Abstract

Health Equity and Justice Introduction

APHA 2022 Annual Meeting and Expo

Abstract

Merging Science and Political Action: The Call for Activist Research Approaches in Public Health

Nolan Kline, PhD, MPH, CPH University of North Texas Health Science Center

APHA 2022 Annual Meeting and Expo

Across the US, a number of state legislatures have proposed and passed legislation that threatens the health and wellbeing of socially marginalized individuals, including transgender individuals, immigrants, and people of color. As state and local governments pass explicitly harmful legislation that undermines public health goals, public health researchers and practitioners are called upon to act in the interest of health equity, which may place them against governmental objectives. Although public health researchers and practitioners often find themselves engaging in advocacy and policy work, such work does not often involve questioning the power dynamics of the state itself. Further, those who work in the field of public health often embrace ethical commitments to research participants and communities, and attempt to engage in research that balances power dynamics between researchers and community members through methodological approaches such as community-based particularly research. Similarly, the field uses frameworks such as social determinants of health to describe factors beyond behavioral and biological determinants to emphasize how individual and population health is situated in a number of social, political, and economic relationships. Absent from dominant models in public health research, however, are explicitly activist research methods that emphasize political commitments to communities and challenge state authority. In this presentation, I argue that public health as a field can borrow from other health-related social sciences such as medical anthropology to merge activism and research. An activist-informed research approach in public health is especially needed given the current US political climate and can advance the field overall.

Abstract

Effective altruism: Philosophical concerns with the movement and its impact on global health

Aashna Lal The Hastings Center

APHA 2022 Annual Meeting and Expo

Given that the United States has a surplus of resources that other nations lack, what should we do to strive towards health equity? Effective altruism is a social movement and philosophy that provides one answer to this question.

Effective altruism is based on the belief that relatively well-off individuals in wealthy countries have a moral duty to reduce global suffering through the most effective use of resources possible. Effective altruists rank cause areas based on scale, neglectedness, and tractability and advocate for donations to highly effective charities. Despite the quantitative success of these interventions, some philosophers raise concerns about the unintended consequences of effective altruism’s methods and utilitarian basis, arguing that they result in a disregard for institutional reform and the prioritization of cost-effectiveness over values such as justice and human rights.

This paper examines philosophical criticisms of effective altruism, discussing concepts of individualism, justice and human rights, and the language of philanthropy. Furthermore, given that global health is one of effective altruism’s top priorities, this paper builds upon existing criticisms to argue that the movement has the potential to impose harm through its global health aid efforts.

Examining the philosophical limitations of effective altruism provides insight into the broader landscape of philanthropy and wealth inequality as it relates to health outcomes. By exploring the intersection of wealth, resource distribution, and global health through the lens of effective altruism, this work contributes to ongoing discourse about ethical global health interventions and the necessity of creating equity-based frameworks.

Abstract

Does SDOH technology allow others to profit at the expense of the BIPOC community?

Artair Rogers¹, Jen Lewis-Walden ², Rey Faustino ³ (1)Harvard University, Population Health Sciences and Harvard FXB Health and Human Rights Center , (2)Shift Health Accelerator , (3)Alluma

APHA 2022 Annual Meeting and Expo

Growing trends in the healthcare space reveal deep investments in social determinants of health (SDOH) technology solutions led by White, for-profit companies, rather than resourcing the very communities that experience marginalization and oppression. Tech-forward SDOH interventions are interventions built on digital resources and patient data that emphasize the use of technology and favor institutional priorities and return-on-investment/value cases (health systems and technology vendors) over the needs, perspectives and preferences of the communities they intend to serve.

A recent study showed that there is a rise in the average size of equity funding deals for these for-profit SDOH organizations, like these technology vendors, increased in average size from $11.4 million in 2019 to $75.7 million in 2021. The same study also showed that a total of five companies have a valuation of a billion dollars or higher. The more these trends continue, the more data is collected and monetized, without true transparency, at the expense of Black and Brown communities.

Community governance and ownership has potential to fundamentally shift how healthcare invests in commitments to address racial and health inequities. Specifically, shifting decisions and ownership to communities has implications for social determinants of health investments, including tech-forward investments.

There is a need to create and test a counter-approach where communities are co-owning funding and investment decisions and processes, and in turn, the outcomes achieved.

Abstract

A Pathway to Measuring Health Inequity: Health Equity Indicators in Cardiovascular Disease Prevention

Rashon Lane¹, Simone McPhearson², Katie Miller³, Refilwe Moeti¹ (1)Centers for Disease Control and Prevention, (2)Cherokee Nation Operational Solutions, LLC, (3)Prevention Institute

APHA 2022 Annual Meeting and Expo

In the U.S., historical and current unequal policies and systems, as well as intentional disenfranchisement of Black, Latinx and Indigenous communities, account for health inequities in the leading causes of death, including cardiovascular disease (CVD). There remains a lack of public health evaluation measures that examine how oppressive systems, including racism, classism, genderism and transphobia, account for health disparities. This presentation shares a theoretical framing and process undertaken by the Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention to develop health equity indicators (HEI) for CVD interventions. As an initial step, social justice and equity frameworks were used to identify health equity measurements that depict factors influencing CVD inequities. The identified health equity indicators span societal and institutional levels (e.g., individuals, communities, and healthcare systems). Next, public health practitioners and measurement experts were interviewed to determine the utility and feasibility of the HEI framework and indicators. This presentation will provide an overview of the process and key learnings. It will underscore the importance of intentionally honoring the historical lineages of equity and social science scholars in public health evaluation to inform equity measurement. Lastly, we will discuss how health equity data alone will not end the systemic health inequities observed in disadvantaged communities. We will highlight how we can leverage long-standing work and develop new social justice frameworks to address inequitable systems.