2010 Annual Health Disparities Conference Proceedings

2 0 1 0 A n n u a l C o n f e r e n c e P r o c e e d i n g s

C e n t e r o n H e a l t h

D i s p a r i t i e s A D V E N T I S T H E A L T H C A R E

S U M M E R 2 0 1 1

Authored by Staff of the Center on Health Disparities at Adventist HealthCare Marcos Pesquera, RPh, MPH Executive Director Talya Frelick, MPH Project Coordinator Marilyn Lynk, PhD Program Manager Eme Martin, MPH Project Coordinator Sonia Portillo Research Assistant Deidre Washington, PhD Research Associate Designed by Tiffany Capeles, MBA Consultant

To download additional copies of the proceedings or learn about the activities of the Center on Health Disparities, visit the Center’s web site at:

http://www.adventisthealthcare.com/disparities

2010 Annual Conference Proceedings

Acknowledgments ··············································································· 5

Welcome ························································································· 7

Executive Summary ············································································· 9

Overview ························································································ 10

Agenda ·························································································· 13

Conference Planning Process ································································ 14

Speakers ························································································· 16

Panelists ························································································· 19

Networking In Action ········································································· 24

2010 Blue Ribbon Award ···································································· 28

Conference Evaluation Summary ··························································· 30

Analysis and Recommendations ····························································· 32

Future Directions ·············································································· 36

Conference Attendees List ··································································· 42

TABLE OF CONTENTS


Adventist HealthCare and the Center on Health Disparities would like to thank all of the 2010 Health Disparities Conference participants, speakers, panelists, and sponsors for their continued support of the Center’s activities. We are grateful to the members of the planning committee—especially the Montgomery County Health and Human Services Minority Initiatives who provided financial support for the conference. Their guidance and support helped make this conference another success. CHD 2010 Annual Health Disparities Conference Proceedings The 2010 conference proceedings summarizes recommended research, policy, and community action strategies to address social determinants of health and is based on speakers’ presentation slides and transcription notes. Also included is a list of attendees interested in networking and partnering across multiple sectors to address a wide range of public health issues.

ACKNOWLEDGMENTS


Marcos Pesquera, Executive Director, Center on Health Disparities at Adventist HealthCare, introduced the speakers and panelists, and acknowledged the audience members who give their time and effort—but more importantly their hearts—to serve our community.

Mr. Pesquera thanked the Montgomery County Department of Health and Human Services for their support of this conference and their continued commitment to improve the health of our communities. Also, he thanked Frederick and Prince George’s Counties Departments of Health and Human Services for their partnership in the planning.

Several members of the planning committee were asked to stand to acknowledge their participation in the planning and execution of the conference: Betty Lam, Brenda Lockley, Sonia Mora, Talya Frelick, Eme Martin, Dr. Jackie Dougé, Dr. Donald Shell, Dr. Marilyn Lynk, and Dr. Deidre Washington

Mr. Pesquera mentioned leadership at the top of an organization as a critical piece of successfully incorporating strategies to achieve equity. He introduced and acknowledged Bill Robertson, President and CEO of Adventist HealthCare, for his vision to create a Center on Health Disparities, and for engaging community leaders and seeking support and guidance for the launch of such an endeavor. He also invited Uma Ahluwalia, Director, Montgomery County Department of Health and Human Services, to speak, acknowledging her tireless work to improve the health and living conditions of the most vulnerable populations in our communities and lead the effort to remove barriers to care and services for all county residents.

WELCOME


Marcos Pesquera, Executive Direc-tor, Center on Health Disparities at Adventist HealthCare.

The 2010 Fourth Annual Health Disparities Conference, sponsored by the Adventist HealthCare, Center on Health Disparities, was held on November 3, 2010 in Rockville, Maryland at the Universities of Shady Grove Conference Center. The theme of this year’s conference was Social Determinants of Health. Conference attendees included Adventist HealthCare employees, state and local government officials, public health professionals, policymakers, students, and other community stakeholders. Attendees heard compelling presentations by nationally-recognized leaders, explaining how social determinants, such as educational opportunities, income disparities, the built environment, and neighborhood conditions, contribute to inequitable and unfair differences in health and access to health care between different racial/ethnic groups. Presenters also gave examples of ongoing programs and initiatives they are involved in that address these social determinants, to help disadvantaged populations achieve better health and quality of life. Social Determinants of Health was also the topic of the Center on Health Disparities’ 2010 Annual Progress Report, available on the Center on Health Disparities website (www.adventisthealthcare.com/disparities). These 2010 Annual Health Disparities Conference Proceedings offer an overview of conference activities, and summarize the major themes and ideas to emerge from the speakers and the attendees. We describe the conference planning process in detail, including the members of our planning committee. We summarize the presentations given by our speakers, including Margaret O’Bryon, the President and CEO of Consumer Health Foundation, who gave opening remarks. The morning and afternoon keynote presentations were given by Dr. Brian Smedley of the Joint Center for Political and Economic Studies, and Dr. Betina Jean Louis of the Harlem Children’s Zone, respectively. Morning and afternoon panel sessions followed the keynote presentations. During the lunch break, a networking exercise facilitated discussion and idea-exchange among the attendees on how organizations could collaborate to address the social determinants of health in their community. We present a summary of the suggestions that emerged from this networking exercise. Finally, we offer an analysis of the themes that emerged from dialogue among the speakers, panelists, and attendees; the challenges discussed; and recommendations for future research, education, and service strategies, both for the Center on Health Disparities and community organizations. In conclusion, we feel that our 2010 Annual Conference was a tremendous success. We hope that you will use these proceedings as a resource when considering new strategies for advancing your organization’s health disparities agenda. Although much work remains to be done in order to achieve health equity, we are heartened to know that there are so many dedicated professionals in the Washington, D.C. area, and across the country, who are working toward accomplishing this lofty goal.

EXECUTIVE SUMMARY


Across the nation, more and more people are facing persistent and pervasive inequality and disparities where they are born, grow, work, learn, and live. Together these disparities can have a profoundly negative effect on one’s health and wellbeing. The engagement of community partners—especially leaders and professionals across all public and private sectors—is crucial to address the root causes of these disparities and improve the health of communities. In 2007, Adventist HealthCare created the Center on Health Disparities to help raise community awareness, improve capacity, and develop solutions to eliminate local disparities in health care. The Center on Health Disparities’ mission is to achieve health equity by reducing and eliminating disparities in health status, and health care access, treatment, quality, and outcomes throughout the communities it serves. CCENTERENTER ONON HHEALTHEALTH DDISPARITIESISPARITIES AANNUALNNUAL CCONFERENCESONFERENCES: 2007: 2007––20092009 The Center on Health Disparities has developed and disseminated three annual reports in conjunction with a health disparities conference to bring community stakeholders together and share best practices in research and community interventions to eliminate health disparities locally. The Center held its first conference in November 2007, less than a year after its inception at Adventist HealthCare, to disseminate the findings published in its inaugural report, Partnering Toward a Healthier Future: Eliminating Health Disparities in Frederick, Montgomery, and Prince George’s Counties in Maryland (Center on Health Disparities, 2007). The report provided local stakeholders with information about health disparities in the tri-county Maryland region, including compiled data on demographic characteristics and health outcomes across several health indicators for racial, ethnic, and linguistic groups, and cultural influences on health. The Center also outlined several recommendations to help health care and other organizations address health disparities by: expanding outreach and services to racial and ethnic minorities; promoting systematic data collection and research; disseminating knowledge from best practices in data collection to community members and leaders in health care; promoting innovative, linguistically and culturally-sensitive care in the community; and funding mechanisms to foster the exchange of best practices. The 2008 Center on Health Disparities report described community partners’ achievements in response to the 2007 report recommendations and identified ways the Center on Health Disparities could support their partners’ progress (Center on Health Disparities, 2008). The report recommendations called for more community collaboration to disseminate information about organizations’ activities and accomplishments; improved standardization of racial/ethnic identifying data procedures,

