1. HEALTH EQUITY AND CULTURAL COMPETENCE 2016 If the slideshow does not automatically start, press F5

2. Purpose The purpose of this training is to enhance the social, cultural and linguistic competence of Panhandle Health District employees in providing services to populations with higher health risks and poorer health outcomes. PHAB Measure 11.1.4 A

3. Learning Objectives  Understand The importance of a culturally competent healthcare system in achieving health equity  Define Cultural competence Health equity, health inequities and health disparities  Identify Factors affecting and populations most affected by health inequities A culturally competent organization and staff member Learning Objectives Define Identify Understand

4. Cultural Competence The ability of systems (Panhandle Health District) to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural and linguistic needs. National Center for Cultural Competence, Betancourt et al,. 2002

5. Health Equity Health equity is achieved when every person has the opportunity to attain his or her full health potential. CDC/Healthequityguide

6. Health Inequities Differences in health which are not only unnecessary and avoidable, but are considered unfair and unjust. Health Equity Institute, http://healthequity.sfsu.eduhttp://healthequity.sfsu.edu Incorporating Health Equity into Foundational Skills of Public Health Click here to start the video: Health Equity Institute video Enjoy this one-minute video from the Health Equity Institute.

7. Health Disparities Differences in health outcomes and their causes among groups of people. Demographic factors affected by health disparities include: Race and ethnicity Gender Sexual identity and orientation Disability status or special health care needs Geographic location (rural and urban)

8. Populations Most Affected by Health Inequities  Race/ethnicity  People with disabilities  Rural communities  Older adults  Mental or substance abuse disorders  Low literacy  Non-English speaking  Less than a high school education  Low income or poverty  Lesbian, gay, bisexual or transgender (LGBT) CDC.GOV/HEALTHEQUITYGUIDE

9. Health Inequity Rates in Idaho 13.8% of Idahoans are over age 65. (RWJ County Health Rankings) 15.5% of Idaho adults are living below poverty. (US Census) 19% of children are living below poverty. (RWJ County Health Rankings) 3.9% of Idaho residents are unemployed with Shoshone County being among the highest in the state. (Idaho Department of Labor)

10. Factors Affecting Health Inequity  Health behaviors - Social, economic and environmental conditions affect health knowledge and behavior.  Social conditions - Unfair treatment because of race, gender, sexual orientation or immigration status.  Economic conditions - Unequal educational and job opportunities.  Environmental conditions - Where you live. “Many (North Idaho) residents have to travel far distances for health services, and as gas prices rise, people are less willing to travel. The ten northern counties of Idaho have few, if any, options for mass transportation. Winding roads and winter conditions also limit the ability to travel during certain times of the year.” 2013 Community Health Assessment2013 Community Health Assessment

11. Characteristics of a Culturally Competent Organization Panhandle Health District acknowledges and incorporates : The importance of cultureAn assessment of cultural competencyCultural differences and diverse perspectivesCultural diversity training for all employeesAdaptation of services to meet culturally unique needs of the community

12. How PHD Achieves Health Equity health equity efforts. Panhandle Health District must be culturally competent in working toward achieving health equity in the communities we serve. EngageDevelopIdentifyBuildPromoteConsiderEvaluate the community to include diverse populations affected by health inequities in efforts to improve. diverse partnerships to include unheard voices of diverse populations most directly affected by health inequities. health inequities by collecting data, establishing baselines, monitoring trends and ensuring strategies account for needs of diverse populations. organizational capacity around health equity. health equity by understanding community and stakeholder issues. health equity in strategy selection, design and implementation.

13. How PHD Incorporates Cultural Competence Limited English Proficiency Procedure To communicate with clients with limited English proficiency. To communicate with clients that are hearing impaired. To monitor language needs and implementation. Click the link to read the Limited English Proficiency ProcedureLimited English Proficiency Procedure 2016 Strategic Plan Strategic Priority A, Objective 1: Strategically Expand Services Strategic Priority A, Objective 2C: Cultural Competency Assessment. A Cultural and Linguistic Competence Assessment was completed January 2016. Strategic Priority B, Objective 3: Focus program priorities to community needs. Strategic Priority B, Objective 4: Update the Community Health Assessment Strategic Priority D, Objective 2e: Cultural and Linguistic Competence Training Click the link to read the Strategic PrioritiesStrategic Priorities

14. Standards of Conduct-Code of Ethics Policy Public health should advocate for, or work for the empowerment of, disenfranchised community members, ensuring that the basic resources and conditions necessary for health are accessible to all people in the community. Protocol 3-13B.A.4 Public health programs and policies should incorporate a variety of approaches that anticipate and respect diverse values, beliefs and cultures in the community. Protocol 3-13B.A.8 Panhandle Health District’s Standards of Conduct-Code of Ethics Policy 3-13 states: Click the link to read the Standards of Conduct-Code of Ethics Policy 3-13 in it’s entirety.Standards of Conduct-Code of Ethics Policy 3-13

15. Policy/Procedure Development/Management Panhandle Health District’s Policy/Procedure Development/ Management Policy 1-1 states: “In order to provide public health programs/services that meet the needs of the population, the District Director will assure that health equity is considered/ incorporated into all policies/procedures. PHD policies/procedures will, as appropriate, minimize health inequities in populations that are at risk for discrimination/health inequities based on ethnicity, race, gender, age, disability, religion, income, educational level or linguistic ability.” Click the link to read the Policy/Procedure Development Management Policy 1-1 in its entirety.Policy/Procedure Development Management Policy 1-1

16. Characteristics of Culturally Competent Employees Awareness Is conscious of one’s own reactions to diverse populations Attitude Is conscious of one’s own beliefs and values about cultural diversity Knowledge Seeks training, knows where to access resources and stays up-to- date on diversity issues Skill Practices cultural competence in verbal and non-verbal communication that varies from culture to culture

17. Thank you for taking the Health Equity and Cultural Competence training. To complete the training, click on the link below to complete the assessment. Health Equity and Cultural Competence Assessment Note: Clicking on the link will navigate you to the TRAIN website to complete the assessment. Log in and click on “My Action Items”.