ELIMINATING HEPATITIS IS A HEALTH EQUITY AND SOCIAL JUSTICE ISSUE Terrance Moore, Deputy Executive Director Welcome everyone! I’m Terrance Moore, Deputy Executive Director at NASTAD. For those of you who have been doing this work for a long time – you may remember that when I started at NASTAD 13 years ago, one of the projects that I worked on was hepatitis policy – the work that Mariah Johnson now leads. So its great to be continuing this work and be here with you for this meeting. We wanted to include a session at this meeting on the topic of health equity and social justice. Implicit in our work is that our work and our goal of eliminating hepatitis IS a health equity and social justice issue. However we haven’t spent much time actually talking about the work in that way. I’m excited to be joined by Jasmine Tyler and Rachel McLean as we spend some time diving deeper into what we mean by health equity, social justice, some historical context – and what this means for our work. National Hepatitis Technical Assistance Meeting December 5-7, 2016

Mission and Vision NASTAD’s mission is to end the intersecting epidemics of HIV, viral hepatitis, and related conditions by strengthening domestic and global governmental public health through advocacy, capacity building, and social justice. NASTAD's vision is a world free of HIV and viral hepatitis. Health equity and social justice have been a central part of NASTAD (and health departments) work since the earliest days of the HIV and hepatitis epidemics. To better reflect this – earlier this year, our Board of Directors updated our Mission to explicitly reference the importance of ending the intersecting epidemics of HIV, hepatitis and related conditions – and highlight the important role of social justice in this work.

What Is Health Equity? Health Equity: Attainment of the highest level of health for all people. Health Equity means efforts to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives. Health Inequities: Differences in health that are avoidable, unfair, and unjust. Health inequities are affected by social, economic, and environmental conditions. Health Disparities: Differences in health outcomes among groups of people. In public health, we hear a lot about these terms – so let’s spend a minute on some definitions.

What Is Health Equity? This visual nicely shows the difference between equality vs. equity. In our work to address hepatitis (or any other health issue) – we know that the same messages, approach and strategies don’t work for everyone. Rather, we need to ensure that our efforts for the most impacted communities are tailored to speak to their specific needs, lived experiences and the realities of their lives

What Is Social Justice? Social justice is promoting a just society by challenging injustice and valuing diversity. It exists when all people share a common humanity and therefore have a right to equitable treatment, support for their human rights, and a fair allocation of community resources. To achieve health equity – we need to ensure there is social justice. Again – providing the same messages, approach and strategies for all communities doesn’t necessarily work. The “majority” community – whatever that may be or look like – is intrinsically at a place where they have access to services, experience better health outcomes, etc. For others, including communities of color, people with substance use disorders, the economically disadvantaged, and geographically isolated communities – access to services may be limited, these communities may experience poorer health outcomes, etc. By approaching the need for health equity through a social justice approach, we can follow the model of other health and social issues to raise attention to these urgent yet complex needs.

What Is Social Justice? Over the course of history – there have been many social justice movements which have sought to address a variety of health and social issues. Some resulting in successful policy changes and increased health outcomes. Others are still working to achieve equity. Here are examples of social justice movements from the more recent past.

How Does this Relate to Hepatitis? Who is most impacted by new cases of hepatitis? Where is there less harm reduction infrastructure? Why are people who inject drugs being denied HCV treatment? Why are people who are incarcerated being denied HCV treatment? Why hasn’t this issue risen to the top of policymakers’ priority list? So how does this specifically relate to our work in hepatitis? We’ll spend some time exploring these issues in the next two presentations – and throughout this meeting.

Health Equity & Social Justice To reach our goal of elimination, we as a nation must: Prioritize prevention, care and treatment for people who inject drugs Ensure that vulnerable communities have access to a range of services, including primary medical care, substance use and mental health treatment, housing and economic development Ensure that regardless of where one lives, they have access to needed services (rural, suburban, urban) Give voice to people most impacted by hepatitis – by engaging in meaningful ways, ensuring their voice is included in discussions Speak up when you hear stigmatizing language, policies and attitudes As we continue to work towards meeting basic health needs related to hepatitis – with our eye on eventual elimination, here are some important factors we should be acknowledging and working to address.

Not Business As Usual. You’ve heard about our Chair’s Challenge to “End the Epidemics” – but I want to specifically point out one piece of this from our Chair DeAnn Gruber. Specifically – This is not business as usual.

The Fight Continues Thanks again for your incredible work, and I look forward to hearing more from Jasmine Tyler from the Open Society Foundations and Rachel McLean from the California Department of Public Health. Jasmine -