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Health Equity Matters

In this Newsletter

Winter 2015 ~ Vol.4, #1

A quarterly e-newsletter in which the Centers for Disease Control and Prevention's (CDC) Office of Minority Health and Health Equity (OMHHE) shares news, perspectives and progress in the science and practice of health equity.

Leandris C. Liburd, PhD, MPH, MA
Associate Director for Minority Health and Health Equity, CDC/ATSDR

Welcome to Health Equity Matters, an electronic newsletter intended to promote awareness of minority health and health equity issues that affect our work at CDC and in the broader public health community, support the achievement of our goal to eliminate health disparities, and foster ongoing communication and collaboration.

Greetings! We hope your work in the New Year is progressing toward health equity as we celebrate Black History Month, the 50th anniversary of the passage of the Voting Rights Act of 1965, the creation of Medicaid and Medicare and the Head Start program. This year marks a number of milestones in our nation’s efforts to reduce health disparities and improve minority health. We will celebrate 30 years since the release of the 1985 Secretary’s Task Force Report on Black & Minority Health and 100 years since the establishment of National Negro Health Week by Dr. Booker T. Washington which evolved to National Minority Health Month. The Office of Minority Health and Health Equity is collaborating with a number of partners this year to pause, reflect, assess our progress, and continue to move forward toward achieving health equity. For example, we will be releasing several new reports this year including the first Vital Signs Report on Hispanic Health. We are also co-sponsoring in partnership with Tuskegee University, Morehouse School of Medicine, and the Atlanta University Center a health summit at CDC that will examine African American and minority health over the past 100 years, review federal initiatives to improve minority health through research, practice, and policies, and explore health equity strategies needed to improve population health outcomes in the 21st century. Stay tuned… There is much more to come!

In this issue of Health Equity Matters, we congratulate Dr. Camara Jones on her recent election as President-elect of the American Public Health Association, and we honor Dr. Robert Hahn – the first CDC scientist to be selected Health Equity Champion by the Office of Minority Health and Health Equity. Both Dr. Jones and Dr. Hahn have long and distinguished careers promoting equity and social justice. We also celebrate the accomplishments of several members of the Health Disparities Subcommittee whose leadership is helping to accelerate public health’s impact in achieving health equity; and there are snapshots of activities underway at CDC that support the science and practice of health equity and our efforts to ensure a diverse and inclusive workforce.

With great respect, we salute the life and legacy of Lark Galloway-Gilliam who passed away December 1, 2014. Her vision to end racial and ethnic health disparities will live on through her family and colleagues, and all who have dedicated themselves to eliminating health inequities.

As always, we hope you will enjoy this issue, and your comments are always welcome!
Our readership continues to grow. We now have over 19,000 subscribers, so please continue to shareHealth Equity Matters with others in your professional networks.

CDC's Office of Minority Health & Health Equity (OMHHE)

We look forward to your comments, and encourage you to continue to circulate the newsletter among your colleagues and friends.

Leandris C. Liburd, PhD, MPH, MA
Associate Director for Minority Health and Health Equity, CDC/ATSDR
Office of Minority Health & Health Equity (OMHHE)

News You Can Use!

Work Towards Health Equity Requires Practice and Collaboration
CDC leaders and staff gathered for the State of Health Equity at CDC Forum on November 12, 2014, at CDC’s headquarters in Atlanta, Georgia. This Forum, convened by OMHHE, is the third in an annual series of agency-wide gatherings to discuss issues, opportunities, and challenges related to health equity efforts at CDC.

This year’s forum “Toward Achieving Health Equity: Emerging Evidence and Program Practice,” featured two panels. The first panel, “What are the key characteristics and evidence requirements for effective health equity-relevant programs?” highlighted programs from across the agency addressing a variety of health disparities (e.g. violence prevention, HIV, sexually transmitted diseases, smoking).

The second panel “What are the organizational and structural supports needed for developing effective health equity programs?,” discussed cross-cutting policies and planning activities needed to develop effective and appropriate health equity programs. Engaging in collaboration, developing interventions with more than one approach, and education were recurring themes. “We have been pushing and encouraging collaborations with non-traditional partners,” said Kim Williams, PhD, MSW, Behavioral Scientist, Prevention Research Branch, Division of HIV/AIDS Prevention/NCHHSTP.