OVERVIEW


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practices, and utilization; and more cultural competency education and training for health care organizations, providers, and staff. At the conference that same year, speakers and panelists discussed how to leverage health disparities research and policy at national, state, and local levels to eliminate disparities. The speakers discussed advancing race/ethnicity and language data collection strategies and facilitating partnerships among health disparities research experts and policy leaders committed to achieving health equity. Whereas the previous report focused on community initiatives primarily, the 2009 report highlighted education, health services, and research initiatives at Adventist HealthCare to help improve cultural competency in health care and eliminate disparities (Center on Health Disparities, 2009). The 2009 report evaluated Adventist HealthCare’s progress in achieving the recommendations and initial goals set out in the 2007 Progress Report and by the founding Blue Ribbon Panel. The main goals of the 2009 conference were to identify and share strategies for implementing cultural competence standards in order to reduce barriers to quality health care for underserved populations, and foster community partnerships among stakeholders committed to measuring and reporting cultural competency and quality of care to local residents. Speakers and participants exchanged ideas and best practices in improving health care quality during breakout sessions. Kaiser Permanente has provided funding to support the Center’s initiatives including annual health disparities conferences in 2008 and 2009, and the Qualified Bilingual Staff Train-the-Trainer Program in 2010. The Center’s 2010 annual conference, entitled "Social Determinants of Health: The Role of Health Care in Leading Social Change in Local Communities," provided community stakeholders from different sectors the opportunity to learn from one another and explore potential collaborative partnerships by networking with participants from multiple sectors of the community. Leaders, professionals, and community members from criminal justice, education, and business as well as health care shared knowledge and began discussing ways to improve quality of life and promote health equity locally. More than 250 people attended the conference; approximately 40% of them were from non-health occupations.

OVERVIEW


CCENTERENTER ONON HHEALTHEALTH DDISPARITIESISPARITIES 2010 A2010 ANNUALNNUAL HHEALTHEALTH DDISPARITIESISPARITIES CCONFERENCEONFERENCE

The 2010 annual conference was held on November 3, 2010 at the Universities of Shady Grove in Rockville, Maryland, to facilitate dialogue among community stakeholders about social factors affecting community and individual health. At the one-day conference, experts in research, policy, and community initiatives described factors such as living conditions and work environment that affect Latinos, African Americans, and Asian Americans, and how such factors can affect their health and wellbeing. Speakers involved in local initiatives addressed challenges and suggested strategies for building cooperative partnerships to address these social factors in order to improve health care quality and health outcomes for racial and ethnic minorities. The networking lunch at the conference brought community stakeholders from various domains together to facilitate networking among colleagues to share knowledge, discuss barriers and solutions, and build collaborative partnerships across multiple domains to promote health equity locally. Participants worked in pairs or small groups and answered a set of questions. After the activity, volunteers were asked to share what they learned with regard to partnership ideas and strategies to address social determinants. The conference concluded with

an award presented to the Chinese Culture and Community Service Center for accomplishments in promoting health equity in our communities through collaboration and outreach (Edvin Chow, Executive Director, accepted the award on their behalf), and closing comments from Marcos Pesquera thanking presenters and attendees for their contributions to the conference.

OVERVIEW


Conference attendees during a fruitful discussion.

AGENDA AT A GLANCE


Conference Speakers

Welcome: Marcos Pesquera Executive Director, Center on Health Disparities at Adventist HealthCare

William “Bill” Robertson President and CEO, Adventist HealthCare, Inc.

Uma Ahluwalia Director, Montgomery County Department of Health and Human Services

Opening Remarks: Margaret O’Bryon, President and CEO, Consumer Health Foundation

Morning Keynote Speaker: Brian Smedley, PhD, VP and Director, Health Pol-icy Institute, Joint Center for Political and Economic Studies

Panel Discussion: Addressing Social Determinants of Health to Improve Community Health

• Diego Uriburu, MS, Co-Founder, The Latino Youth Collaborative, and Deputy Executive Director, IDENTITY, Inc.

• Jermane Bond, PhD, Research Associate and Director, Commission on Paternal Involvement in Pregnancy Outcomes, Joint Center for Political and Economic Studies

• Arnab Mukherjea, PhD, MPH, Postdoctoral Scholar, Center for To-bacco Control Research and Education, Cardiovascular Research Institute, University of California-San Francisco

Moderator: Deborah Willis-Fillinger, MD, Director, Office of Health Equity, Health Resources and Services Administration Networking Lunch and Activity: Connecting Leaders and Organizations Across Sectors

Afternoon Keynote Speaker: Betina Jean-Louis, PhD, Director of Evaluation, Harlem Children’s Zone

Panel Discussion: Collaborative Initiatives and Community Engagement • Donald Shell, MD, MA, Health Officer, Prince George’s County Health

Department • Eric Seleznow, State Policy Director, National Skills Coalition • Myron Dean Quon, JD, MBA, Chief Executive, Quon Consulting

Moderator: Rose Marie Martinez, ScD, Director, Board on Population Health and Public Health Practice, Institute of Medicine

2010 Blue Ribbon Award: Presented to the Chinese Culture and Community Ser-vice Center

Closing Remarks: Marcos Pesquera

PLANNING MEETING SCHEDULE: March – December 2010 PHASE

Determined topics, speakers, and format

Drafted preliminary conference program and agenda

Chose target audience(s)

Proposed outcomes and deliverables

Identified potential sponsors, funding sources

Determined conference staffing needs

Drafted preliminary budget

PHASE

Identified areas of interest: criminal justice, workforce and economic development,

housing and environment, & and education

Contacted participants in and outside of health care

Planned Networking Lunch

Scheduled and led speaker/topic subgroup meetings

PHASE

Sent Invitations

Nominated and Selected Blue Ribbon Award Candidates

Proposed discussion questions

Selected Moderator

November 3, 2010: Health Disparities Conference

PHASE

Evaluation Summary and Analysis

Recommendations for Future Directions

Proceedings Development and Dissemination

CONFERENCE PLANNING PROCESS


PLANNING COMMITTEE MEMBERS Julie Bawa, MPH Public Health Analyst/Project Officer, West Pacific Branch, Bureau of Primary Health Care, Health Resources and Services Administration, Department of Health and Human Services Tiffany Capeles, MBA Consultant, Center on Health Disparities Adventist HealthCare Jacqueline Dougé, MD, MPH, FAAP Deputy Health Officer Director, Health Care Connection Division Frederick County Health Department Anika Hines, PhD, MPH Consultant, Center on Health Disparities Adventist HealthCare Betty Lam, MA Chief, Office of Community Affairs Montgomery County Department of Health and Human Services Brenda Lockley, RN, MS Program Manager, African-American Health Program Montgomery County Department of Health and Human Services Marilyn Lynk, PhD Program Manager, Center on Health Disparities Adventist HealthCare Sonia Mora, MPH Program Manager, Latino Health Initiative Montgomery County Department of Health and Human Services Marcos Pesquera, RPh, MPH Executive Director, Center on Health Disparities Adventist HealthCare Donald Shell, MD, MA Health Officer Prince George’s County Health Department

