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Promote equitable social, economic and environmental conditions to
achieve optimal health, mental health, and well-being for all.
Office of Health Equity MISSION
“Health equity” means efforts to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives.
Source: California Health and Safety Code Section 131019.5
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Wealth is Health
The life expectancy used is the average of the male and female life expectancies for 2009.Compiled by SFRB. Life Expectancy: Institute for Health Metrics and Evaluation, Life Expectancy US Counties, 2009.
The Office of Health Equity (OHE) was established in 2012 to align state resources, decision making, and programs to accomplish all of the following:
Achieve the highest level of health and mental health for all people, with special attention focused on those who have experienced socioeconomic disadvantage and historical injustice
Work collaboratively with the Health in All Policies (HiAP) Task Force
Advise and assist other state departments in their mission to increase access to, and the quality of, culturally and linguistically competent health and mental health care and services
Improve the health status of all populations and places, with a priority on eliminating health and mental health disparities and inequities
CA Health and Safety Code 131019.5
Conduct policy analysis and develop strategic policies and plans regarding specific issues affecting vulnerable communities and vulnerable places.
The policies and plans shall also include strategies to address social and environmental inequities and improve health and mental health.
The office shall assist other departments in their missions to increase access to services and supports and improve quality of care for vulnerable communities.
Key Duties of the Office of Health Equity
Achieving equity at every level
Achieving Health & Mental Health Equity At Every Level. Source: California Department of Public Health, Office of Health Equity as inspired by World Health Organization, Robert Wood Johnson Foundation, and many others.
Addressing the causes of the causes
Bay Area Regional Health Inequities Initiative (BARHII) Conceptual Framework, 2006.
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Stakeholder guided process
Demographic analysis
Coordinationwith HIAP
Guidance from
OHE-AC
https://www.youtube.com/watch?v=tItJMWItll0&feature=youtu.be
12The California Statewide Plan to Promote Health and Mental Health Equity
Demographic Report
2002 2003 2004 2005 2006 2007 2008 2009 20100
200
400
600
800
1000
1200
African American
White/Other/Unknown
Pacific Islander
Latino
Asian
American Indian
Multi-Race
Male
Female
Age
-adj
uste
d de
ath
rate
per
100
,000
pop
ulati
on
Source: California Department of Public Health, Death Records; and California Department of Finance, Race and Ethnic Population with Age and Sex Detail, 2000-2050. Sacramento, California, July 2007.
Note: Age-adjusted rates are calculated using year 2000 U.S. standard population.
About 33% of female-headed households and 9% of married-couple households live below the federal poverty level
Source: U.S. Census Bureau, American Community Survey, 5-year Estimate (2006-2010).
Percentage of people aged 0-64 without health insurance† during the past 12 months, by race/ethnicity and gender, California, 2001 to 2011.
Source: University of California Los Angeles, California Health Interview Survey, 2001-2011.Note: Asian includes Native Hawaiian and other Pacific Islander.† Had no insurance the entire year or had insurance only part of the past year.* Statistically unreliable data.
Latinos have the highest rates of being uninsured for health insurance of any racial/ethnic group in California
2001 2003 2005 2007 2009 20110
5
10
15
20
25
30
35
40
LatinoWhiteAfrican AmericanAmerican Indian and Alaska Na-tiveAsianMulti-RaceCaliforniaMaleFemale
Perc
ent
unin
sure
d
*
1 in 4 children in California does not have enough food to eat
Child food insecurity rate: percentage of children under 18 years old who are food insecure, California, 2012.
Source: Feeding America, Map the Meal Gap, 2012; U.S. Census Bureau, American Community Survey, 3-year Estimate (2009-2011) and 5-year Estimate (2008-2012); and California Department of Education, Graduation Data, 2011-2012.†Median family income with own children under 18 years.
Number of violent crimes per 1,000 population, by cities and towns, Los Angeles County and Bay Area, California, 2010.
Source: Federal Bureau of Investigation, Uniform Crime Reports, 2010. Analysis by CDPH-Office of Health Equity and UCSF, Healthy Community Indicators Project.
The risk of crime can be highly disparate for neighboring California cities and towns
Percentage of adults who reported having seriously thought about committing suicide, by race/ethnicity, sexual orientation and gender, California, 2011-2012.
Source: University of California Los Angeles, California Health Interview Survey, 2011-2012.Note: Other includes not sexual/celibate/none/other.* Statistically unreliable data.
