1. GOVERNOR’S INTERAGENCY COUNCIL ON HEALTH DISPARITIES Emma Medicine White Crow Association of Public Hospital Districts, Membership Meeting June 24, 2013 1

2. Presentation Overview 2 About the Council Rural Health Disparities Selected Activities and Recommendations

3. About the Council 3 Charged with creating a state policy action plan to eliminate health disparities by race/ethnicity and gender Facilitate communication and coordination among health disparities activities Improve language access Assess potential impacts of state government actions on health disparities

4. Council Membership 4 Chair & two public members appointed by the Governor Representatives from 14 agencies, boards, & commissions Governor’s Appointee (Chair) Consumer Representatives (2) Commission on African American Affairs Commission on Asian Pacific American Affairs Commission on Hispanic Affairs Governor’s Office of Indian Affairs Department of Agriculture Department of Commerce Department of Early Learning Department of Ecology Department of Health Department of Social and Health Services Health Care Authority Office of Superintendent of Public Instruction State Board of Health Workforce Training and Education Coordinating Board

5. 2010 Action Plan Five Priorities Education Health Insurance Coverage Healthcare Workforce Diversity Obesity Diabetes 5

6. 2012 Action Plan Three Priorities Behavioral Health Environmental Exposures and Hazards Poverty 6

7. Behavioral Health 7 Education Pipeline Workforce Diversity Cultural Competency Workforce Development Data Disaggregation Health Homes Culturally Competent Care Community Access and Engagement Health Reform Implementation

8. Environmental Exposures &Hazards 8 Institutional Awareness and Diversity Service Equity, Accountability, and Metrics Environmental Justice Community Capacity Community Engagement Community Capacity Building & Involvement Precautionary Approach Reducing Harmful Exposures Children’s Health and Development Precautionary Approach

9. Poverty 9 Workforce Diversity Cultural Competency Early Learning 2012 Rural Health Care Strategic Plan for Washington State Rural Health Care Food System Roundtable Diversity Community Engagement Healthy Foods in Diverse Communities

10. Rural-Urban Areas in Washington 10 Source: Washington State Department of Health

11. Washington Demographics 11

12. Counties Ranked by % Minority 12 County% Total Minority% Minority (Non-Hispanic) % Minority (Hispanic) Statewide27.316.111.2 Adams61.11.959.3 Franklin56.65.451.2 Yakima52.17.145.0 Grant42.54.238.3 King35.026.18.9 Douglas32.03.328.7 Okanogan31.514.017.6 Pierce29.520.49.2 Chelan29.23.425.8 Office of Financial Management: 2012 Population Trends

13. Rural Health Disparities 13 Rural Areas have a higher: % of overweight adults % of adults who smoke % of women who smoke during pregnancy Rate of teenage births Rate of children hospitalized for unintentional injuries % of adults who delay seeing a doctor due to cost Rural Ares have a lower: % of adults who receive yearly dental care % of adults/children with health insurance % of adults with a personal health care provider % of pregnant women who receive prenatal care. % of adults who eat 5+ servings of fruits/vegetables each day Department of Health Fact Sheet - Rural Washington: Closing Health Disparities, 2010 Update

14. Rural Health Disparities 14 People who live in rural areas have less access to health care. They are: Less likely to have health care coverage More likely to delay a medical visit due to cost Less likely to have an annual dental visit Less likely to be screened for cervical, breast, and colorectal cancers Source: Washington State Department of Health

15. Rural Health Disparities 15 Rural residents have a higher risk of preventable deaths. Death rates (per 100,000): 713 in urban areas 774 in large town rural areas 762 in small town/isolated rural areas Causes of death where rural-urban disparities are the greatest: Heart disease Cancer Unintentional injury Suicide Department of Health Fact Sheet - Rural Disparities in Mortality

16. Council Activities 16 Rural representation on advisory committees Recommendations to improve health of rural communities – Poverty Recommendations Legislature should support the 2012 Rural Health Care Strategic Plan Ensuring rural communities are represented on the Food System Roundtable Support health fairs and other community events

17. Council Activities 17

18. Health Care Authority Activities 18 The Medicaid Outreach program – Supports Medicaid outreach to improve enrollment across the state, including in rural communities. Washington Collaborative Medicaid Outreach meetings devoted to enrollment, outreach, new Medicaid eligibility and the Exchange. Medicaid Administrative Match

19. Department of Health Activities 19 Washington State Office of Community Health Systems, Rural Health section, helps rural and underserved communities have access to health services. www.doh.wa.gov/PublicHealthandHealthcareProviders/RuralHealth.aspx

20. Department of Health Activities 20 Healthy Community Program – Community Transformation Grants Medical Homes Maternal Child Health Programs

21. DSHS Activities 21 Chronic Disease Self-Management Education Health Homes Medically Intensive Children’s Program Nurse Delegation Individual Providers Regional Support Networks

22. Health Benefit Exchange Activities 22 In-Person Assistance Customer Support Media Outreach Direct Mail Partnerships

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24. Closing Comments 24

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