CONFERENCE PLANNING PROCESS


OPENING REMARKS

Margaret O’Bryon, President and CEO of the Consumer Health Foundation, addressed the conference participants and started off the day talking about three of her passions: The Consumer Health Foundation (CHF), health justice, and the power of community. Her main points were about how her foundation came to focus on health justice, their vision and work in this area, and challenges and opportunities for advancing their work in the community. She stressed how important it is to have an outside assessment of their work by community experts. Their assessment included conversations with CHF grantees and other community partners. They learned there was a lot of work to do to address the strong forces that affect health and well being, including, but not limited to health care. Part of what they did was change their grant making and adopt a much stronger focus on advocacy to change systems and policies at the intersections of health care, health, and other social and economic areas. Her final remarks

encouraged making more connections between multiple institutions and interests to create a convergence of expertise, knowledge, and power. “In the space where interconnections are made, real change can occur to reverse the trend of poverty, eliminate health inequity, and improve the overall health of our community and its residents,” she concluded.

MORNING KEYNOTE ADDRESS:

Our morning speaker, Brian Smedley, PhD, VP & Director, Health Policy Institute, Joint Center for Political and Economic Studies, discussed scientific evidence on social determinants of health as fundamental causes of health inequities and discussed policy implications and comprehensive solutions. In his 45-minute presentation, Building Stronger Communities for Better Health, Dr. Smedley discussed how one’s health is embedded in a community context, economic context, and political context. He said the key to transforming our communities is understanding and addressing the root causes of health inequities. He addressed the tremendous gaps in education, income, and wealth,

and how they arise out of a historical context. “Historic and contemporary racism and discrimination, residential segregation, and other systemic behaviors and practices have negative effects of health and human development. While there are differences in health risk and health-seeking behaviors among individuals, such as diet and sedentary lifestyles, many of

SPEAKERS


Margaret O’Bryon delivering opening remarks.

Dr. Brian Smedley ad-dresses how building stronger communities leads to better health.

Building Stronger Communities for Better Health

these behaviors are deeply embedded in the context of where we live, the living conditions in communities, and the quality of schools.”

Dr. Smedley mentioned several strategies to address these differences including (1) improving conditions in which people live, work and play to prevent negative health outcomes; (2) establishing partnerships with other stakeholders in the community across a range of sectors, not just public health or our health care systems (e.g., faith groups, business groups, educators, community-based organizations); and (3) having a sustained investment and a long-term policy agenda. Two general strategies he suggested were (1) place-based strategies to increase investments in communities that have suffered from disinvestment and (2) people-based strategies to increase opportunities for housing mobility (i.e., to allow folks who live in communities that suffer from disinvestment to leave distressed communities and move into communities with better opportunity structures). He stressed that both strategies need to happen simultaneously. He concluded by describing the Place Matters initiative at the Joint Center, going into its fifth year to build the capacity of local leaders to address social determinants of health by improving neighborhood conditions for health, improving the quality of the food environment, reducing the concentration of environmental health risks, and improving conditions for health child development. All of these are important community-based strategies addressing conditions in neighborhoods that shape health. The Joint Center is working with different groups to look at social determinants and health status within these communities and track progress over time.

AFTERNOON KEYNOTE ADDRESS:

Our afternoon speaker, Betina Jean-Louis, PhD, Director of Evaluation at the Harlem Children’s Zone (HCZ) introduced the Harlem Children’s Zone Project and discussed initiatives and strategies used for coordination and collaboration with community partners to address factors affecting health and wellbeing of children, families, and communities. Harlem Children’s Zone has a strategic approach to change the nature of the community, engaging the whole community and providing comprehensive interventions from birth through graduation. The place-based initiative is neighborhood-based and works to address issues faced by residents living within

100 blocks in Central Harlem. They established a pipeline of best-practice programs for children from 0–24 years old with supports for families and communities. To ensure community buy-in, they have a community advisory board to support community building efforts. Finally,

SPEAKERS


The Harlem Children’s Zone: Breaking the Cycle of Poverty

Dr. Betina Jean-Louis stresses the importance of collaboration.

they have internal program evaluation capacity and resources to build a data infrastructure in order to continuously improve their programs. Their best practices and evaluation efforts have had a positive impact on children’s academic achievement from elementary school through college. Dr. Jean-Louis started her presentation by noting the national crisis that has greatly affected U.S. residents, including those from the HCZ Project area. Poverty, failing schools, high unemployment rates, and high rates of incarceration all amount to a crisis in Harlem affecting children, families, and the greater Central Harlem community. She cited an amazing figure from research conducted at Columbia University: the amount of money that is spent to incarcerate an individual in the United States ($30,000 to $52,000 for adults in 2003) is much higher than the amount of money being spent per child—$3,200—to participate in the Harlem Children’s Zone Project. Dr. Jean-Louis showed a video featuring HCZ on CNN's series Black in America. In the video, journalist Soledad O'Brien profiled some of the solutions HCZ has devised to address health-related problems among African American youth including obesity and risks for chronic diseases. She also highlighted work at HCZ’s Asthma Initiative, where they provide services to address the high rate of asthma among children living in the zone (in 2009–2010, 29% compared to 5–7% national rate). They collaborate with hospitals, education and health departments, foundations, and legal services organizations to provide a range of interventions, including educational, social, medical, environmental and legal assistance to families. She noted that with multiple collaborators, it’s really important to have unity of purpose and to maintain one’s purpose. HCZ and its partner organizations work very hard to stay focused and facilitate collaboration through regular steering committee participation, and by having a memorandum of understanding at the beginning of the work. HCZ shares its knowledge nationwide through their Practitioners Institute where a group of people (e.g., board members, organization staff, and others.) working together on a project learn about what HCZ does, how to replicate a different program, or how to create their own zone in a community. Finally, Dr. Jean-Louis discussed Promise Neighborhoods, President Obama’s attempt to replicate the work being done in different communities. A number of communities have received planning grants, including Cesar Chavez Public Policy Charter High School in Washington, D.C. The Promise Neighborhoods Institute is creating a series of resources for neighborhood-based collaborative work.

SPEAKERS


Morning

Panel:

“Addressing Social Determinants to Improve Community Health”

Each panel speaker was asked to discuss the social, economic, and environmental conditions that affect specific populations, challenges they face, and strategies to address these conditions. The salient theme that emerged across all presentations was the importance of using a comprehensive approach to address social determinants. Each speaker had about 15 minutes to present and a moderator led a discussion after the panel presentations.

