1. Health Equity Panel Wisconsin State Prevention Conference June 12, 2012

2. Objectives Better understand the root causes of health- related inequities and disparities Understand the application of strategies to improve health equity Be able to identify at least one strategy to address health inequity within your own organization or setting

4. Family &Culture Health Inequities Health Disparities

5. Work on Health Equity The interventions for the medical model look very different then interventions in the social determinants model!

6. Medical and Public Health Interventions (Traditional) Health Equity Interventions (Public Health 2.0) Tend to focus on individuals Surveillance, healthy behavior promotion When focus on policies usually narrow policy focus (e.g., seat belts, imms, smoking) Work at a system, policy level Social systems, policies and practices Adapted from a lecture by Dr. Tony Iton

7. Medical and Public Health Interventions (Traditional) Health Equity Interventions (Public Health 2.0) Tend to focus on individualsWork at a system, policy level Tend to be remedial in natureProactive Adapted from a lecture by Dr. Tony Iton

8. Medical and Public Health Interventions (Traditional) Health Equity Interventions (Public Health 2.0) Tend to focus on individualsWork at a system, policy level Tend to be remedial in natureProactive Do not address underlying conditionsWork on root causes Social Determinants Equity Adapted from a lecture by Dr. Tony Iton

9. Medical and Public Health Interventions (Traditional) Health Equity Interventions (Public Health 2.0) Tend to focus on individualsWork at a system, policy level Tend to be remedial in natureProactive Do not address underlying conditionsWork on root causes (Social Determinants) Expensive and difficult to sustainCost Effective in the long term? But need long term investment Adapted from a lecture by Dr. Tony Iton

10. Medical and Public Health Interventions (Traditional) Health Equity Interventions (Public Health 2.0) Tend to focus on individualsWork at a system, policy level Tend to be remedial in natureProactive Do not address underlying conditionsWork on root causes (Social Determinants) Expensive and difficult to sustainCost Effective in the long term? But need long term investment No sustained impact on health disparitiesDirectly address the reason for disparity Adapted from a lecture by Dr. Tony Iton

11. Medical and Public Health Model Interventions Health Equity Interventions Tend to focus on individualsWork at a system, policy level Tend to be remedial in natureProactive Do not address underlying conditionsWork on root causes (Social Determinants) Expensive and difficult to sustainCost Effective in the long term? But need long term investment No sustained impact on health disparitiesDirectly address the reason for disparity Interventions tend to be designed and implemented in top-down approach Interventions should build community capacity Medical and Public Health Interventions (Traditional) Health Equity Interventions (Public Health 2.0) Tend to focus on individualsWork at a system, policy level Tend to be remedial in natureProactive Do not address underlying conditionsWork on root causes (Social Determinants) Expensive and difficult to sustainCost Effective in the long term? But need long term investment No sustained impact on health disparitiesDirectly address the reason for disparity Interventions tend to be designed and implemented in top-down approach Interventions should build community capacity Adapted from a lecture by Dr. Tony Iton

12. Medical and Public Health Model Interventions Health Equity Interventions Tend to focus on individualsWork at a system, policy level Tend to be remedial in natureProactive Do not address underlying conditionsWork on root causes (Social Determinants) Expensive and difficult to sustainCost Effective in the long term? But need long term investment No sustained impact on health disparitiesDirectly address the reason for disparity Medical and Public Health Interventions (Traditional) Health Equity Interventions (Public Health 2.0) Tend to focus on individualsWork at a system, policy level Tend to be remedial in natureProactive Do not address underlying conditionsWork on root causes Expensive and difficult to sustainCost Effective in the long term? But need long term investment No sustained impact on health disparitiesDirectly address the reason for disparity Interventions tend to be designed and implemented in top-down approach Interventions should build community capacity Partners largely include health care providers and social service agencies Engage non-traditional partners Organizations who work on policy and advocacy on social, economic and environmental issues Community organizers who work on civic engagement Community planners Adapted from a lecture by Dr. Tony Iton

13. Medical and Public Health Interventions (Traditional) Health Equity Interventions (Public Health 2.0) Tend to focus on individualsWork at a system, policy level Tend to be remedial in natureProactive Do not address underlying conditionsWork on root causes (Social Determinants) Expensive and difficult to sustainCost Effective in the long term. But need long term investment No sustained impact on health disparitiesDirectly address the reason for disparity Interventions tend to be designed and implemented in top-down approach Interventions should build community capacity Partners largely include health care providers and social service agencies Engage non-traditional partners Majority of Health, Social Services & Criminal Justice budget spent on these kind of interventions Funding does not match potential impact Adapted from a lecture by Dr. Tony Iton

14. Wisconsin Center for Health Equity Guiding Principles WCHE focuses its efforts on: – Socioeconomic factors that most greatly affect population health – Systemic, policy-oriented approaches to improving population

15. Wisconsin Center for Health Equity Strategies WCHE is dedicated to improving the social and economic factors that strongly influence population health by : – improving our understanding of how socioeconomic conditions affect peoples health – incorporating health into a wide range of policies to promote and sustain health – encouraging community involvement to support changes in public policy

16. Panelists Amy Harley – UW-Milwaukee, Zilber School of Public Health, Jill Hoiting – Supporting Families Together Association Margarita Santiago – UW-Madison, Department of Nutritional Sciences Moderator: Raisa Koltun – Wisconsin Center for Health Equity

17. Questions 1.Describe your organization and your position within the organization. 2.What does health equity mean to you? 3.What does your work look like through a health equity lens, hitting on the points below? – Where do social determinants of health fit in your work? – What is the role of your organization in engaging in policy or systems change? – How do you engage non-traditional partners or sectors in your work? – How do you engage community in your work? 4.Describe an initiative you are involved in that illustrates health equity.

18. Closing Question How do you suggest organizations or individuals can begin to incorporate health equity principles into their work?

19. Thank You! Raisa Koltun rkoltun@wche.org 414-213-4986

20. DiseaseBehavior Community Death Diseased Societal Decision Processes Death Biased Behaviors (Isms) Medical Model (individuals)Socio-Ecological (society) Emergency Rooms Clinics Health Education Comm. Capacity Building Policy Advocacy ?????? Adapted from a lecture by Dr. Tony Iton