By Lori Freeman, MBA
Chief Executive Officer, AMCHP
This edition of Pulse continues our approach in 2016 to focus issue themes on select core values and major initiatives at AMCHP, including health equity and social justice, quality improvement, consumer and community engagement and evidence-based/informed practice.
This change of focus allows each theme to be a focal point and for articles from various other areas of MCH – such as women’s and infant health, CYSHCN, child and adolescent health, health reform implementation, and workforce and leadership development – to contribute to our discussion of these high-level, broader themes.
Health equity and social justice present an important first topic to address. It has been encouraging this past year or so to see health equity and social justice emerge as a necessity to advance current public health initiatives. Interventions can and do often improve certain health outcomes; yet, there is new willingness to recognize that unless underlying conditions that affect people’s health and well-being are acknowledged and addressed alongside traditional public health and clinical interventions, progress will be slow and our goals illusive.
There are some excellent recent examples (many more than noted here) of intersections in AMCHP’s work with partners and funders where we see the importance of health equity and social justice playing out in real time and showing strong influence and promise.
The March of Dimes – The March of Dimes recently hosted a two-day strategic planning session for its Prematurity Campaign. The purpose of the meeting was to develop a five-year strategic map for mobilizing support to meet aggressive preterm birth rate reduction goals. You might remember from one of my previous Pulse articles that March of Dimes has established ambitious goals to reduce preterm birth rates in the U.S. to 8.1 percent by 2020 and to 5.5 percent by 2030 with a focus on high-burden populations and areas. If the 2020 goal is achieved, 210,000 fewer babies will be born preterm (1.1 million fewer if the 2030 goal is achieved), resulting in savings of $67 billion in health and societal costs. The meeting was a unique attempt to conduct a strategic planning session with a full collaboration of 30 different organizational leaders.
By the end of our time together, we had drafted a strategic map with a central challenge to "Achieve Demonstrated Improvements and Health Equity in Preterm Birth."
This was a rather significant development with the focus on health equity across five major strategic priorities including: a) increasing effective use of evidence-based clinical and public health practice; b) expanding discovery and accelerating translation; c) prioritizing population- and place-based strategies; d) developing and implementing messaging, policy and practice strategies; and e) securing the funding and resources required for success. I was also particularly impressed that we also agreed to three crosscutting, important themes across these five priorities: 1) emphasizing the health of women and adolescents; 2) engaging families, communities and other strategic partners across sectors through a collaborative infrastructure; and 3) optimizing the use of data and evaluation to drive learning and success.
There’s much more to come from these efforts as a partner with March of Dimes in the Prematurity Campaign, so stay tuned for next steps as we further synthesize the mapping and proceed with implementation planning, identifying tracks of work for the next year and communicating the strategic map to our various publics and other constituencies.
ASTHO – As a member of the affiliate council of the Association of State and Territorial Health Officials (ASTHO), AMCHP was briefed last September by Dr. Ed Ehlinger, Minnesota commissioner of health and new ASTHO president, on his 2016 ASTHO President’s Challenge, "Advancing Health Equity and Optimal Health for All." Dr. Ehlinger challenged states to go back to their roots, change how they do their public health work and change their public health practices in order to help ensure the conditions in which all people can be healthy. The emphasis of the challenge is to use a "triple aim" for health equity including: a) Expand the understanding of what creates health and change the narrative that health is determined mostly by medical care and personal choices. In his remarks, Dr. Ehlinger reminded the group that medical intervention only contributes about 10 percent to individual health; b) Take a "health in all policies" (HiAP) approach, with health equity as the goal. Understanding how polices relating to transportation, housing, education, public safety or environmental protection can impact health outcomes is part of the HiAP approach; however, Dr. Ehlinger challenges us to add the health equity lens by considering who is benefiting and who is left out; and c) Strengthen the capacity of communities to create their healthy future by involving them in creating policies and systems that improve conditions for their residents. You can read much more about the challenge here.
Best Babies Zones – An example of both cross-sectoral and place-based efforts, particularly in the context of health equity and social justice in MCH, is the work AMCHP and many other organizations do to support Best Babies Zones (BBZ). The initiative is a multi-sector approach to reducing infant mortality and racial disparities in birth outcomes and improving birth and health outcomes. The focus of this work is on mobilizing communities, at a zonal/neighborhood level, to address the social determinants that affect health by targeting economics, education, health and community. BBZ is funded by the W.K. Kellogg Foundation and is being implemented in three cities: Cincinnati, New Orleans, and Oakland, California. AMCHP is a national partner and member of the BBZ Policy Corps that helps to strategically position and grow the initiative. BBZ also has an important subcomponent, the Multisector Advisory Group, which focuses on bringing partners from other sectors to the table and ensuring multisector engagement at the local level. This group helps to identify indicators for the project and what sectors should be included and prioritized for engagement given the indicators selected: how to engage sectors effectively, how to identify each sector’s contribution, how to tie sectors to health and how to broadly influence policy change and multisector engagement above community levels. If you are interested in learning more the importance of healthy equity in the context of this work, I recommend two readings: "Growing a Best Babies Zone: Lessons Learned from the Pilot Phase of a Multi-Sector, Place-Based Initiative to Reduce Infant Mortality" and "Developmental Origins, Epigenetics, and Equity: Moving Upstream."
Because healthy equity and social justice are part of AMCHP’s core values, this work is crucial and should be actively considered in all of our approaches and activities. As part of AMCHP’s 2016-2018 strategic plan, our evidence-based goal reflects this approach by increasing the capacity of states and territories to use evidence to drive policy and program design to improve MCH outcomes and health equity. Please enjoy reading how health equity and social justice are being incorporated across many other facets of MCH and public health in this issue.