LLATINOATINO YYOUTHOUTH CCOLLABORATIVEOLLABORATIVE: : MMRR. D. DIEGOIEGO UURIBURURIBURU Mr. Uriburu discussed some of the social determinants adversely affecting the Latino youth population in Montgomery County. Education, living environment (isolation, minimal family support), and violence all contributed to what Mr. Uriburu referred to as “a lost generation of Latino youth.” He cited specific examples, saying that over most of the past 13 years, Latino youth had the highest high school dropout rates, the lowest graduation rates, and the lowest attendance rates in Montgomery County. Community involvement was important in addressing these issues, so elected officials within Montgomery County were brought into discussions about developing long-term solutions, including the County Executive, council members, and members of the Board of Education. The result was the development of a public-private partnership (the Latino Youth Collaborative) consisting of County government Departments that work with youth and families, including Health and Human Services, Recreation, Police, Economic Development, and Corrections among others. The partnership divided into three separate subgroups: the first addressed policies that were negatively impacting Latino youth; the second worked on responsive services that needed to be implemented, improved or changed in order to achieve general wellbeing, violence prevention, and educational development; and the third focused on social integration, to address the problem of social isolation for the Latino community in Montgomery County.

PANELISTS


Morning Panelists (left to right): Arnab Mukerhjea, Jermane Bond, and Diego Uriburu, with Moderator Deborah Willis-Fillinger.

Mr. Uriburu’s remarks emphasized the importance of having participation and buy-in from the members of the community, including elected officials such as the County Council and the Board of Education. Without this buy-in, any recommendations from the Collaborative would have very little chance of being implemented. Also, by including them in the process, they can be held accountable for the recommendations. In April 2011, Montgomery County Executive Isiah Leggett released the Latino Youth Collaborative Steering Committee Report titled, “A Generation of Youth Hanging in the Balance.” The report includes the final recommendations from the Collaborative, which includes calls to: · Develop policies and implement strategies for increasing career/job-based education opportunities for Montgomery County Public School students. · Identify and enhance the capability of key contact/entry point in Montgomery County to connect with Latino families and assess their needs. · Provide Latino youth and families with the necessary tools, knowledge, and access to strengthen their civic engagement capabilities.

BBOYSOYS--TOTO--MMENEN--TOTO--FFATHERSATHERS: P: PATHWAYSATHWAYS TOTO IIMPROVEMPROVE PPATERNALATERNAL IINVOLVEMENTNVOLVEMENT ININ PPREGNANCYREGNANCY OOUTCOMESUTCOMES: : DDRR. J. JERMANEERMANE BBONDOND Dr. Bond’s presentation focused on the problem of infant mortality in the United States. The U.S. ranks 28th among developed countries in infant mortality, which is considered a key indicator of the health of a nation. Although pregnancy outcomes are improving overall in the U.S., African American infants still die at twice the rate of white infants. The social determinants of health that affect pregnancy outcomes include income, education, employment and housing. Each of these factors can contribute to higher levels of stress during pregnancy. Dr. Bond’s research builds upon previous research showing that paternal involvement (involvement of fathers) may be a significant factor in determining the prenatal health of infants, which in turn affects their likelihood of survival. Dr. Bond’s research aims to determine how paternal involvement of African American fathers can reduce the rate of infant mortality, and how to increase African American fathers’ involvement during the prenatal period. He also stresses the importance of preconception care for men, in the form education, health promotion, and routine physical exams. With funding from the Office of Minority Health, the Joint Center for Political and Economic Studies-Health Policy Institute created the Commission on Paternal Involvement in Pregnancy Outcomes (CPIPO) in 2009 to raise awareness of the issue of paternal involvement in pregnancy outcomes. CPIPO is a trans-disciplinary group of scholars from the social sciences

PANELISTS


and public health community to help inform research, practice and policy, and to raise awareness regarding paternal involvement. CPIPO has developed several recommendations to inform the research agenda in this area, and to affect current practices and policies as well. One research recommendation includes urging the National Institutes of Health to expand their efforts and support for research of paternal involvement, especially in the African American community. Concerning current practices, the CPIPO recommends dissemination of best practices for involvement during the periods before, during, and beyond pregnancy, and that practitioners make more effort to address the needs, emotions and concerns of fathers. Another recommendation is that organizations such as the Joint Commission and American Hospital Association promote more father-friendly hospital settings, practices, and policies. Finally, policy recommendations include amending the Family and Medical Leave Act to include paid parental leave for both mothers and fathers.

EENSURINGNSURING HHEALTHEALTH PPARITYARITY FORFOR AASIANSIAN AAMERICANSMERICANS, N, NATIVEATIVE HHAWAIIANSAWAIIANS, , ANDAND PPACIFICACIFIC IISLANDERSSLANDERS: : DDRR. A. ARNABRNAB MMUKHERJEAUKHERJEA Dr. Mukherjea spoke on disparities issues affecting the Asian American, Native Hawaiian, and Pacific Islander populations. As with the earlier speakers, Dr. Mukherjea referenced income, education, and employment as a few of the social determinants of health that affect these populations. This is especially true when disaggregating data to the level of country of origin. Some subgroups may have much higher rates of poverty, poor education, etc. than others, which may be masked when presented as an aggregated group. He strongly cautioned against the common practice of grouping all persons from Asia, Hawaii and the Pacific Islands into one large group, as the regions are extremely diverse. Asians alone come from more than 50 countries or regions, speak over 30 official languages, and practice more than 20 different religions. Disaggregation is also important for reporting health disparities in these populations. Dr. Mukherjea highlighted data showing low rates of cancer incidence and mortality in these populations overall. However, when looking at more granular data, persistent cancer health disparities within certain segments of the population become more apparent. In his talk, he also spoke about the benefits of community-based participatory research in addressing health disparities, as the community can best describe the social reality of their personal situations. Finally, Dr. Mukherjea urged the audience to capitalize on movements such as the Asian American Health Initiative in Montgomery County, as a progressive, community-based model, which develops its program based upon feedback and input from the local community.

PANELISTS


Afternoon panelists: Donald Shell, Eric Seleznow, and Myron Dean Quon (far right), with Moderator Rose Marie Martinez (center) and Afternoon Speaker Betina Jean-Louis.

Afternoon

Panel:

“Collaborative Initiatives and Community Engagement” Each panel speaker was asked to describe local programs or initiatives requiring cooperative efforts among community organizations, and discuss challenges, barriers, and best practices regarding how to engage local community partners to discuss the importance of addressing social determinants and support cooperative efforts. Each speaker had about 15 minutes to present and a moderator led a discussion after the panel presentations.

