A State-by-State Approach to Closing the Health Equity Gap

1/21/2022 9:37:00 PM

We need to establish directors for health equity at the state level

Health, Inequality

Governments at all levels have taken notice of the disproportionate impact of COVID on minority and rural communities. This proposal establishes the need for a permanent director for health equity in each state. | Perspective

We need to establish directors for health equity at the state level

As the Delta variant causes COVID-19 cases to swell, resurrects mask mandates and forces hospitals back to surge capacity, a familiar pattern is emerging. Like its less transmissible predecessors, this dangerous SARS-CoV-2 variant is especially affecting vulnerable populations in minority and rural communities, where vaccinations have lagged because of a perfect storm of reduced access to care, vaccine hesitancy, targeted misinformation campaigns and historically rooted mistrust.

Governments at all levels have taken notice of the disproportionate impact of COVID on these populations over the past year. At the federal level, President Joe Biden appointed a COVID-19 Health Equity Task Force by executive order. Many states, including Illinois, Louisiana and Tennessee, established similar task forces, working groups and councils dedicated to promoting health equity in the context of COVID-19. The National Governors Association recently highlighted Virginia’s task force as a model for other states. These conveners have helped motivate billions of dollars in federal and state investments to improve access to testing and vaccination in underserved areas. More recently, they have partnered with community leaders to disseminate effective messaging around masking, social distancing and vaccines amid evolving and sometimes confusing federal guidance.

Read more: Scientific American »

Necessary Realness: Kim Kardashian & Pete Davidson SPLIT | E! News

Kim Kardashian and Pete Davidson break up after 9 months of dating--but will this bring Kim closer to Kanye West? Plus, Beyonce teams up with Madonna for an ... Read more >>

They have been trying with the best of intentions to “close” the IQ gap (not the Jewish / white IQ gap, mind you) and have made no significant progress. Review you assumptions as to “equity”. Where is the rebuttal to the EO Wilson article? As with many it is a disease of poverty. Woke

Utah Gov. Spencer Cox's 2022 State of State message: 'Be strong' for children amid COVID-19Utah Gov. Spencer Cox began his second State of the State address on Thursday evening with a call to action for Utahns. What action? Banning doctors/nurses from wearing masks in hospitals? 😂😂😂 Action on Covid….”now everyone go around and lick doorknobs and windows. Once we all get it, we won’t have to test anymore. Testing is bad. So bad. See, all better.”

Nurses union urges state to declare state of emergencyThe Massachusetts Nurses Association says hospitals across the state need to tighten visitation and extend quarantine for workers who catch COVID. Yes

Democratic secretaries of state group posts record fundraisingThe Democratic Association of Secretaries of State and its affiliated groups raised $4.5 million last year -- a record haul for the group and the latest indication of the heightened interest in once-sleepy down-ballot races for state election chiefs

State Route 18 To Reopen Tonight After Being Washed Out On Christmas EveCaltrans had embarked on a $4.2 million emergency project to repair the mountain highway, which had been washed out after a series of storms dumped several inches of rain and snow on Southern California during the holidays.

Militants kidnap over a dozen schoolchildren in Nigeria’s Borno stateThe militants razed part of the village, including a church, and burnt 10 vehicles in the three-hour-long attack in Piyemi village, near Chibok where Boko Haram militants abducted more than 200 schoolgirls eight years ago, residents say. There is no political will here. The sad part is women and children are abducted. MBuhari surely you know who is behind this abductions. Your government is failing the people of Chibok. NigeriaNews Previous lessons where not learned. The Nigeria government is not doing much in terms of national security. They’re prioritizing marriage to the likes of China for their own selfish gains.

Pennsylvania Set State Record for Gambling Revenue in 2021Pennsylvania set another annual record for gambling revenue in the era of online gambling and sports betting, state regulators said, reporting that casinos and other operators won more than $4.7 billion from gamblers in calendar year 2021.

Editor’s Note (12/21/21): This article is being showcased in a special collection about equity in health care that was made possible by the support of Takeda Pharmaceuticals..State health data show more than 3,100 people are hospitalized with COVID.(CNN)The Democratic Association of Secretaries of State and its affiliated groups raised $4.

The article was published independently and without sponsorship. As the Delta variant causes COVID-19 cases to swell, resurrects mask mandates and forces hospitals back to surge capacity, a familiar pattern is emerging. Like its less transmissible predecessors, this dangerous SARS-CoV-2 variant is especially affecting vulnerable populations in minority and rural communities, where vaccinations have lagged because of a perfect storm of reduced access to care, vaccine hesitancy, targeted misinformation campaigns and historically rooted mistrust. Union president Katie Murphy said these are necessary changes that would better reflect what nurses are seeing on the ground. Governments at all levels have taken notice of the disproportionate impact of COVID on these populations over the past year. At the federal level, President Joe Biden appointed a COVID-19 Health Equity Task Force by executive order.The failure to advance federal voting protections in the US Senate this week will drive"even greater attention to the states," she said.

Many states, including Illinois, Louisiana and Tennessee, established similar task forces, working groups and councils dedicated to promoting health equity in the context of COVID-19.. The National Governors Association recently highlighted Virginia’s task force as a model for other states. These conveners have helped motivate billions of dollars in federal and state investments to improve access to testing and vaccination in underserved areas. More recently, they have partnered with community leaders to disseminate effective messaging around masking, social distancing and vaccines amid evolving and sometimes confusing federal guidance. With reporting by WBUR News' Dave Faneuf. While these efforts may help combat disparities in COVID outcomes, we must recognize that the root causes of these disparities existed for generations before the pandemic and will persist for generations afterward if health equity is not prioritized. Jody Hice in a Republican primary against sitting Secretary of State Brad Raffensperger, who resisted Trump's pressure to"find" the votes needed to overturn Joe Biden's 2020 victory in the state.

COVID had a disproportionate impact on vulnerable populations because it exacerbated preexisting inequities in our society. Long-standing disparities in health, including the unequal incidence of comorbidities that increase the risk of poor outcomes from COVID, and in health-related social factors, such as housing insecurity and environmental exposures, contributed to the stark disparities in cases and deaths. These systemic disadvantages demand more than mobile clinics, temporary committees and short-term investments. Rather they reflect the need for a more general and sustained commitment to health equity—indeed, to health justice from governments at all levels. President Biden signaled an interest in such a commitment through a series of executive orders on racial equity, while the Department of Health and Human Services continues to support focused efforts through its offices of minority health and health equity.Advertising executive Edward"Beau" Lane, one of four candidates seeking the GOP nomination in Arizona, topped the field in fundraising, with total receipts of more than $716,000.

At the state level, however, similar opportunities to promote health equity beyond the pandemic have received less attention, despite the highly local nature of the structural factors that drive inequities in health and disease. Thus, we propose establishing a permanent director for health equity in each state. This office would be charged with coordinating the full range of state-level efforts to advance health equity. Achieving equity demands attention not only to downstream factors such as unequal access to medical care, but also upstream factors that extend beyond the health care sector. These upstream factors, often referred to as the social determinants of health, include education, housing and transportation, which collectively influence health and well-being more than medical care does.3 million in 2021.

Similarly, the political determinants of health, including the unequal distribution of power in society and the growing disenfranchisement of certain populations, are increasingly recognized as critical to health equity. Given that such a broad range of issues—many unrelated to health care itself—underlie health inequities, the directors for health equity would not only work within the health department, as is often the case with such roles today, but would collaborate with leaders across government, including the departments of education, housing and justice. In this way, they could help break down silos and orchestrate a pangovernmental approach to health equity that incorporates both upstream and downstream efforts. For example, after noting wide gaps in rates of diabetes across race in the western part of a state, a director could coordinate a comprehensive effort with targeted messaging from the public health commissioner and governor, specific guidance from the health secretary and Medicaid agency to local hospitals and doctors, and direction from the education and commerce departments to schools and retailers to promote healthy diets and limit the sale of sugar-rich foods. These directors for health equity would use data and analytics to better define state and local health disparities and inform the design of efforts to close those disparities..

They would provide strategic and programmatic leadership for equity-focused initiatives and advise government agencies on how their programs may be affecting disparities and how they might be reformed to better advance equity. They might also liaise with diversity, equity and inclusion staff that sit within each department or agency to assess disparities specific to that agency and its stakeholders as well as their relationship to the distribution of health and illness. The need for a position like this has been recognized by many organizations in health care, including in the private sector. For example, two Fortune 50 corporations, Humana and Anthem, each recently appointed a chief health equity officer (CHEO). At Humana, the CHEO sets direction and establishes strategy to promote health equity across all lines of business, including health insurance and care delivery.

Responsibilities include leading work to define enterprise-wide measures of equity, creating goals for improvement and coordinating efforts to achieve them, and integrating cultural sensitivity into the design and development of Humana clinical programs, products and services. If the journey to health equity requires thoughtful planning and evidence-based interventions across sectors, then appointing leaders and empowering them with the resources to execute on the vision we propose here will be a necessary part of that journey. As the pandemic rages on, we hope our leaders will continue to consider integrated strategies to advance health equity at this unique moment in history. This is an opinion and analysis article; the views expressed by the author or authors are not necessarily those of Scientific American. .