Discussions at the Forum also included breaking down silos to reduce duplication of public health efforts and resources. “We need to address all levels concurrently, and the real leverage is in things like structural and societal changes. These are difficult, expensive, and require a focus on collective, cross-sectorial impact that has not typically characterized public health efforts. I think many of us in public health and in program evaluation are up to this challenge,” said Tom Chapel, MA, MBA, Chief Evaluation Officer, Office of the Director/Program Planning and Evaluation Office.

The next Forum, to be held in the fall of 2015, will focus on policy levers that support health equity.
Healthy People 2020: Resources to Address the Social Determinants of Health
Health starts in our homes, schools, workplaces, neighborhoods, and communities. Healthy People 2020 focuses on identifying, measuring, tracking, and reducing health disparities through a determinants of health approach and its newSocial Determinants of Health (SDOH) topic area and objectives. Healthy People 2020 organized the SDOH around five key domains: (1) Economic Stability, (2) Education, (3) Health and Health Care, (4) Neighborhood and Built Environment, and (5) Social and Community Context.

Improving health status by addressing the social determinants that impact individual health requires careful assessment, planning, and use of effective interventions at the community level. Healthy People 2020 recently launched a database of social determinants of health resources, organized by domain, to help departments of public health, community-based organizations, policymakers and others identify strategies for addressing the social determinants of health in their communities and to explore ways communities across the country are addressing these critical issues.
New CDC Diversity & Inclusion Executive Steering Committee (DIESC)
As part of CDC’s ongoing diversity and inclusion management efforts, OMHHE’s Diversity and Inclusion Management (DM) Team created a new, more inclusive Diversity & Inclusion Executive Steering Committee (DIESC). The initial meeting of the DIESC took place on November 18, 2014 at the CDC headquarters in Atlanta, Georgia. It comprises CDC top, middle, division, branch leaders, seven Chairs of employee organizations; one labor management partnership council member, one Hispanic work group member, and one Veteran work group member.

The new Steering Committee will guide and provide support for agency-wide diversity and inclusion initiatives. “Our top four diversity and inclusion management priorities and objectives for fiscal year 2015 are recruitment, retention, succession planning, and sustainability,” said Dr. James Nelson, Chief Diversity Officer, Office of Minority Health and Health Equity.

CDC’s definition of diversity is “an appreciation and respect for the many similarities and differences in the workplace, including the varied perspectives, approaches and competencies of co-workers and populations we serve. Diversity is a resource that is fundamental to organizational excellence.”
“The expanded DIESC creates a space for new relationships to be formed, multiple viewpoints to be heard, and to support efforts to sustain a “habitable work environment.” Coming together through the DIESC will allow us to share experiences and influence change. We want to let all employees know they are valued and engaged in achieving the mission of the agency every day,” said Dr. Liburd, DIESC’s co-chair along with Dr. Ileana Arias, CDC’s Principal Deputy Director.
Remembering, Celebrating, and Acting on Dr. King’s Legacy
CDC held a lively Martin Luther King Commemoration on January 15, 2015. “Remember, Celebrate, Act: Our legacy of Peace for Our World,” was the theme of this year’s celebration. “ At CDC we continue to dedicate our efforts to the spirit of Dr. King’s legacy with primarily our service to communities around the world through our mission to promote health equity, enhance quality of life by preventing and controlling disease, injury and disability,” said Dr. Ileana Arias, CDC’s Principal Deputy Director, on behalf of CDC Director Dr. Tom Frieden. “We are committed to promoting equal opportunity for employment, promotion, and training in all segments of the workforce, and embrace a diverse workforce not only here at CDC but globally.”

This year’s guest speakers were Dr. Nicole R. Phillips, Assistant Professor of Religion and Human Difference, and Dr. Gregory C Ellison, II, Assistant Professor of Pastoral Care, Candler School of Theology, Emory University.
Anniversary of a Landmark Report
The year 2015 marks the 30th Anniversary of the 1985 Report of the Secretary’s Task Force on Black and Minority Health , a landmark eight-volume report, known as the Heckler Report, documenting health disparities affecting Americans of color and recommending action steps for the nation to address these disparities. Both theDepartment of Health and Human Services (HHS)and CDC’s Offices of Minority Health were set up in response to the report.

After years of observing poorer health for Blacks and other minorities in comparison to Whites, the Secretary of HHS, Margaret Heckler, commissioned a powerful task force in 1984 to describe the health status of racial and ethnic minority populations more fully and to consider what the federal government could do to address them.