AADAMDAM’’SS HHOUSEOUSE: : DDRR. D. DONALDONALD SSHELLHELL Adam’s House is located in Prince George’s County, Maryland, and serves as a resource where adolescents and young adults in need can receive myriad health and social services. Adam’s House works with individuals to address any barriers they encounter that can impede their probability for employment and economic stability. These barriers may be financial, health-related, criminal justice-related, educational, or environmental in nature. Dr. Shell recounted how, as a family physician volunteering in the public health department several years ago, he recognized a need to engage more men in their overall health and well-being. However, instead of waiting for men to come to the health department, the health department proactively decided to go to the places where men normally interact with other systems. These places include the criminal justice system (child support, parole and probation hearings), the school system, and the Department of Transportation. In doing this, they also discovered that many men felt angry, isolated and disenfranchised within their communities. As a result, Adam’s House was created to be a safe haven for young boys, men, and families, to come to express themselves, while improving access to many health, community and social services. Other strategies involve improving men’s experiences at other County agencies. As one example, Adam’s House placed staff members in the men’s waiting room at child support hearings, to educate the men about the process and their rights. Now, they are able to provide in

PANELISTS


-court consultations to judges in cases of delinquency, as well as provide follow-up support for men to facilitate compliance with child support orders. Adam’s House also works with men to help them find employment, battle substance abuse, deal with relationship issues, and become more active in the lives of their children. Their ultimate goal is to assist men with becoming active, productive and successful members of society.

SSUBURBANUBURBAN MMARYLANDARYLAND WWELCOMEELCOME BBACKACK CCENTERENTER: : MMRR. E. ERICRIC SSELEZNOWELEZNOW Mr. Seleznow works in the area of labor and workforce development. Several years ago, the Latino Health Initiative in Montgomery County organized a coalition to meet two specific needs identified within the county: (1) address the health care workforce shortage, especially in the field of nursing, due in part to an aging workforce; and (2) address cultural competence in the health care workforce to meet the needs of the diverse patient population being served. In tackling the first issue, the coalition realized that many immigrant women who had been trained as nurses and other medical professionals in their home countries were unable to get comparable jobs in Montgomery County. Many instead worked in less-skilled professions, such as housecleaning and food service. In response, the coalition helped remove barriers, helped engage other partners, engaged the business community, and eventually developed well-trained nursing candidates to go through English language refresher training and health care refresher training, and to get the necessary assistance to remove the barriers and go through the licensing process in the state of Maryland. This network eventually grew into the Welcome Back Center, which is part of a national, 10-center network that provides assistance for internationally trained health care workers who live in the United States. Mr. Seleznow highlighted the positive effects of this workforce investment not only on the workers, but on their families and the communities as well.

LLANGUAGEANGUAGE AACCESSCCESS, C, COMMUNITYOMMUNITY BBUILDINGUILDING, , ANDAND HHEALTHEALTH DDISPARITIESISPARITIES: : MMRR. M. MYRONYRON DDEANEAN QQUONUON Mr. Quon, a civil rights attorney, spoke about barriers faced by many Asian American communities in accessing health care, particularly their immigration status and the geographic and linguistic isolation that may go along with it. Mr. Quon also praised Montgomery County and Maryland for its current laws around language access services for residents with limited English proficiency, which are more progressive than many other states in the U.S. In particular, there are large communities of Bangladeshi, Nepali and Vietnamese residents in the local area. Many of these residents may be political refugees, and often experience high levels of poverty and linguistic isolation. The South Asian Americans Leading Together (SAALT) and the Maryland Vietnamese Mutual Association are two local organizations that collaborated with government entities and the Asian Pacific American Legal Resource Center to do a needs assessment of South Asians and Vietnamese living in the District of Columbia, respectively.

PANELISTS


NETWORKING ACTIVITY


INSTRUCTIONS:

· Break into groups of about four people (at least one from a non-health domain) · Assign Roles: Facilitator (guides group, keeps time) & Reporter (takes notes, reports output) · Take 20 minutes total to answer each of the following questions · Reporter should take notes on partnerships and strategies for debriefing with the whole group · Conference planners will collect notes to disseminate in conference proceedings

Where do you work? Who is your target population?

MD State Mental Hygiene Admin Fund local Mental Health Authorities: children, adolescents, adults, and families

Latino Health Initiative Welcome Back Center: work with nurses from other countries to get them certified

Health &Human Services Child Welfare Service. Target: youth, parents, and families

National Institute of Aging (NIH) Elderly, Latinos, and Immigrant groups

Washington Adventist Hospital Awareness & Fundraising for Hospital's Relocation. Target: local and national community

Montgomery County Health & Human Services

Division of School Health Service. Target: Child and Family (birth - 21)

Amerigroup Medicaid/Medicare population

Kaiser MD: multicultural competent care for MD and asthma

US Office of Minority Health Minority population, minority health

WRTC - Washington Regional Transplant Community

Population is multi-cultural communities, importance of being an educated donor; stay off waiting lists Non-health representative: Community Assessment for Takoma Park area

Holy Cross Mammogram Assistant

Uninsured, Under-Insured, Minority & Immigrant groups

African American Health Program Black Community Montgomery County - address health inequities

NETWORKING ACTIVITY


QU

ES

TIO

N O

NE

How would you explain the impact of your work on the health of the community?

Bridging the economic and cultural gap for underserved people in the community, particularly with health disparities.

Hoping to shift focus to population/community health from just individual health

Helping people be healthy so they can succeed in their education

AAHP: Education and prevention activities in Infant Mortality, Cardiovascular Care, Diabetes, & HIV/AIDS

PCC: partner to leverage resources for the uninsured. Contribute to building infrastructure at the community level around data systems and reporting. Provide prevention/intervention through screening outreach and education related to cervical and breast cancer. Care coordination linking to other sources. Train future health professionals.

Who do you partner

with currently?

How could you see our organiza-tions working together to address social determinants of health?

Forming grass roots groups from all areas in community

Help people gain information and leverage resources

Book club In community to promote discussion of health disparities

Commission on Health The COH partners with many advisory commissions to add impact to key issues

PCC Partners a lot, but needs to partner more from the bottom up, from the perspective of those impacted

Washington Adventist Hospital End-of-life issues partnerships

NETWORKING ACTIVITY


QU

ES

TIO

N T

WO

Q

UE

ST

ION

TH

RE

E

At the conference, the Center on Health Disparities presented the 2010 Blue Ribbon Award to the Chinese Culture and Community Service Center (CCACC) in recognition for accomplishments in promoting health equity in our communities through collaboration and outreach. Mr. Edvin Chow, Executive Director, made brief remarks and accepted the award on behalf of the CCACC.

BBACKGROUNDACKGROUND CCACC is a 501(c)(3) volunteer non-profit and non-partisan organization serving the greater Washington D.C. area. Established in 1982, it has grown to become an organization of over 1000 family members. With a motto of “Together We Can”, CCACC promotes culturally- and linguistically- conscious activities, advancing understanding of the Asian Americans community’s diverse cultures and backgrounds, and implements innovative health, education, and social programs. CCACC fosters partnerships with numerous community- and faith- based organizations, public agencies, and the private sector to develop services aimed at reduce disparities and barriers due to language or culture. Collaborators have included the US Census Bureau, Center for Medicare and Medicaid Services, Mid-Atlantic Equality Association, Montgomery County Senior Health Insurance Program, Asian American Health Initiative, and United Way. To meet the needs of the community, CCACC created seven program focus areas: Education, Culture & Arts, Health Services, Community Services, Senior Services, Sports & Fitness, and Youth.