Rates of suicidal thoughts are higher among bisexual, gay and lesbian adults
Strategic Elements of Plan
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Tangible goals
ASSESSMENT• Build capacity to collect and analyze
data highlighting social determinants of health
• Assess data shortcomings and explore disaggregated data
• Scan environment for local community responses
The Healthy Communities Data and Indicators Project (HCDIP)
• What is the HCDIP? • HCDIP uses the “Healthy Community Framework” as the
basis for the selection of a standardized set of indicators or measures of economic, geographic, social, and physical environmental conditions, that are recognized as important determinants of population health.
• Work is conducted by CDPH’s Office of Health Equity.
• What is the Healthy Community Framework?
• It is a set of twenty aspirational goals grouped in five domains that outline what is a healthy community. It was developed by the California Department of Public Health in consultation with Health in All Policies Task Force members and stakeholders.
The Healthy Communities Data and Indicators Project (HCDIP)
• What has the HCDIP achieved? • The project identified 56 indicators of healthy communities,
researched data sources and methods to produce the indicators, conducted focus groups, and produced Excel data files for 26 indicators.
• Depending on availability the data files contain information (1) at the state, region, county, city/town, and census tract level; (2) for multiple time periods; (3) for race/ethnicity subgroups.
• A How-to Manual that helps users create a community report card. Website: http://www.cdph.ca.gov/programs/Pages/HealthyCommunityIndicators.aspx
• What is the future of the project?
• The project continues the development of indicators and is searching for new funding opportunities to create an interactive website and to update the existing indicators.
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Tangible goals
COMMUNICATION• Create comprehensive marketing and
communications plan
• Build broad-based communications network to engage stakeholders
• Develop and launch state-of-the-art website
• Provide leadership in sharing health equity efforts for adoption state wide
“It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change.”
Institute of Medicine
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California Health In All Policies Task Force
Health in All Policies: A Guide For State and Local
Governments (October 2013)
Created in partnership by:• American Public Health
Association• Public Health Institute• The California Endowment • California Department of
Public Health • http://
www.cdph.ca.gov/programs/Pages/HealthinAllPolicies.aspx
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Tangible goals
INFRASTRUCTURE• Partner on existing equity summits for practitioners
and policymakers
• Recommend equity be embedded as a priority in
funding streams
• Monitor and partner with federal efforts to reduce
disparities
• Ensure gender lens is used when assessing
promotion of health equity
• Leverage community efforts to impact equity issues
statewide
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http://www.cdph.ca.gov/programs/Pages/OHECaliforniaReducingDisparitiesProject.aspx
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CRDP Overview
• Community Mobilizing/Grassroots Partnership
• Community-Defined Evidence (CDE)
• This is a key statewide policy initiative to improve:o Access to careo Quality of careo Positive mental health outcomes for racial,
ethnic, and cultural communities
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CRDP Vision
• Identification of strategies developed across targeted communities to improve outcomes and reduce disparities
• Implementation of selected community-identified strategies
• Culturally and linguistically competent Community Participatory Evaluation of community-defined evidence (CDE) for racial, ethnic, and cultural communities
• Replication of approaches to reduce mental health disparities
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“service delivery defined by multicultural communities for multicultural communities”
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CRDP Population Reports
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Community Recommended Actions
Systems Level• Workforce development• Capacity building
Community Level
• Community involvement/engagement• Community leadership
Provider Level• Linguistic access• Robust community engagement/cultural brokering
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Status of CRDP Phase II
• Solicitations went out for public comment and the deadline for all feedback was April 8, 2015.
• CDPH finalized edits.• Solicitations were released in August
and updated in September 2015.• Find Frequently Asked Questions on
the webpage. • Direct all CRDP-related questions to
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33The California Statewide Plan to Promote Health and Mental Health Equity
Everyone Has a Role
• Make recommendations to OHE on implementing the plan
• Public comment - OHE Advisory Committee meetings and your local equivalent
• Respond to calls for action and solicitations• Educate and engage your spheres of influence• Local replication of statewide efforts• Model and implement health equity practices and
policies – build knowledge and network through trainings, webinars and summits
• Distribute the plan and complementary documents, media, or other tools
34The California Statewide Plan to Promote Health and Mental Health Equity
We Want to Hear from You
• Which communities or populations are being disproportionately impacted and what are the causes and consequences of their inequities?
• Recommendations on policies or practices that OHE or other governmental entities might be able to impact?
• Data to collect, analyze or distribute?• Processes for improved stakeholder or
decision-maker engagement?• Resource or partnership opportunities?
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Aligning Efforts for Plan Implementation
• What equity issues are you addressing?
• What have been your successes?• What have been your challenges?• In what ways is your work aligned
with the Statewide Plan?
Sign up for OHE e-blasts at [email protected]
Visit our website athttps://
www.cdph.ca.gov/programs/Pages/OHEMain.aspx
Stay Connected to the Office of Health Equity