The Task Force defined minorities as Blacks, Hispanics, Native Americans, and Asian/Pacific Islanders. The Task Force paid particular attention to the higher death rates of Blacks and other minorities in comparison to Whites; noting that there were 59,000 greater deaths for Blacks per year, higher than for any other racial or ethnic group.
Congratulations to the new President-elect of the American Public Health Association (APHA)
OMHHE wishes to congratulate Camara P. Jones, MD, MPH, PhD, Senior Fellow, Satcher Health Leadership Institute, new president-elect of APHA, one of the largest and oldest public health organizations committed to speaking out about public health issues and supporting policies and practices that are most likely to improve the nation’s health.

In November 2014, Jones became the second CDC employee to be elected president-elect of APHA (Faye Wong, MPH, served as APHA president from 2001–2002). Jones, who has over 30 years of public health and medical experience, is a family physician and epidemiologist. In 2000 she joined CDC to serve as research director on social determinants of health and equity within the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). In that role, she led the development of the “Reactions to Race” module on the Behavioral Risk Factor Surveillance System and the establishment and formalization of the CDC Racism and Health Workgroup as an official CDC scientific workgroup.

Now a medical officer in the Office of Public Health Scientific Services’ (OPHSS) Community Guide Branch, Jones is currently on loan to the Morehouse School of Medicine’s Satcher Health Leadership Institute as a senior fellow. Her scholarship on social determinants of health and equity, with a focus on the impacts of racism on the health and well-being of the nation, has earned her awards from APHA, the Cobb Institute of the National Medical Association, and the Association of State and Territorial Directors of Health Promotion and Public Health Education, among others.
From Our Partners on the Health Disparities Subcommittee (HDS)
The following announcements were shared by our partners on the Health Disparities Subcommittee – a subcommittee of the Advisory Committee to the Director (ACD) that provides expert advice and guidance on health disparities to OMHHE and the CDC Director. The Health Disparities Subcommittee is comprised of national leaders representing a broad range of health equity, public health, and health care expertise.
- New Health Equity Office in Connecticut’s Department of Public Health
  HDS member Jewel M. Mullen, MD, MPH, MPA, Commissioner and State Health Officer Connecticut Department of Public Health, has risen to the rank of President of the Association of State and Territorial Health Officials (ASTHO), and has indicated that her President’s Challenge will focus on healthy aging.
  
  She also announced the formation of the Connecticut Department of Public Health Office of Health Equity, replacing the former DPH Office of Multicultural Health. “Promoting health equity is central to our mission at the Department of Public Health,” said Dr. Mullen. “This office provides support and resources to all our programs so they can incorporate health equity into their everyday work.” Dr. Mullen noted that the new Office of Health Equity has supported recent efforts at DPH, including the department’s strategic plan, which now includes “Champion a Culture of Health Equity” as a new cross-cutting objective; and the State Health Improvement Plan, in which health equity and the social determinants of health are overarching themes for the entire plan. The office facilitated the development of a new DPH “Health Equity Toolkit,” which serves as a resource for all DPH staff wanting to incorporate health equity principles into their work through programming, analysis, training, and/or work with subcontractors.
- A Promotion to Advance Reducing Health Disparities
  HDS member Will R. Ross, MD, MPH, Associate Dean for Diversity at Washington University School of Medicine, was promoted last year to Professor in the Department of Internal Medicine, Renal Division. His promotion was largely based on his tireless efforts to enhance Washington University’s public health “footprint” locally and globally. His work can best be described broadly in three areas, each aimed at reducing health disparities: Increasing awareness of health literacy; broadening the understanding of social determinants of health; and improving public health workforce diversity.
  
  Dr. Ross served on the task force that culminated in the creation of the Washington University Institute of Public Health, and pioneered the integration of public health into the medical school curriculum. In 2013, Dr. Ross received the Samuel R. Goldstein Leadership Award in Medical School Teaching, one of the medical school’s most prestigious awards, on the basis of his longstanding efforts to improve student’s knowledge of cultural competence, diversity, and social determinants of health through service learning. “Improving cultural diversity within the public health workforce is not only a 21st century moral imperative, but the centerpiece in our national effort to achieve health equity,” said Dr. Ross.
- Award from the American College of Emergency Physicians
  HDS Chair Lynne D. Richardson, MD, FACEP, Professor and Vice Chair of Emergency Medicine; Professor of Health Evidence and Policy, was the recipient of the 2014 Colin C. Rorrie Jr. Award for Excellence in Health Policy .
  