2010 BLUE RIBBON AWARD


Chinese Culture and Community Service Center, Inc. (CCACC)

HHEALTHEALTH PPROGRAMSROGRAMS ANDAND SSERVICESERVICES

Since 2003, CCACC has operated the Pan Asian Volunteer Health Clinic (PAVHC), a community clinic within the Montgomery Cares

network. The PAVHC provides linguistically and culturally sensitive, high quality primary care service to low income and uninsured Montgomery County residents, with a predominantly

Asian American clientele. The clinic is staffed by multilingual and multicultural volunteer physicians, pharmacists, nurses, and clinic

assistants of various ethnic backgrounds. Open every Friday, the PAVHC serves approximately 500 unduplicated patients annually, totaling

approximately 800 visits each year. Established September 2008, CCACC’s Adult Day Health Care Program (ADHC) serves Montgomery County seniors and adults with disabilities. The structured comprehensive program provides health, social and other related support services (e.g., nursing care, medicine management, doctor visits, therapeutic exercise, health seminar, arts & crafts) to over 170 low income residents, mostly Chinese Americans over the age of 80. While there are several Medical Day Care centers in the County, prior to 2008, very few Chinese Americans participated due to language and cultural barriers. The establishment of this program addresses such challenges to promote a happier and healthier community. Both the PAVHC and the ADHC are successful models aimed to improving health care, access, treatment, or outcomes among Chinese and other Asian American communities in the DC-metropolitan area. In addition to health-specific programs, CCACC also provides a Chinese language and culture school for non-Chinese speaking families, adult ESOL classes, citizenship classes for recent immigrants, and a Parent Resource Center and Parents as Liaison to Schools (PALS) program, just to name a few. CCACC also provides general referral services to help more than 1,000 clients through their help line. Moreover, CCACC has been awarded community grants to support capacity-building, adult English literacy, and senior nutrition.

Contact:

Mr. Edvin Chow Executive Director Chinese Culture and

Community Service Center (CCACC), Inc.

16039 Comprint Circle Gaithersburg, MD 20877

Tel: 240-631-1200 www.ccacc-dc.org

2010 BLUE RIBBON AWARD


The Center on Health Disparities’ Fourth Annual Conference on Health Disparities was a huge success. More than 250 people attended the meeting and represented a number of local, state, and national organizations. Per the conference theme of addressing the social determinants of health, the Center on Health Disparities

made a concerted effort to invite individuals from a myriad of sectors, including social services, law, and policy. Approximately 40% of the conference attendees represented non-health related fields. Throughout the day, conference attendees positively commented on the high quality of presentations and program outline. Feedback received from online evaluations following the conference also reflected positive impressions. Nearly 60% of the conference attendees completed an extensive online survey tool shortly after the conclusion of the Fourth Annual Conference. Almost all survey respondents (94%) agreed that the annual conference topic and presentations were relevant to their work. Most survey respondents also enjoyed the conference presenters, panelists, and moderators. For some conference participants, learning about the social determinants of health was new and eye-opening. One survey respondent commented: “I was very surprised to learn how having transportation, grocery stores, some kind of restaurants, etc. actually determine[s] health disparities, because of access to healthy practices.” Another respondent noted that, “I learned about place and race [and]…that where you live determines your health outcome[s].” Another common idea expressed among survey respondents is the need for collaboration to address health disparities. “The most important thing I learned at the conference is that each of us has the power to produce the change we wish to see regarding health inequities, but only if we work

SUMMARY


Highlights

More than 250 people at-tended

Approximately 40% of the conference attendees rep-resented non-health related fields.

Nearly 60% of the confer-ence attendees completed an extensive online survey tool

Nearly 75% of the survey respondents found the net-working activity useful

Conference Evaluation Summary

collaboratively with other health and community experts, and if have the support from all levels of our specific entities.” Organizations working together is crucial to eliminating health disparities because of the “interconnectedness between social and economic factors and a state of health and wellbeing.”

Similarly, another respondent noted that “[e]verything is interconnected. We all have a duty to fight health inequities.”

Nearly 75% of the survey respondents felt that the networking activity held during lunch was useful; however, many also felt that the activity yielded insufficient time to connect with other conference attendees. One respondent simply noted that “the networking activity was too brief.” Other respondents echoed similar responses, indicating that “[a]ny ways to increase networking are very helpful.” A number or respondents also noted a need to be more engaged as conference

participants. Perhaps the most comprehensive comment speaking to this issue is the following: “[We] could use guidance on steps to forming partnerships, networks, and coalitions. [We] could [also] benefit from role plays demonstrating how organizations with differing agendas come together and can struggle to find acceptable partnership arrangements and ways to address this issue.”

SUMMARY


Conference attendees talking together.

rganizations working together is crucial to elimi-nating health disparities.

The 2010 Annual Health Disparities Conference served as a forum for researchers, policymakers, and other community stakeholders to engage in pertinent discussions about current and future strategies for addressing health disparities. Several recommendations came out of questions posed to our speakers/panelists, as well as the general Question & Answer (Q&A) sessions. Here, we present a summary of the ideas and recommendations put forth and, where appropriate, how we plan to incorporate them into our organizational strategic plan. The morning keynote speaker and the panelists presented data to demonstrate the effect of social determinants on health and health disparities. The presentations featured previously collected data and ongoing research, including those that focused on specific demographic populations, such as men, Latino youth, Asian Americans, Native Americans, and Pacific Islanders. A major theme that emerged during the morning Q&A sessions was the importance of disaggregating data on race and ethnicity down to the most granular level possible. Several

attendees expressed dismay that people from different regions routinely get lumped into one category. As an example, people born in the Caribbean who immigrate to the U.S., and persons of African descent born in the U.S., are often all categorized as “African Americans,” although their experiences in the U.S. may be very different. Similarly, when persons born in China, India, Korea, the Philippines, and Vietnam are all lumped into the category of “Asian American,” it can mask the characteristics specific to only one group. The Center on Health Disparities agrees that when analyzing health disparities by race and ethnicity, the most granular data should be utilized and reported, to the

extent the data are available. Adventist HealthCare currently collects patients’ race, ethnicity (Hispanic and non-Hispanic), ethnic group (e.g., Chinese, Ethiopian, Salvadorian), language preference, and country of origin. The Center is currently working closely with several other departments during the development and implementation of our new platform for electronic medical records, expected to go live in September 2011. In alignment with new regulations from the Joint Commission, the new platform will have the functionality to capture and report not only granular race/ethnicity data, language preference, and county of origin, but provision of qualified interpreter services as well. This will allow us to examine our patient population with more specificity, and better identify health disparities within our patient population that need to

ANALYSIS AND RECOMENDATIONS


Analysis and Recommendations

major theme that emerged during the morning Q&A sessions was the importance of disaggregating data on race and ethnicity down to the most granular level possible.

