Public Health Practice: Informing, Connecting, Acting City Match Conference September 21, 2008 Albuquerque, New Mexico

Jamal Martin Victoria Sanchez Kristine Suozzi New Mexico Health Equity Working Group (NMHEWG)

NMHEWG Mission To promote health equity in New Mexico by: Reframing the predominant view of health to include and address the social determinants (social, economic and political factors) of health; Connecting individuals, communities, and organizations to work together towards health equity and; Advocating for ethical policies that eliminate or mitigate disparities and inequalities that affect health.

Today’s Session Inform – listen; experience together Connect – analyze and learn together Act – identify and commit to action

Policy and Public Health Arena Community setting Clinical setting - Services available - Built environment - Social environment - Services available - Competent staff - Structure Improved Healthcare - Processes -Intermediate/ surrogate outcomes Improved Community Status Address quality of care Address local factors Access Outreach Lesson Disparities in Health Improved Health Clinical and Community Approaches to Health Source: Challenges and Successes in Reducing Health Disparities: Workshop Summary (2008) (adapted)

6 Intrapersonal Interpersonal Organizational Community Socio-Political Social Ecological Framework

BUT WHY? Problem: Low birth weight Community Organizational Interpersonal Individual Socio-political

8 Ecological Level:Target of change:Types of interventions/initiatives: Intrapersonal/Individualcharacteristics of the individual (e.g., knowledge, attitudes, skills) educational programs mass media support groups organizational incentives peer counseling InterpersonalInterpersonal processes, and primary groups including family, friends, peers, that provide social identity, support, and role definition educational programs peer education support groups LHAs Institutional/Organizational Social institutions Organizational norms Organizational structures and processes educational programs organizational policies training programs worksite modification changes in changes in rules and regulations, benefits, structure of work Community/social environment Social environment; community norms informal networks of people access of community to decision- making processes local health policy initiatives Public PolicyLocal, state, and national laws and policies; government regulations and other regulatory processes, procedures, or laws to protect health Government and other regulatory processes: – behavioral incentives – allocation of resources – behavior restriction Social Ecological Framework

Undoing Racism in Public Health: A Blueprint for Action in Urban MCH A Special Report to the W.K. Kellogg Foundation Barnes-Josiah, D.L., (2004) CityMatCH at the University of Nebraska Medical Center