  This award was presented to Dr. Richardson by the American College of Emergency Physicians for her outstanding leadership at the national level on policy development to end healthcare disparities in the United States. "I am grateful for this recognition by my colleagues in emergency medicine for my efforts to promote health equity - this is work that I am passionate about," said Dr. Richardson.
In Memoriam
Lark Galloway-Gilliam

Tribute to Lark Galloway-Gilliam
OMHHE expresses its condolences on the passing of Lark Galloway-Gilliam, Executive Director, Community Health Councils (CHC) , a Los Angeles-based health promotion, advocacy and policy organization dedicated to building healthy communities and the elimination of racial and ethnic health disparities. She was 61. Ms. Galloway-Gilliam was an advocate for health and human rights, public accountability and quality healthcare for uninsured and underinsured communities. Her reach extended far beyond her own community, and in the summer of 2012 she was nominated by the Office of Minority Health and Health Equity as a Health Equity Champion for communities across the nation working to overcome health disparities and achieve health equity. Her leadership and dedication to the pursuit of health equity will be greatly missed.

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Science Speaks

Selected Publications from OMHHE Authors:

Man-Huei Chang, Michael T. Molla, Benedict I. Truman, Heba Athar, Ramal Moonesinghe, Paula W. Yoon.
Differences in healthy life expectancy for the US population by sex, race/ethnicity and geographic region: 2008.

Journal of Public Health, August 30, 2014.

nternational Journal of Environmental Research and Public Health

Ramal Moonesinghe, Karen Bouye, Ana Penman-Aguilar.
Difference in Health Inequity between Two Population Groups due to a Social Determinant of Health.

International Journal of Environmental Research and Public Health, December 16, 2014; 11(12):13074-83.

Priscilla A. Barnes, Paul C. Erwin, Ramal Moonesinghe.
Measures of Highly Functioning Health Coalitions: Corollaries for an Effective Public Health System.

Frontiers in Public Health Services and Systems Research, August, 2014; 3(3): Article 1.

Tanya Telfair LeBlanc PhD, MS, Laurie Reid BSN, Hazel D. Dean ScD, MPH, Yvonne Green RN, CNM, MSN
Introduction: Health Equity among Incarcerated Female Adolescents and Adult Women: Infectious and Other Disease Morbidity.

.
Women & Health, November 6, 2014; 54(8):687-693.

The Joint Commission Journal on Quality and Patient Safety

Tsulukidze M, Honoré P, Ramal Moonesinghe, PhD, Fisher J.
Classification tree analysis of race-specific subgroups at risk for a central venous catheter-related bloodstream infection.

.
Jt Comm J Qual Patient Saf, March, 2014; 40(3):134-143.

Wayne A. Duffus, Cynthia Trawick, Ramal Moonesinghe, Jigsa Tola, Benedict I. Truman, Hazel D. Dean.
Training Racial and Ethnic Minority Students for Careers in Public Health Sciences.

.
American Journal of Preventive Medicine, November, 2014; 47(5 Supplement 3):S368-S375.

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Health Equity Champion

Robert A. Hahn, PhD, MPH
Coordinating Scientist, CDC Community Guide

On behalf of the Office of Minority Health and Health Equity, I am pleased to recognize Dr. Robert Hahn as a Health Equity Champion. Dr. Hahn is an accomplished medical anthropologist, epidemiologist, and community activist. He embodies the best of the convergence of anthropology and epidemiology, and his expertise is sought globally. At CDC, Dr. Hahn has been a forerunner – a visionary leader motivated by values, ideals, and evidence, who championed the integration of health equity into public health research, policies, and practice much before health equity was as widely discussed or considered essential to achieving the mission of public health. Dr. Hahn is a deep thinker, change agent, and activist anthropologist whose career has been devoted to ensuring the best health for all.

We congratulate Dr. Hahn for his distinguished and enduring service, and designate him a Health Equity Champion!

--Leandris C. Liburd

Robert A. Hahn received his PhD in anthropology at Harvard University (1976) and his MPH in epidemiology from the University of Washington (1986). He began his career at the CDC in Atlanta in 1986 in the Epidemic Intelligence Service.