be addressed. We would encourage other organizations that study health disparities to also re-examine current methods of data collection, and identify opportunities for improvement as well. In a related theme, an attendee expressed disappointment that the majority of health disparities research has focused primarily on Latino and African American health issues, while significantly less attention has been given to disparities in Native Americans/American Indians. Data have shown that disparities in this population are a significant problem, particularly related to obesity, alcohol abuse, and depression. Continued attention to disparities in this population is warranted, although small numbers may make it difficult to draw strong conclusions. In fact, recent 2010 Census data shows that American Indians and Native Alaskans account for approximately 0.4% of the Maryland population. Finally, a panelist commented on the fact that research often operates from a deficit model, asking questions such as “What are the needs in our communities?”, “What are the health issues

our communities face?”, “What are the disparities we observe in our communities?” An alternative approach is to consider any protective factors that may be present and at work in other communities. By focusing on protective factors that are prevalent in communities that are thriving, we can work to replicate these models in our own communities, hopefully with the same positive outcomes. One example would be the approach of Promise Academy Charter Schools used in the Harlem’s Children Zone. The HCZ Promise Academy Charter Schools, created to provide a safe, enriching environment, have achieved significant success in closing some academic achievement gaps seen in New York City. Results have shown that students in the elementary school eliminate racial test score gaps in math and language arts by the third grade. Likewise, students in the middle school eliminate gaps in math and significantly narrow them in English language arts. Adapting the HCZ model in different communities is one approach to eliminating these racial education gaps and promoting academic success for the most vulnerable populations. In summary, the morning presentations underscored the importance of identifying social determinants that affect racial/ethnic minorities, and other underserved populations, such as those categorized as low socio-economic status. We encourage those who focus on this area to continue working to identify non-health factors that impact health outcomes for your particular community of interest. The afternoon keynote speaker, Betina Jean-Louis, is the Director of Evaluation for the Harlem Children’s Zone. The three panelists in the afternoon spoke about their respective

ANALYSIS AND RECOMMENDATIONS


y focusing on protective factors that are prevalent in communities that are thriving, we can work to replicate these models in our own communities, hopefully with the same positive outcomes.

organizations, all of which strive to address some of the social determinants and disparities highlighted in the morning session. Following the presentations, the afternoon’s moderator opened the discussion by posing a question about the strategies and challenges of developing successful collaborations and partnerships. In response, speakers discussed the importance of building trust among partners early on in the relationship, the importance of information sharing, and

allowing time to observe measurable outcomes. One panelist also stressed the importance of having a healthy workforce in order for any

business to thrive. He gave an example of how his organization gives pre-employment physicals to individuals before referring them to a partner

organization for a job. This also works to build trust between the two organizations, since the employing organization knows that the individual they are accepting is both able and willing to work. An attendee also posed a question about how to combat the problem of drug dealing/abuse in the community. In response, a panelist related involvement in drugs with decreased educational attainment and opportunities for employment. He discussed the importance of identifying at-risk children as early as possible, and how his organization works to identify and help young men who are having trouble performing well in a traditional school system. He posits that by improving their educational and employment opportunities, you may decrease their risk for becoming involved in drugs. A final afternoon dialogue focused on how organizations could identify resources to help maintain the sustainability of these programs. A panelist mentioned that Montgomery County, in particular, enjoys a high level of civic engagement, which helps, but acknowledged that in these economic times, securing funding may be especially difficult. Dr. Jean-Louis also mentioned her organization’s decreased dependence on public (government) funds compared to the past, due to the current economic climate.

ANALYSIS AND RECOMMENDATIONS


Left to Right: Deidre Washington, Marcos Pesquera, Marilyn Lynk, Eme Martin, Sonia Portillo, and Talya Frelick

BBACKGROUNDACKGROUND In 2007, Adventist HealthCare established the Center on Health Disparities, part of its Vision for Expanded Access, to help achieve health equity by reducing and eliminating health disparities in the communities it serves. Based on recommendations from a Blue Ribbon Panel of experts, the Center was organized into three focus areas: Education and Training, Research, and Health Care Services. Since its inception, the Center has hosted an annual conference as part of its overall mission. Each conference and corresponding annual report has included information related to best practices and progress in each of the focus areas. The annual conferences serve to inform community stakeholders of relevant and timely topics relating to the elimination of health disparities in our communities. Speakers at our conferences have included researchers, policy experts, health care providers, and others from various areas including academia, government agencies, and health care organizations. Previous conferences (2007–2010) have addressed topics including the importance of developing community partnerships and collecting data to combat disparities, implementation of cultural and linguistic competence programs throughout Adventist HealthCare entities, and how social determinants such as education, employment, and the environment contribute to the health of people and communities. Keeping with shifting paradigms in strategies to eliminate health disparities, our Fifth Annual Health Disparities Conference on November 2, 2011, aims to (1) educate health care providers and community partners about the provisions of the Patient Protection and Accountability Care Act that target low-income and minority populations, (2) receive input from federal and state leaders regarding progress in health care reform implementation, and (3) provide health care leaders with

FUTURE DIRECTIONS


Future Directions

Qualified Bilingual Staff Training held De-cember 2010 at Washington Adventist Hos-pital’s Conference Center.

ideas on community and state-level best practices for implementing provisions of health care reform that will help us achieve health equity.

SSTRATEGICTRATEGIC PPLANLAN As part of our charge to raise community awareness, improve capacity, and develop solutions to eliminate local disparities in health care, we aim to continue developing and implementing activities related to our three strategic areas. The Center is always interested in establishing partnerships and expanding its education and training offerings, research program, and healthcare services. The following sections highlight some of our current and future efforts. EDUCATION AND TRAINING PROGRAMS. The Center develops and offers classes and programs to train providers and institutions in ways to improve cultural and linguistic competence, and to increase awareness of the Center on Health Disparities’ activities within the community. Since 2007, the Center has developed and delivered classroom and web-based cultural competency training modules to equip community physicians, nurses, and other health care staff with information and enhance their ability to communicate effectively with patients from diverse cultural backgrounds and to provide patient-centered and equitable care. Furthermore, the Center provides a growing Qualified Bilingual Staff Program to train and certify bilingual health care staff on proper language interpreting skills to better meet the needs of limited English proficient patients. These programs improve the organization’s ability to provide culturally and linguistically appropriate care and services and comply with legal requirements and standards of care (e.g., Office of Minority Health’s CLAS standards and The Joint Commission’s patient-centered communication standards for 2011). The Center will continue providing language interpreting and cultural competence training sessions to providers and staff within as well as outside of Adventist HealthCare to increase awareness of racial and ethnic disparities in health care, eliminate cultural and linguistic barriers

FUTURE DIRECTIONS


555THTHTH AAANNUALNNUALNNUAL HHHEALTHEALTHEALTH DDDISPARITIESISPARITIESISPARITIES CCCONFERENCEONFERENCEONFERENCE

NNNOVEMBEROVEMBEROVEMBER 2, 20112, 20112, 2011

In partnership with the Maryland Hospital Asso-ciation, Adventist HealthCare’s Center on Health Disparities and Kaiser Permanente hosted a Fa-cilitator Training of the Qualified Bilingual Staff Program for other hospitals throughout the state of Maryland on August 23–27, 2010.

