Public health accreditation, which a growing number of health departments undergo, requires that health departments conduct or participate in a collaborative process of comprehensive health needs assessment in their communities (PHAB, 2011). 1B). Journal of Policy Analysis and Management 25(1):197–214. But policies in a variety of areas, ranging from education to land use and housing, the environment, and criminal justice, can be relevant to health disparities. Priorities for research to reduce the threat of firearm-related violence. Equal justice means more than freedom from unhealthy, environmentally degraded communities. In 2012 Maryland passed the Maryland Health Improvement and Disparities Reduction Act. CEBU City -- Leaders in business, government, and the medical community will discuss Covid 19-related public health policies that are crucial for economic recovery. Pediatrics 115(4):1077–1083. or create opportunities for communities to promote health equity. Housing affordability and federal HUD policies are part of a larger dialogue concerning housing that also includes land use, residential and commercial development, natural resource use, transportation, and, even more broadly, changing neighborhoods and concerns over potential residential disruption. Accounting for social risk factors in Medicare payment: Criteria, factors, and methods. In its original conception, the Triple Aim seeks to improve the individual experience of care, improve the health of populations, and reduce the per capita costs of care for populations (Berwick et al., 2008). 2006. The Community Health Planning & Policy Development Section develops and advocates for health planning, policies and practices to promote health equity, community empowerment and social justice. The expansions of Medicaid, including expansions under the ACA, have been found to substantially reduce the financial burden of medical care on low-income individuals and to increase their financial well-being (Baicker et al., 2013; Gross and Notowidigdo, 2011; Hu et al., 2016). 2013. Because ESSA is clear that educators must work in partnership with their communities on behalf of children and youth, this is a chance for communities to seize these opportunities in ways that help them foster a genuine culture of health, which will improve education outcomes. Washington, DC: The National Academies Press. The content development process was rigorous and thorough with a lot of input and feedback for consensus building. Freeman, L. 2005. 2015. School improvement plans represent another key feature of the new federal education legislation. The effect of the Patient Protection and Affordable Care Act Medicaid expansions on financial wellbeing. 2014. Conclusion 6-2: The committee concludes that using civil rights approaches in devising and implementing community solutions to promote health equity can guard against unjustified and unnecessary discriminatory impacts, as well as against intentional discrimination in programs that affect health. 2016. 27 To evaluate an intentional discrimination claim, circumstantial evidence includes (1) whether an action impacts one group more than another, including numerical disparities shown through statistical studies and anecdotal evidence; (2) a history of discrimination; (3) departures from substantive norms; (4) departures from procedural norms; (5) a pattern of discrimination; and (6) the decision maker knows the harm a decision will cause. This notion of the “Triple Aim” is a term coined by the Institute for Healthcare Improvement and incorporated in ACA implementation, becoming part of the U.S. national strategy for tackling health care issues (AHRQ, 2016a; Berwick et al., 2008; Whittington et al., 2015). Corp., 429 U.S. 252, 265 (1977); Griggs v. Duke Power Co., 401 U.S. 424 (1971); U.S. Department of Justice, Civil Rights Division, Title VI Legal Manual at pages 42–58 and cases cited (2001), available at https://www.justice.gov/sites/default/files/crt/legacy/2011/06/23/vimanual.pdf (accessed June 24, 2016); and Robert García and Erica Flores Baltodano, Free the Beach! 2008. 2008. reduce disparities for Hispanics and, to some extent, for African Americans (Nicosia et al., 2013). A recent study underscores the stark relationship between income inequality and health and how this manifests locally. 2014. The impact of family income on child achievement. US Army Corps of Engineers best practice for revitalizing L.A. River for all. http://www.pewtrusts.org/~/media/assets/2014/11/pspp_juvenilejudges_qa_brief_web.pdf (accessed October 24, 2016). As of 2016 more than 150 cities and counties have adopted “ban the box” policies that prohibit employers from considering criminal records at the beginning of the application process. withheld federal subsidies for a proposed warehouse project in response to significant local community action, pending a full study under the civil rights and environmental justice laws to consider a park alternative and the impact on people of color and low-income people. New York, for example, extends benefits to noncustodial parents, which has been found to increase employment and child support payments (Nichols and Rothstein, 2016). The U.S. Department of Housing and Urban Development (HUD) HOPE VI program promoted demolition of public housing and sought to replace distressed public housing developments with lower-density, mixed-income developments (Schwartz, 2014); however, just over half of the demolished units have been replaced. It is an opportunity, in this regard, to use additional types of data and use data in different ways. WHO guideline on health policy and system support to optimize community health worker programmes. https://multco.us/diversity-equity/equity-and-empowerment-lens (accessed October 24, 2016). American Sociological Review 69(2):151–169. Parks & Recreation 32–33. A continued focus on rewarding health outcomes at the mean, without rewarding a compression in the variations in health, is likely to encourage interventions that target healthier, and socially less disadvantaged, populations in order to demonstrate improvements. Government enforcement is particularly important to guard against discriminatory impact because there is no private cause of action for individuals and organizations to seek justice through the courts under the discriminatory impact standard, according to the U.S. Supreme Court (“the Sandoval problem”).16 This is widely held to be a major problem in rights enforcement, as it can be more difficult to show intentional discrimination. 2016a. Blumstein, A. Recognizing the role that local policies play in marginalizing those with a criminal record, some communities have advocated for laws aimed at reducing the barriers to reentry for the formerly incarcerated. There are a number of mechanisms through which income differences might drive local health patterns. Programs and policies such as SNAP have the potential to reduce childhood and adulthood obesity and provide substantial economic returns on investment, and their effects could potentially be amplified by local sugar-sweetened beverage or “soda tax” policies. Many states have developed special programs for youth, including mentoring, mental health counseling, education supports, and family reunification supports, to facilitate successful reintegration and the transition to adulthood, and some have. So-called before-tax incomes rose between 32 and 39 percent in the lowest four quintiles, compared to 18 percent when government transfers are excluded. http://www.taxpolicycenter.org/sites/default/files/legacy/taxfacts/content/PDF/state_min_wage.pdf (accessed November 2, 2016). 22170. Los Angeles, CA: The City Project. Significantly, in part because 32 states expanded their Medicaid programs and 19 did not, the rates of uninsured among the nonelderly population varies significantly from a low of 5 percent in Massachusetts to a high of 19 percent in Texas (Kaiser Family Foundation, 2015, 2016). Half of tax offsets, including exclusions, deductions, preferential rates, and credits, go to those in the highest fifth of incomes (CBO, 2016). Environmental justice state guidance: How to incorporate equity and justice into your state clean power planning approach.http://www.eesi.org/files/EJ-State-Guidance-Final-v5-jan-15-2016.pdf (accessed October 24, 2016). The first, which is conceptually straightforward, includes the health care screening and treatment services that the system provides to adult and juvenile prisoners and probationers. Latest local health insurance statistics available through Census Bureau’s American Community Survey. 2016. Blumstein highlights several other mechanisms by which racial and socioeconomic disproportionality can compound itself in the criminal justice system (Blumstein, 2009). The status of low-income neighborhoods in the post-welfare reform environment. Healthy parks healthy people community engagement e-guide: Edition 1. Part 100, 78 Fed. Gentrification, displacement, and role of public investment: A literature review. Racial and socioeconomic disparities in residential proximity to polluting industrial facilities: Evidence from the Americans’ changing lives study. While the facts in that case involved the Fair Housing Act of 1968, the discriminatory impact standard is analogous under Title VI regulations and Affordable Care Act section 1557. As one strategy to support a focus on health disparities, the Centers for Medicare & Medicaid Services could undertake research on payment reforms that could spur accounting for social risk factors in the value-based payment programs it oversees. 6 S.1177 Every Student Succeeds Act. 34 Alley et al. 2016b. Neumark, D., J. I. Salas, and W. Wascher. 14 For example, California Government Code 11135 et seq. Both the community examples that the committee has examined and other information the committee has gathered suggest that achieving greater equity in health outcomes will require collaboration and collective action across sectors and new forms of community engagement and partnership. Community Health Options (Health Options) gathered for its 2020 Annual Member Meeting via webinar on November 19. Economics of Education Review 54:321–339. This work should include meaningful participation by members of low-income and minority populations in the community. 2013. We seek to shift policy in order to eliminate disparities and promote healthy communities in public and private venues. Darcy, J. The spatial bias of federal housing law and policy: Concentrated poverty in urban America. State policy around health insurance, particularly through Medicaid decision making, has serious implications for health and other disparities. IZA Journal of Labor Policy 3(1):26. The effect of food store access and income on household purchases of fruits and vegetables: A mixed effects analysis. Executive Office of the President. Pursuing the triple aim: The first 7 years. http://www.ahrq.gov/workingforquality/about.htm#priorities (accessed October 14, 2016). food insecurity, particularly for children, and has also helped to reduce rates of obesity among its beneficiaries (Executive Office of the President, 2015). 2016. Hospital and health systems should also advocate for the expansion of efficient and effective services responding to health-related social needs34 for vulnerable populations and people living in poverty. The National Academies Committee on Accounting for Socioeconomic Status in Medicare Payment Programs has shown in its reports (NASEM, 2016a,b,c,e) that value-based payment systems that do not account for social risk factors can have unintended adverse consequences, including providers and health plans avoiding low-income patients and underpayment to providers disproportionately serving socially at-risk populations (such as safety net providers). The law also reinforces the idea of thinking more broadly about who has a stake in student well-being. JAMA 311(9):937–948. The resources below provide information about CDC offices and programs that focus on policy-related matters and on various laws, regulations, and policies that have public health implications. Chicago, IL: University of Chicago Press. Health Affairs 25(6):w432–w443. Huynh, M., and A. R. Maroko. Phillips, D., L. Flores Jr., and J. Henderson. APA's Healthy Communities Policy Guide identifies policy ideas for local, state, and federally elected officials aimed at improving community health and quality of living through planning. Communities—and the federal and state agencies that support them in their efforts to address health disparities—have multiple examples to follow in expanding their focus beyond health care and social services and examining opportunities in economic development, land use and housing, education, and criminal justice, areas which have not traditionally been the focus of health improvement efforts. Cambridge, MA: Institute for Healthcare Improvement. Another component of the ACA is an emphasis on improving care, improving population health, and reducing the per capita cost of care. 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