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:
Welcome to This Week in Equity Engagement on Twitter (TWEET) for the week of November 2, 2015. Once again, we have a bunch of great social and environmental justice discussion to highlight. Let’s get to it!
California’s prison spending continues to pace the country.
Last week, CPEHN was one of the many organizations that attended the PolicyLink “Equity Summit 2015: All in for inclusion, justice, and prosperity” in Los Angeles. This three day national gathering convened thousands of advocates, organizers, and elected officials from all over the country to discuss and brainstorm opportunities for policy change with a clear equity focus. Over 60 sessions were offered covering a broad swath of equity-focused topics including: social entrepreneurship, climate change, housing, transportation, incarceration, inclusive governance, employment, and many more.
CPEHN kicked off the Equity Summit by participating in a pre-summit Alliance for Boys and Men of Color Policy Convening where we worked with the Health Policy Workgroup to narrow down the Alliance’s primary focuses for 2016. We have been co-leading the workgroup with PolicyLink and have continued to bring health equity legislation and policy issues to the discussions.
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:
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
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!
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.