ReimaginingHealth Through an Equity Lens Northern California Grantmakers Bay Area Health Funders Group Health Equity: Achieving Quality Health For All People April 17, 2015 George R. Flores MD, MPH

Who We Are 2 Largest statewide health foundation in CA Mission is to expand access to affordable, quality health care for underserved individuals and communities, and to promote fundamental improvements in the health status of all Californians. 10-year, $1 billion Building Healthy Communities (BHC) initiative to advance statewide policy, change the narrative, and transform 14 of California’s communities most devastated by health inequities into places where all people have an opportunity to thrive. How? Strategic grantmaking, campaigns, and partnerships

The Program Structure 3 Healthy California (Statewide)- Three basic teams: Prevention, Schools, and Neighborhoods. Healthy Communities (Local)- Initiative: Building Healthy Communities. 14 sites. Sub-Campaigns: -Health Happens Here -Asegurate/Get Covered -#HealthandJustice4All -#Do the Math -#Schools not Prisons -#Raise the Wage -Junk Drinks -#Agua4All -#SonsandBrothers

Our health largely depends on conditions where we live, learn, work and play - and not just on the medical treatment we receive.

Inequitable Conditions Link to Poor Outcomes

Historical Narrative POLICIES: Redlining, racially restrictive covenants, land ownership rights, Medicaid, Social Security, affordable housing PRACTICES: Racial segregation- inner cities, barrios, reservations, Chinatowns PRESENT: Predatory lending, immigration, incarceration, school push out, gay marriage Common Denominator: EXCLUSION

“Simply put, in the absence of a radical shift towards prevention and public health, we will not be successful in containing medical costs or improving the health of the American people.” - President Obama

Unprecedented Resources to Prevent Illness & Keep People Healthy Expanded Insurance Coverage Prevention Services Innovation Models Health Equity Provisions Health Workforce Incentives Health Homes Better Care  Lower Cost  Better Health Equity Equity

Equity Improves the Bottom Line Despite our wealth, the U.S. is unhealthier across the board than our peers. There is evidence that flattening the social gradient improves the health of all. Transferring some of the medical care overspend to equitable social and infrastructure investments can both stabilize the nation’s fiscal health, and improve well-being. Focused upstream interventions (policy, system, and environmental changes) offer promise.

Advancing Health Equity Must explicitly address and understand how we got here. (What is the history?) Must give voice to those most impacted by the inequitable conditions.

Collaboration for Change Health Equity Priority Bridge Care and Community Health Impact Assessment Health in All Policies 100% Coverage & Access Health Homes Community Outreach Empowered Patients Build Capacity Advocate Partnerships Stewardship Youth Involvement Individual Medical Care Public Health Community Health

Family &Culture

Building Healthy Communities 17 Del Norte and ATL South Sacramento Richmond East Oakland Southwest/East Merced County East Salinas Central/West Fresno South Kern Boyle Heights Central Long Beach South Los Angeles Central Santa Ana Eastern Coachella Valley City Heights

Healthy Communities Build Resident Capacity Leverage Partnerships Change the Narrative Youth Leadership Health & Equity Advocacy POWER POLICY COMMUNICATIONS

Transformative Policies School Climate School Wellness Comprehensive Supports Food Environment and Food Systems Land-Use Planning and Anti-Displacement Community and Economic Development Environmental Health and Justice Systems that Restore and Heal Healthy Youth Opportunities Public Health Coverage, Care and Community Prevention Health Care Services

Big Wins at the Half-way Point Cutting the numbers of uninsured Californians in half. Igniting a statewide policy debate about health coverage for undocumented Californians. Reducing epidemic numbers of school suspensions by nearly a third. Catalyzing nationwide and statewide strategies on improving wellness in young men of color. Influencing regional planning with health and prevention approaches.

Community is the Cure, Health Equity the aim. We all have a role. We all stand to gain.

Thank you! George R. Flores MD, MPH Program Manager, Healthy California Phone: Website: