Charlene Julien's blog
As promised, I've included some examples of the earlier suggestions to this post below. If you have any questions give us a ring or if you'd like to share your experiences let us know!
Here's an example of the six tips:
Carol works as a coordinator for a local coalition in an ethnically uniform town but socio-economically diverse and the board, comprised of upper-middle class members, would like Carol to recruit members from the different socio-economic classes in the town on their Advisory Board. The board would like to learn from the community what their needs are and act upon them.
1. Carol is a busy busy busy bee but she is able to allot one hour a week to seeking new members and working with her board to recruit advisory board members.
2. The board, through Carol, would like these advisory members to help the Board understand the needs of their diverse socio-economic community so they may provide/support programs that improve the community's standard of living.
3. The maximum number of the Advisory Board is 12 and so far there are 0 members. It would be nice to have four members from each class: lower-income, middle-income and upper income. The term limit would be two years.
4. Carol asked the board to join her in listing individuals to contact since she has information from step #3. Carol and the board also list some possible places the target populations visit/work/receive assistance. From their she finds out the times appropriate to call/go and email if more convenient.
5. Based on the list, Carol crafts a brief message for each individual which takes a few minutes since she articulated #2.
6.
An example of an email,
Dear Ms. X,
My name is Carol XXYY and I am a coordinator at the _____. We are a 501c3 organization committed to improving the living conditions of our community residents. I am writing you because you are active in the community through your ____ and ___ activities and the board would like to speak with you regarding joining their advisory board. We'd like to improve our actions with your knowledge of the needs and assets of the community. The committment is one meeting every quarter for two hours. When would be a good time to talk about this opportunity.
Sincerely,
Carol
-Picture courtesy of townofajax.com
As some of you may know, I'm working with CHNA 20 (http://www.bluehillscha.org/activiti.htm) on their community assessment. This process has involved lots of planning and meeting with the members of the Assessment Advisory Group (AGG) so that we may have a better understanding of the assets and needs of the thirteen communities represented by CHNA 20.*
It's great to learn more about the community we live and work in and what is more exciting is that the role of the assessment is to take this knowledge a step further. Specifically, CHNA 20 will use the information collected from community residents, employees, key stakeholders and existing data resources to help promote the assets that exist within these communities as well as work with the community to address the needs in order to strengthen the health of each and every member. Though this may seem like a lofty goal, it is one that appears to be in the minds of all of us to some degree or we just wouldn't be working so hard to improve living conditions for others as well as ourselves.
Looking back at the visions and reasons for participation of each our AGG members at our first meeting in June 2010 struck me. Can you pick out some themes below?
"Know what's available in the community-web-based resource guide"
"Greater connectedness in community (face-to-face; all members of community & vulnerable populations)"
"Better communication (written as well)"
"Increased membership in CHNA"
"Roadmap of who has information/keeping data up to date"
"Have something to share with all in community/snapshot of health in community"
"Find information to identify needs & be able to address them"
Immediately looking at some of their visions I thought 'Engagement', with a capital 'E', from all sectors and groups within the thirteen communities that make up CHNA 20. This may seem like a familiar vision for you whether you work in the Accounting Department at a major retail store , or as a Coordinator for a direct-service center here and maybe even as a grantwriter in Port-au-Prince. No matter where you are and what you're doing, we all seek to engage with others and especially how to do it. Although I'm continually learning how to engage with diverse groups there have been some tips that have come helpful in this endeavor and they are:
1. Be prepared to spend some considerable time in the planning and actual engaging of individuals/groups
2. Articulate why you want him/her/them to engage and what you expect from his/her/their participation. (Is there a maximum of people you'd like to join and how long is their expected participation?) Whoever you reach out to would want to know this.
3. List the populations/groups/individuals you'd like to engage and how many. Ex. I'd like ______ to join this group because __#2__
4. Locate your desired population and find out the best way for them to be reached. Ex. I'd like _______ to join our coalition and ______ works/hangs out/spends time at _________ and cannot be reached via _______. This is not promoting stalking whatsoever but strategic encounters...
5. Create an elevator speech and some information about your group and what you'd like from the person your are engaging. Empahsis is placed on #2 .
6. Contact (via phone, email, face to face, skype your prospective member and follow up with them). This is so important.