As a child growing up with parents who were German refugees, Dr. Robert A. Hahn, developed a strong sense of social justice at an early age. It was this development and his interest in other cultures that would lead him to study anthropology.

While pursuing a master’s of public health in epidemiology from the University of Washington, Dr. Hahn learned about the Epidemic Intelligence Service program at the Centers for Disease Control and Prevention (CDC). “I’m very interested in the interaction of mind, body and culture and I wanted to make my anthropology useful,” A member of the Senior Biomedical Research Service, Dr. Hahn has also served as an epidemiological consultant on international projects in Brazil, Hungary, and West Africa. He is the author of Sickness and Healing: An Anthropological Perspective (Yale, 1995) and co-editor of Anthropology and Public Health: Bridging Differences in Culture and Society (Oxford, 2008, second edition). In 1998-1999, he worked as a Capitol Hill fellow in the House of Representatives Committee on Veterans' Affairs and in the office of Congresswoman Louise Slaughter. “I’m honored to be recognized and I feel gratified knowing that what I’ve tried to do in my work is thought to be helpful,” said Dr. Hahn after accepting the Health Equity Champion nomination.

As a Coordinating Scientist of systematic reviews for the Guide to Community Preventive Services (The Community Guide

), Dr. Hahn has led reviews on the prevention of excessive alcohol consumption and violence prevention. Incarcerated Youth

He currently leads a team in reviews of educational interventions to promote health equity. Dr. Hahn believes that working to improve education should be an important part of the efforts of public health professionals to reduce health disparities.

In his work on violence prevention, Dr. Hahn and his review team examined laws and policies that facilitated the transfer of youths from juvenile justice systems to adult criminal justice systems for the purpose of reducing violence. His team found that such laws and policies are actually associated with increased subsequent violent behavior among transferred youth.

For his leadership in the founding of CDC’s Behavioral and Social Science Working Group, he was awarded the “Lifetime Contribution Award for Outstanding Dedication to Excellence in Behavioral and Social Science.” And in 2012, he was awarded the Career Achievement Award by the Society for Medical Anthropology. Dr. Hahn is an active member of the American Anthropological Association and currently participates in leading efforts to bring anthropological expertise to CDC’s Ebola response.
Education

He is an adjunct associate professor in the department of anthropology at Emory University. Also, he is actively involved as a tutor and advisory board member for KIPP (Knowledge Is Power Program) West End Young Scholars middle school in Atlanta. KIPP is a public charter school system that uses a structured learning environment to prepare students in low-income communities for college.

“A long-term goal of mine is to help make education a public health tool, not just health education, but education overall so that young people can understand social issues and work to address them,” Dr. Hahn said. “I believe that education is probably the most important way of breaking the cycle of poverty.”

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Announcements

2015 Latino Medical Student Association Southeast Regional
February 27–28, 2015
San Juan, Puerto Rico
8th Health Disparities Conference
Xavier University of Louisiana College of Pharmacy
March 12–14, 2015
New Orleans, Louisiana
National Conference on Health and Domestic Violence
March 20-21, 2015
Washington, D.C.
2015 Associations of Schools & Programs of Public Health (ASPPH) Annual Meeting
Framing the Future: A New Paradigm for Academic Public Health
March 22–25, 2015
Arlington, Virginia
4th Annual Public Health Ethics Intensive Course
National Center for Bioethics in Research and Healthcare at Tuskegee University
March 23–27, 2015
Society for Public Health Education (SOPHE) 66th Annual Meeting
Blazing a Trail for Health Education and Health Promotion
April 23–25, 2015
Portland, Oregon

For more announcements, see the Minority Health Announcements Page

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Statistics Highlight

Vital Signs: Preventable Deaths from Heart Disease & Stroke

Vital Signs: Preventable Deaths per 100,000 People, Men, Black-143, AmericanIndian/AlaskaNative-90, White-81, Hispanic-63, AsianPacificIslander-47

Nearly 1 in 3 deaths in the U.S. each year is caused by heart disease and stroke.

At least 200,000 of these deaths could have been prevented through changes in health habits.

Men have the highest risk of death across all races and ethnic groups.

Black men are most at risk. Blacks are nearly twice as likely as Whites to die early from heart disease and stroke.

For More Information:
Holt JB, Huston SL, Heidari K, et al.
Indicators for Chronic Disease Surveillance — United States, 2013
MMWR Recommendations and Reports, January 9, 2015 / 64(RR01);1-15.

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