Abstract
Readiness for Perspective Transformation Regarding Structural Racism in the Workplace
Scott Frank, MD, MS1, Colleen Walsh, PhD2, Gregory Brown, Executive Director, Policy Bridge3, Erika Anthony4, Evelyn Burnett4, Matthew Kucmanic, MA, MPH5 and Heidi Gullett, MD, MPH1
(1)Case Western Reserve University School of Medicine, Cleveland, OH, (2)Cleveland State University, Cleveland, OH, (3)Policy Bridge, Cleveland, OH, (4)Cleveland Neighborhood Progress, Cleveland, OH, (5)Case Western Reserve University, Cleveland, OH
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Purpose: Describe attitudes among Community Health Improvement Planning (CHIP) consortium members concerning readiness for perspective transformation regarding racism in the workplace. Background: A large CHIP partnership in an urban Midwestern County identified “Eliminating Structural Racism as a Social Determinant of Health” as a top CHIP priority. Perspective transformation was identified as a mechanism to advance this priority, defined as becoming critically aware of how and why people’s assumptions limit the way they perceive the world and act on this understanding. Methods: Cross-sectional online survey was distributed to CHIP members (n >300, 69 respondents). Factor analysis and reliability testing were used to analyze items (27) and create 3 Racial Awareness scales: Racial Cognizance (8 items), Readiness for Workplace Perspective Transformation (7 items), and Personal Experience of Workplace Racism (5 items). Results: Respondents were 35-60 years (76%); had significant minority representation (36%); and had more than 2-years of experience with the CHIP consortium (48%). Substantially higher levels of racial cognizance (mean=3.4/4) were demonstrated than readiness for workplace perspective transformation regarding racism (mean=2.9/4) and personal experience of workplace racism (mean=2.7/4). Higher racial incognizance was noted among those in a position of strategic leadership. Those already more racially aware advocated for more education in structural racism. Respondents who had participated in a one-day equity workshop during the past year showed significantly higher scores on all racial awareness scales. Conclusion: While racial cognizance alone is insufficient to engender readiness for workplace perspective transformation, equity training was demonstrated to increase all levels of racial awareness.
Administration, management, leadership Diversity and culture Public health administration or related administration Public health or related organizational policy, standards, or other guidelines Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Trends in Health Impact Assessments in the United States-Does State Government Ideology Matter?
Shweta Pathak, PhD, MPH1, J. Michael Swint, PhD2 and David Low, MD, PhD3
(1)University of Texas School of Public Health, Houston, TX, (2)The University of Texas School of Public Health, Houston, TX, (3)University of Texas School of Public Health (UTHealth), Houston, TX
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Many prevalent chronic health conditions facing our nation—such as diabetes,heart disease, obesity and asthma—are shaped by the places where we live and work. Health impact assessment (HIA) is a systematic tool for policy makers to gather scientific data, health expertise and public input to identify the potential health effects of proposed new laws, regulations, projects and programs. Some laws directly require, indirectly facilitate, or potentially inhibit the performance and use of HIAs to guide decisions. However, several agencies and communities have conducted most HIAs voluntarily.
Purpose: To examine HIA implementation trends from 2006 to 2014, and determine whether state educational attainment levels, poverty and political ideology were driving HIA implementation among U.S states.
Methods: We used data available through the Health Impact Project-a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. Additionally, we supplemented the data with state-level characteristics such as education and poverty obtained through American Community Survey and state political ideology scores developed by Richard Fording at the University of Alabama. We performed tests of association to examine the relationship between HIA implementation and socio-politico-economic characteristics.
Results: HIA implementation significantly increased over time across all states. Western states had the highest count of Health Impact Assessments in the nation. State political ideology was not associated with the likelihood of HIA implementation among states in a given year but educational attainment -levels seemed to be strongly associated with HIA implementation.
Conclusion: Educational attainment is a key factor associated with HIA implementation in the United States. Knowledge dispersion and increasing awareness among policy-makers about HIA in non-health sectors can help facilitate HIA implementation over time. Educational institutions can play a major role in bridging this gap between knowledge and practice of HIAs.
Administer health education strategies, interventions and programs Administration, management, leadership Advocacy for health and health education Program planning Public health or related public policy Public health or related research
Abstract
Promoting Health Equity: Health in All Policies in Practice
Peter D. Jacobson, JD, MPH
University of Michigan, Ann Arbor, MI
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Scholars and public health advocates have expressed optimism about the potential for Health in All Policies (HiAP) to address social disparities in health. The defining feature of this approach is a decision making process that involves cross-sector collaboration, but little research has been done on whether it promotes health equity in practice. Based on 65 in-depth interviews with U.S. state and local officials conducted in five states from 2016-2017, we found a relationship between the use of a HiAP and the prominence of health equity as a policy concern. In emphasizing the social determinants of health, HiAP gives public officials and policy entrepreneurs a framework for promoting this goal. In some areas, we found a gradual transition in focus from health generally to health equity. At the same time, the connection between HiAP and health equity is variable; it tends to be organized around specific issues. Finally, our interviews indicate that framing HiAP initiatives in equity terms tends to be strategic and selective. Health officials anticipate and adapt to the incentives and constraints created by other institutional actors, which has lessons for other policy actors in applying the HiAP approach. Respondents noted that in working across sectors it is important for public health practitioners to avoid public health imperialism. Our results suggest that HiAP is useful as an organizing principle by providing a framework around which multiple stakeholders can operate. The successful HiAP efforts start small, based on bilateral interpersonal relationships, demonstrate proof of concept to other governmental agencies and community organizations, and then expand to multilateral collaborations. In particular, initial success leads to joint grantmaking efforts. But implementation is a long process. In our case studies, there were only limited data to demonstrate how these initiatives have improved health equity or reduced health disparities.
Administration, management, leadership Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Other professions or practice related to public health Public health administration or related administration Public health or related organizational policy, standards, or other guidelines
Abstract
Implementation of the National CLAS Standards to Advance Health Equity and Eliminate Health Disparities
Dianne Fragueiro, MPH1, Jennifer Kenyon, BA2, Kimberly Green, MPH, CHES1, Karolina Schantz, MPH2, C. Godfrey Jacobs2 and Alexis Bakos, PhD, MPH, RN3
(1)CSRA, Rockville, MD, (2)Health Determinants and Disparities Practice, GDIT, Rockville, MD, (3)U.S. Department of Health and Human Services, Rockville, MD
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
According to the U.S. Census Bureau, racial and ethnic minority communities make up about 37.9% of the U.S. population and will become the majority nationwide within 30 years.1 Racial and ethnic minority communities face significant disparities in access to care, quality of care, and health outcomes. Health and healthcare organizations must find ways to address these disparities by bridging cultural and communication barriers to provide equitable, appropriate services to all populations. Culturally and linguistically appropriate services (CLAS) represent an important strategy to help eliminate health disparities and improve health outcomes for diverse populations. CLAS are services that are respectful of and responsive to an individual’s cultural and communication needs. CLAS can improve the quality of care provided to individuals regardless of race, ethnicity, socioeconomic status, communication needs, or other cultural characteristics.
To operationalize CLAS, the Office of Minority Health at the U.S. Department of Health and Human Services developed guidelines called the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. The National CLAS Standards provide health and health care organizations and professionals with 15 action steps for providing effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.
This presentation will describe how the National CLAS Standards help organizations improve quality of care, eliminate health disparities, and advance health equity.
Diversity and culture Public health or related education Public health or related laws, regulations, standards, or guidelines