Affirming Our Commitment: “A Nation Free of Health and Health Care Disparities” J. Nadine Gracia, MD, MSCE Deputy Assistant Secretary for Minority Health (Acting) Office of Minority Health U.S. Department of Health and Human Services October 19, 2012 The conclusions in this presentation are those of the author and do not necessarily represent the official position of the U.S. Department of Health and Human Services. UVI Caribbean Exploratory Research Center Fifth Annual Health Disparities Institute

OUTLINE  Snapshot of National Initiatives to Address Health Disparities and Social Determinants of Health  Key Strategies and Actions  Building on Partnerships and Collaboration 2

 Globally, approximately 1/4 of diseases, and more than 1/3 of disease burden among children, results from modifiable or preventable factors in the environment  In U.S., cost of diseases in children attributed to environmental factors (e.g., asthma) estimated at $76.6 billion in 2008  Dampness and mold estimated to contribute to 21% of asthma cases (4.6 million) in U.S. at annual cost $3.5 billion  Persistence of health disparities among racial and ethnic minorities  Minorities more likely to live in counties with particulate matter and ozone levels that exceed air quality standards and highest odds of living in inadequate housing 3 Health Disparities and Social Determinants of Health

A National Movement Improving the Health of all Americans 4

Healthy People 2020 Overarching Goals  Attain high quality, longer lives free of preventable disease, disability, injury, and premature death.  Achieve health equity, eliminate disparities, and improve the health of all groups.  Create social and physical environments that promote good health for all.  Promote quality of life, healthy development, and healthy behaviors across all life stages. 5

National Prevention Strategy: Moving the Nation Toward Prevention and Wellness  National Prevention Council: 17 Federal agencies, chaired by the U.S. Surgeon General  Overarching Goal: Increase the number of Americans who are healthy at every stage of life 6

Vision: “A Nation free of disparities in health and health care” 7 Goals I. Transform Health Care II. Strengthen the Nation’s Health and Human Services Infrastructure and Workforce III. Advance the Health, Safety, and Well-Being of the American People IV. Advance Scientific Knowledge and Innovation V. Increase Efficiency, Transparency, and Accountability of HHS Programs HHS Action Plan to Reduce Racial and Ethnic Health Disparities

HHS in Action  Goal Advance the Health, Safety, and Well-Being of the American People  Action Build community capacity to implement evidence-based policies and environmental, programmatic, and infrastructure change strategies  Example CDC Community Transformation Grants –More than $100 million in prevention funding has been awarded to 61 states and communities serving approximately 120 million Americans. –Approximately $70 million was awarded to 40 communities that will directly impact about 9.2 million Americans. – 8

Vision: “A Nation that equitably promotes healthy community environments and protects the health of all people ” 9 Strategic Elements I. Policy Development and Dissemination II. Education and Training III. Research and Data Collection, Analysis, and Utilization IV. Services 2012 HHS Environmental Justice Strategy

HHS in Action  Strategic Element Education and Training  Action Expand and promote educational outreach on health and environmental justice, including continuing education programs, to primary health care and behavioral health care providers, other health professionals, public health professionals and the human services workforce  Examples HRSA Centers of Excellence for Environmental and Occupational Health ATSDR Pediatric Environmental Health Specialty Units – 10

Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities Guiding Principles  Coordinate and collaborate across federal agencies, other levels of government, and community partners  Build on existing and effective federal programs and partnerships  Do more of what we know works. Emphasize activities that address the preventable factors that impact asthma disparities 11

The National Partnership for Action (NPA) Purpose: To mobilize a nationwide, comprehensive, and community-driven approach to combating health disparities. Five Goals of the NPA: Awareness Leadership Health System and Life Experience Cultural and Linguistic Competency Data, Research, and Evaluation 12 National Stakeholder Strategy (NSS): A product of the NPA that offers 20 specific strategies for reaching NPA goals and assists federal, regional, tribal, state, and local stakeholders in adopting effective strategies for their communities.

Making the Connection: Advancing Environmental Justice Through Strategy, Partnership and Action 13

Office of Minority Health U.S. Department of Health and Human Services (800)