Health Equity Meeting 1

Healthy Community Study

Health Equity Work Group Meeting 1

Thursday, April 28th, 2011 – 7:00 a.m.

Rockford Memorial Hospital, Administrative Conference Room

Evelyn Pagán, Mark Hunter, Co-chairs, Presiding

Present: Chris Greenwood, Pastor Pam Hillenbrand, Shelton Kay, Dr. Martin MacDowell, Dr. Colleen, Klein

Staff: Sofya Peysakhovich

The meeting was called to order by Evelyn Pagán. Introductions were made around the room.

Prioritization Process goals and objectives were reviewed, with an acknowledgement that the Health Equity group is somewhat different from all the others and could face unique challenges.

What is Health Equity and what are the recommendations behind it?

Mrs. Pagán led a group brainstorming session on health equity. The following phrases surfaced in the conversation: access to care, equal access, availability of the same services to all, same level quality to all, similar health status characteristics in a community, education and awareness/ health resource literacy. Upon further reflection, members concluded that their immediate thoughts on health equity focused more or less on the factors that grew out of it.

How would you define health equity? Pastor Hillenbrand described it: no matter what her background, or education level, or financial status, when she walks in the door of a health care facility she is treated like everybody else. Dr. McDowell added that there is a gradient in perspectives of the population and their ability to act on the knowledge of health prevention. Everybody knows they are supposed to exercise but not everybody does. There is a continuum of knowledge leading to behavior. Making health care equal is feasible but it is another matter to craft health behaviors and this begins with pre-K education.

The group brainstormed whether health equity meant equality. They arenot mirror images. Health care for Hispanics won’t look like health care for other groups because, for example, there may be a language barrier, and resources would have to be allocated to bridge this language barrier. When speaking of health, one size does not fit all.

What are the core tenets of equity? Trust, access, delivery, quality, communication, and responsiveness were some key words identified.Evelyn Pagán reiterated the need to have a clear operational definition of health equity. To gain a clearer understanding of what health equity means the group viewedIn Sickness and in Wealth of Unnatural Causes[1].

After the screening, people were left somewhat speechless. It was confirmed that based on the 2010 HCS data they were supposed to identify priority health issues (health inequity issues) and come up with interventions to bring before the RHC. The Health Council will take the recommendations under advisement and hopefully move them forward in the community.

After watching the documentary segment the group once again reflected on an operational definition of health equity. Referencing an article,[2]they concluded that health equity was the absence of systematic disparities in health or social determinants of unequal groups (groups in the social hierarchy).

What as a community can we do and what kind of recommendations do we have? Based on the data we do see inequity in the social determinants of health. Part of the health equity group’s charge is to ensure a paradigm shift in thinking about the determinants of health. There is incredible opportunity here, and an ability to look at what’s happening nationally. There are models for interventions that have taken what is conceptual, what is intangible, and translated it into policy that starts to close the gaps. These interventions probably won’t target health care, but rather the upstream determinants of health.

Discussion that followed traced the history contributing to health inequity, the issue of one having control over one’s life, how the term “political” makes people shy away from talking about the issue (which is deeply political), the values framework surrounding the issue, how the (political) issue comes down to what one thinks drives the economy.Key issues include education and early childhood/prenatal development. An important group goal is first and foremost to get everyone on the same page with an operational definition of health equity. For the next meeting the group is asked to complete the first meeting preparation worksheets. Health problem analysis worksheets (HPAWs) will be completed as data is reviewed.

1

[1]

[2] P Braveman, S Gruskin, Defining Equity in Health, The Journal of Epidemiology and Community Health, 2003; 57: 254-258. [