Engaging members is a worthy committment that brings unexpectedly great surprises. In my next blog I'll provide an example of the six steps you could try for engaging new members and on some upcoming blogs I will include more tips on engaging communities and let you know how they've worked for me. If you have any tips that you'd like to share with me that I can post feel free to email me. You can also check out some tools on these pages:
Kansas University's Community Toolbox by : http://ctb.ku.edu/en/tablecontents/chapter_1006.aspx
Rand Corporation's Getting to Outcomes: Chapter 2 http://www.rand.org/content/dam/rand/pubs/technical_reports/2004/RAND_TR101.pdf
*Braintree, Canton, Cohasset, Hingham, Hull, Milton, Norwell, Norwood, Quincy, Randolph, Scituate, Sharon, Weymouth . For more information on CHNAs, please see http://healthier-communities.org/info/chna
-Picture courtesy of townofajax.com
04/27/2010
Health Equity and the Social Determinants of Health
Courtney Boen, Rebekah Gowler and Meghan Patterson
Center for Health Equity and Social Justice, Boston Public Health Commission.
1. Objectives:
· Define health disparities, health equities, and the social determinants of health.
· Understand a health equity framework
· Identify the social determinants of health
· Articulate the impact racism has on shaping the social determinants of health
· Identify how to use community assessments to shape practice.
2. What are health disparities? / What are health inequities?
· Health disparities: differences in the incidence, prevalence, mortality and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.
· Health inequities: differences in health status and mortality rates across population groups that are systemic, avoidable, unfair and unjust.
3. Disparities, Inequality and Inequity
DISPARITY= INEQUALITY and implies differences between individuals or population groups
INEQUITY refers to differences which are unnecessary and avoidable and, in addition, are also considered unfair and unjust.
4. Health Equity
The opportunity for everyone to attain their full health potential.
No one is disadvantaged from achieving this potential because of his or her social position or other socially determined circumstance
Distinct from health equality or health disparities
5. What explains these inequities in health? - A look at the social determinants of health
Segregation:
· Racial segregation concentrates poverty and excludes and isolates communities from mainstream resources.
· Segregation did not materialize naturally
· Today segregation is maintained by economic inequality.
Economic opportunity:
· ‘Poverty Tax”: residents in poor neighborhoods pay more for the exact same consumer products than those in higher income neighborhoods.
· Higher rates of asthma sleep disorders and lead toxicity are more likely in sub-standard housing.
· Food environment: Food desert are areas with no or distant grocery but with many choices of fast-food, convenience stores and liquor stores. Research show that residents in food desert suffer worse diet-related health outcomes, including diabetes, cancer, heart disease and premature health.
· Physical environment (fewer parks, recreational centers, swimming pools, and less walkable areas)
· Education: correlated with health outcomes and life expectancy.
· Social mobility, public safety,….
6. The stress of racism
· Creates structural barriers to health and well-being
· Stress associated with racism and discrimination takes a toll on the body: a study shows that Black women who reported they had been victims of racial discrimination were 31% more likely to develop breast cancer than those who did not. ( + reference to the movie “Unnatural causes: when the bough breaks”).
A health equity framework:
Social capital
Transportation
Education
Employment
Food access
RACISM <-------------- Socioeconomic Status --------------->HEALTH OUTCOMES -
Environmental exposure
Health behaviors
Access to health services
Housing
Public safety
Health and the built environment are inextricably linked: where you live impacts how you live.
- How do you work to eliminate health inequities?
We often say…. “I know my work is connected because….”
Degree of impact
Low High
We don’t We serve a We plan our work
Discriminate vulnerable in such a way to ensure it
Against anyone population addresses the factors
impacted by these leading to disparities
disparities
How can we all get here?
Low Degree of impact High
We don’t We serve a We plan our work
discriminate vulnerable in such way we ensure it
against anyone population addresses the factors
impacted by these leading to disparities
disparities
What can we do?
- Consider “upstream approaches”
- Aim for sustainable change in policy and practice: policy with long term consequences impacts the economic, social, physical and service environments.
- Engage staff and partners at all levels
- Ask questions differently:
Ex: How can we promote healthy behavior?
How can we target dangerous conditions and reorganize land use and transportation policies to ensure healthy spaces and places?
- Conduct a community assessment of the social determinants of health.
- Goal: Identify the key social determinants of health and racial disparities in the community, map assets and resources for addressing the identified needs, use results to shape and develop community-based strategies.
Proposed phases:
1. plan the assessment: review existing data, convene a team, develop tools, decide on methods.
2. conduct the assessment: utilize different methods as focus groups, listening sessions, interviews, paper survey, observations, windshield survey
3. document discussions and findings
4. develop an action plan,
5. organize the larger community
6. take action!
I can't tell you enough times how much I look forward to our weekly staff meetings...only for the food. My colleagues are wonderful but the food they create is astounding. I will start writing about the yummy things I eat during the meetings.
