their families are receiving grants.

Prevention Institute (PI) and The College for Behavioral Health Leadership are co-hosting Summit 2016 - Population Health: Leadership for Building Healthier Communities this April 6-8, 2016 in San Diego. Conference participants will seek to identify and address opportunities for improvement, promote emerging consensus, contribute to the evolution of behavioral health and wellness, and positively impact the health of communities.

The Summit will feature:

On Friday, CPEHN and 17 diverse public health, environmental, and climate change related organizations signed onto a joint letter to the Governor’s Office of Planning and Research commending the recently revised 2015 General Plan Guidelines, which includes new chapters on Healthy Communities and Social Equity, Environmental Justice, and Community Resiliency as well as an updated Public Engagement and Outreach chapter. The revised Guidelines show promise in directing cities and counties to consider health and social equity in future development.

In addition to the strong support for these chapters, the joint letter outlined several recommendations for strengthening them. For example, we call upon OPR to more prominently acknowledge the changing racial, ethnic, economic, and aging demographics of California. By understanding these demographic shifts, our cities and counties can better consider existing and future needs, especially in historically under-resourced communities.  We also recommend the document define key terms, such as health and equity, to build awareness and understanding at the outset of the planning process and to utilize visual representations of key concepts or frameworks within the Guidelines.

The specific chapters on which our groups focused our analysis included Public Engagement and Outreach (Chapter 3), Healthy Communities (Chapter 5), and Social Equity, Environmental Justice, & Community Resilience (Chapter 6). The comment letter also reflected feedback from community workshops hosted by CPEHN in partnership with OPR in Oakland, Fresno, Los Angeles, San Diego, and Orange County in November 2015.

On September 30, 2015, the California Mental Health Services Act Multicultural Coalition (CMMC) presented highlights from various State of the State Reports at the Behavioral Health Policy Forum in Carlsbad. One report focused on the experiences of the Deaf and Hard of Hearing (DHH) community and their access to mental health services in California. DHH community college students were asked to share their personal experiences and these short videos are highlights from their stories. The DHH State of the State Report and others can be found on the Racial and Ethnic Mental Health Disparities Coalition (REMHDCO) website.

Community Safety by Design Report

Every day, people make decisions about land use that impact whether or not communities will be safe. These decisions include where schools are sited, how streets and parks are designed, and the kinds of businesses that are allowed to operate. To the extent that safety has been taken into account in these decisions, it has mostly been through the lens of crime prevention. PI’s new paper, Community Safety by Design: Preventing Violence through Land Use, explains how a violence prevention lens and a crime prevention lens are similar, and how they are different.

One difference is that a violence prevention lens necessarily engages the end-user – community residents—in shaping land-use decisions that work for the community and support community safety. This engagement is a critical component to achieving equitable health and safety outcomes, and applies across many sectors. Our paper drew on extensive research and interviews with 23 key informants from planning, public health, the justice system, and other sectors, and outlines concrete steps to better integrate effective violence prevention strategies into land-use decisions. The report includes:

A few weeks ago, CPEHN wrapped up our fall convening series, A Blueprint for Health: Planning Communities that Promote Equity in Los Angeles and San Diego. Over 100 advocates, planners, and local governmental staff engaged the Governor’s Office of Planning and Research (OPR) on the importance of including health and equity in the newly released draft statewide general plan guidelines. These convenings were space for community advocates to provide direct feedback and comments to OPR staff on how the plan guidelines can be incorporate localized community engagement strategies and fostering more equitable development.

Allison Allbee from our partner organization Changelab Solutions presented in both Los Angeles and San Diego about the context of how important the state’s general plan guidelines can be for local development and how communities can get involved in the process.

Dr. Elizabeth Baca from OPR also presented about what the new draft guidelines currently include. She especially focused on specific sections concerning public engagement, healthy communities and social equity.  These chapters can be read by clicking on the links below.

Chapter 3: Public Engagement and Outreach

Chapter 5: Healthy Communities

Chapter 6: Social Equity, Environmental Justice, & Community Resilience

This week, CPEHN began its fall convening series and over 100 advocates attended events in Fresno and Oakland to discuss the importance of health and equity in neighborhood planning. The convening series, A Blueprint for Health: Planning Communities that Promote Equity, features a discussion of the newly released draft statewide general plan guidelines from the Governor’s Office of Planning and Research (OPR) and how this document can be used to develop healthier, more equitable communities across the state.

Today in Oakland, the convening began with a presentation from Heather Wooten from ChangeLab Solutions about the importance of the state’s general plan guidelines and why community involvement is key.

Both Tuesday’s event in Fresno and today’s in Oakland featured a presentation by Elizabeth Baca and Sahar Shirazi from OPR about what is in the new draft guidelines. In particular, they highlighted three chapters dealing with health, equity, and public engagement. You can read those chapters here:

On November 4, 2015 I attended “Smart on Safety,” an invitational summit to examine how California can reform the criminal justice system and transform communities to prioritize prevention over punishment. As Adam Kruggel, Director of Organizing for PICO California, stated, “mass incarceration creates a legitimacy crisis for some of our most deeply held values – that everyone has a right to be a human being.” Harsh sentences, three strikes, mandatory minimums, racial profiling, gang injunctions, and transfer of juveniles to adult courts have demonized poor black and brown males as less deserving “others” – predators who are beyond redemption.

Anyone who works in marginalized communities knows the toll that these policies take on the health and life prospects of their teen patients. Although one would hope that the appalling scene in South Carolina is not the norm, it has been well documented that black students are three times more likely to be suspended than white students. Suspension is a gateway to dropout, economic instability, crime and incarceration. And we don’t need to look only at teens to see how “tough on crime” affects children’s health. Tamir Rice, a 12 year old who was playing with a toy gun in a park, is dead. The children of Eric Gardner and Walter Scott are fatherless. Approximately 2.7 million children have a parent in prison – a vastly disproportionate number of whom are poor and black. Millions more children experience post-traumatic stress disorder from extended exposure to violent encounters between citizens and law enforcement in their communities.

When it comes to recreational space, not all neighborhoods are created equal. Low-income communities and communities of color consistently have the fewest recreational facilities. Even where recreational facilities do exist, there are often other barriers to meaningful access, such as safety concerns, lack of transportation to the facilities, and poor maintenance due to inadequate funding. The result: Residents of these communities often have the fewest opportunities for physical activity.

In Los Angeles, for instance, access to recreational space is disturbingly inequitable. While standards vary, many experts recommend that a city have at least ten acres of park and recreation space per thousand residents. White L.A. neighborhoods more than meet that standard – with an average of 32 acres of park space per thousand residents – but Latino and African-American neighborhoods have only 0.6 and 1.7 park acres, respectively. Similarly, low-income neighborhoods have less than a half-acre of park space per thousand residents, while higher-income neighborhoods have 21 acres.

These patterns are pervasive. Throughout California and the country, low-income communities and communities of color are far less likely to have access to recreational spaces than their white, higher-income counterparts. Unfortunately, and perhaps not surprisingly, the places with the fewest opportunities for physical activity often have worse health outcomes.

Health Inequities in California

The lack of safe, affordable places to play and be active contributes to the health inequities facing low-income communities and communities of color across the state. Residents of “park poor” communities disproportionately bear the burdens of the obesity and diabetes crises:

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