Sarah's Curried Split Pea Soup is a good place to start off. I don't like peas...actually I tend to loathe them from time to time and when I found out that I waited seven whole days for that as a staff lunch I was quite disappointed to say the least...until I ate it and it was heaven. Sarah even baked her own bread. Move over Martha Stewart the other Stewart is a serious contender for a cooking show. I can't wait for her to make it again. Well you don't have to go by my word that it's delicious. I've pasted below the recipe so you can try making and eating it yourself. If you feel like stopping by the Regional Center on staff meeting day with this dish you will certainly be welcomed with open arms and a spoon by me.
(I didn't get her bread recipe but that will be on my recipe-seeking mission)
Curried Split Pea Soup Recipe
- Prep Time: 15 min Inactive Prep Time:
- --
- Cook Time: 1 hr 0 min Level: Intermediate
- Serves:
- 4 servings
Ingredients
- 2 tablespoons unsalted butter
- 1 cup chopped onion
- Kosher salt and freshly ground black pepper
- 1 tablespoon minced fresh garlic
- 12 ounces dried green or yellow split peas, picked over and rinsed
- 5 cups chicken broth
- 1 tablespoon curry powder
Directions
Place the butter into a large (4 to 6-quart) saucepan over medium-low heat. Once melted, add the onion and a generous pinch of salt and sweat for 2 to 3 minutes. Add the garlic and continue to sweat for an additional 1 to 2 minutes, making certain not to allow onions or garlic to brown.
Add the peas, chicken broth and curry powder. Increase heat to high and bring to a boil. Reduce heat to low, cover and cook at a simmer until the peas are tender and not holding their shape any longer, approximately 45 to 50 minutes. Taste and adjust seasoning as needed. Using care and a stick blender, puree the soup until the desired consistency. Watch out for hot splatters.
Recipe courtesy Alton Brown, 2005
One of the many fun things we do at the RCHC during our lunch breaks, other than eating healthy ;), is hold a journal club. Awesome...I know! Every two weeks we select an article to read as a group and discuss it. Every other article is related to our work the other not-so much (for example we read two articles called "Colonial Legacies and Economic Growth" by RM Grier and "Colonialism and Development: A Comparative Analysis of Spanish and British Colonies" by M. Lange,et. al).
Our most recent journal club meeting focused on an article titled "Cultural Humility" by Melanie Tervalon and Jann Murray-Garcia. The authors argue that we can achieve cultural humility through education, although their focus was on physician education. They offer clear examples of how all of us can strive towards and practice cultural humility so long as we do not view it as something we can attain.
I cannot do this article any justice so I suggest you check it out:
http://info.kp.org/communitybenefit/assets/pdf/our_work/global/Cultural_Humility_article.pdf
http://www.healthier-communities.org/files/Ayiti01.png
When asked at our Tuesday January 12th mid-day staff meeting to write a blog about my work trip in Haiti, which lasted from Saturday December 26th to Sunday January 10th, I was thrilled. Mostly because I saw some amazing work being done throughout Haiti, particularly at UCNH, a university in Limbe, Haiti. Of course life got in the way since that Tuesday January 12th staff request. Then a few hours later, an earthquake struck Haiti’s political, economic and social center thus uniting me with tens of thousands of strangers, family members and new friends worldwide on a search to locate loved ones in Haiti.
Although it’s been two weeks and the media seems to have moved on (or back) to Tiger Woods drama, the reality for millions of Haitians and those who love Haiti worldwide that the island that’s been seen as home now serves as a graveyard for those who are dead and those fighting to stay alive remains palpable and within our consciousness throughout each day, if not hour. There are those who have started the grieving stage, with or without the confirmation of a body. And there are those of us whose relatives survived and we’re trying to find ways, from abroad to help keep them and others alive is a major challenge. There are also those who are a combination of the above two and are channeling their efforts running non-stop fundraisers and coordinating aid from here to get to those unreached.
This tragedy is a painful illustration of what can happen when government and civic involvement are virtually non-existent compounded with a natural disaster. I will not get into the politics of that issue now but they are major factors in the magnitude of the devastation. The rebuilding process of Haiti will require great leadership from the Haitian government and true partnership from the international community.
This earthquake that shattered millions of lives has also provided a snapshot of one of humanity’s best traits, generosity. This generosity has stretched from individuals and governments from around the globe to their fellow man in Delmas, Carrefour, Petionville, and Leogane when literally “things fall apart”. If one positive thing can be said about this hellish experience it is that the human spirit not only exists but it also binds each of us to another.
With that said, I leave you with a Haitian proverb that epitomizes the teamwork that Haitians and members of the international community are engaged in and one of the core messages that we at the Regional Center promote in building healthy communities:
“Men anpil, chay pa lou” or “Many hands make the load light.”
I will write about my recent work-trip in Haiti in a later blog.