during clinical encounters, and improve the quality of care throughout our communities. Current strategies related to education include: expanding core curricula using web-based learning technology and focusing on specific health conditions such as cancer and diabetes; evaluating educational programs; training lead facilitators throughout Adventist HealthCare to leverage Center on Health Disparities expertise; and devising a marketing agenda and strategy for the Center. RESEARCH INITIATIVES. The Center conducts, supports, and participates in innovative

community-based research on health disparities and effective strategies to promote health equity. In 2008–2009, Adventist HealthCare and other hospitals in Montgomery County participated in the Montgomery County Hospital Care Equity Initiative (facilitated by the Brookings Institution’s Engelberg Center for Health Care Reform), which was designed to review aggregate hospital performance data in order to measure and

monitor health disparities at the local level. As part of this effort, the Center provided training to hospital employees who collect patient data (e.g., race/ethnicity and language) to monitor the patient population and health outcomes, address patient concerns and barriers to quality care, and ensure that all patients receive the highest quality of care and best services possible. Now, in addition to collecting patient data including race, ethnicity, country of origin, and language preference, Adventist HealthCare hospitals collect information about patients’ communication needs (including foreign language interpretation or services for hearing impaired). All of this information is essential to facilitate effective communication and provide appropriate healthcare and services. Moving forward, the Center will collect and analyze data, and use research findings on health disparities to implement evidence-based health care practices within Adventist HealthCare and statewide. Strategies will include: monitoring changing population demographics locally and nationally; recruiting clinical and community advisors to develop and pursue a research strategy; pursuing partnerships with leading academic, grant-making, and policy-setting institutions; and seeking external funding for targeted initiatives. In 2011, the Center will prepare an internal Health Equity Report that will present an overview of the patient populations at Washington Adventist and Shady Grove Adventist Hospitals in Montgomery County stratified by race, ethnicity, preferred

FUTURE DIRECTIONS


Montgomery County Health and Human Services healthcare employees attending a Center on Health Disparities Cultural Competence Class (October 2008).

language, and relevant health and quality outcomes. This report will help identify and address disparities that affect people, families, and communities that Adventist HealthCare serves. HEALTH CARE SERVICES. The Center has been fortunate to be a part of Adventist HealthCare’s Vision for Expanded Access and be supported financially by the organization to ensure that quality care is available to everyone who seeks it. Expanding access to care for our communities is a critical part of Adventist HealthCare’s strategic plan. For example, face-to-face interpreting, telephone language interpreting, video remote interpreting for the deaf, Qualified Bilingual Staff Interpreters, and translation services are available for staff serving patients with hearing loss or those who speak little or no English. While training for staff on how to access, use, and document utilization of language services effectively is currently provided for clinical staff only, the Center plans on reaching out to physicians throughout the system as well (e.g., Grand Rounds presentations and MediScene articles). In line with the organization’s mission, the Center will continue to focus on increasing language access by ensuring that patients’ communication needs are met and monitored to ensure quality care.

The Center acknowledges and is grateful to other organizations that support its mission and activities. Kaiser Permanente has provided funding to support the Center’s initiatives including annual health disparities conferences in 2008 and 2009, and the Qualified Bilingual Staff Train-the-Trainer Program in 2010. In November that same year, the Montgomery County Department of Health and Human Services co-sponsored and provided funding for the Center’s annual health disparities conference. The Center hopes to identify and receive additional resources in the future from private and public foundations, government agencies, and other organizations in order to expand its programs and activities throughout the region. The Center hopes to serve as the catalyst for all

of Adventist HealthCare’s efforts to expand and improve services to underserved communities. Future strategies to improve our services include: forming an Adventist HealthCare Health Equity Council to ensure that all services and outreach incorporate culturally competent best practices to reduce health disparities and reach the underserved, and developing an integrated measurement and reporting strategy to assess the impact of Adventist HealthCare’s many outreach programs on community health and health equity. We also plan to further partner with

our community clinics to assess and evaluate current and future programs in order to identify successful practices and help with

dissemination.

FUTURE DIRECTIONS


Dr. Deidre Washington presenting a module on diversity and cultural competency to healthcare educators as part of a Facilitator Training Pro-gram in Elkridge, MD (August 2010).

OOUTREACHUTREACH/D/DISSEMINATIONISSEMINATION In addition to our annual conference, we have several other vehicles to keep staff, community members, and partners informed. Within Adventist HealthCare, we regularly publish articles in the PRISM (all-staff monthly newsletter) and MediScene (physician newsletter), two of our internal publications. Recently, we began a bimonthly feature in PRISM titled “Spotlight on Health Equity”, designed to raise awareness and knowledge about topics regarding equity in health care services for diverse populations. In addition to publishing annual progress reports on topics related to eliminating health disparities, we will continue to pursue opportunities to write and publish scholarly articles on our cultural and linguistic programs and evaluation, data collection and analysis, and other research activities. These activities will support our goal to expand our

programs in the community. Furthermore, in 2011 the Center began distributing a monthly newsletter that focuses on health topics highlighted by the U.S. Department of Health and Human Services, drawing unique attention to the vulnerable populations Adventist HealthCare serves. The newsletter is available on the Center’s website under Additional

Resources. The Center on Health Disparities website (http://www.adventisthealthcare.com/health-disparities/index.aspx) is regularly updated with information on the Center’s activities and publications, including upcoming events and resources. In addition, the Center maintains a Facebook page that highlights community partnerships and Center activities and features current information on strategies and research on eliminating health disparities (http://www.facebook.com/HealthDisparities). The Center will continue staying current with ever-evolving technology and social media to disseminate information about its activities.

IINTERNSHIPNTERNSHIP OOPPORTUNITIESPPORTUNITIES Over the past several years, the Center has provided internship opportunities to high school, undergraduate, and graduate students interested in public health and health disparities, particularly to increase minority student interest and participation in health care, public health, health services research, and related fields. The internship program helps students develop the skills necessary to progress to the next stage of their career/education. One project achieved in collaboration with the

FUTURE DIRECTIONS


Center is the Teen Ambassadors against Health Disparities project (see http://www.endhealthdisparities.org/index.html). The purpose of this project is to create awareness of health inequality and improve overall health among teens through a network or peer educators. The center will continue to offer opportunities to students interested in cultural competence, health care and services, and health disparities research.

CCOMMUNITYOMMUNITY PPARTNERSHIPSARTNERSHIPS Over the years, the Center has partnered with many organizations to make quality health care and services accessible to people in our community. Some of our partners include Montgomery County’s Department of Health and Human Services, Mobile Med, Kaiser Permanente, Sinai Hospital of Baltimore, Mary’s Center, Mercy Health Clinic, University of Maryland College Park School of Public Health, and Primary Care Coalition. The Center seeks to increase funding to expand its ability to collaborate with community partners and address health disparities and related issues such as providing local residents with the knowledge and ability to create healthy, thriving communities (e.g., Community Health and Empowerment through Education and Research or CHEER). Current partnerships will continue in the future to provide health care education and social services for local families, including those needing access to primary care (e.g., Mobile Medical Care) and prenatal care (e.g., Mary’s Center for Maternal and Child Care, Montgomery County Maternal Partnerships Program). Also, the Center will continue to pursue partnerships with other health care organizations seeking to assess and improve their ability to provide culturally competent care to a diverse patient population through strategic plan development and implementation.

FUTURE DIRECTIONS


Left to Right: Bill Robertson, Margaret O’Bryon, Marcos Pesquera, and Uma Ahluwalia

Top Row (left to right): Farrell Sheehan, Charles Li, Mason Pesquera, and Jarrod Sheehan Sitting (left to right): Amalia Oven, Marisol Pesquera, Sewit Haile, Ariana Reguerin, and Makaela Jones

On behalf of the Center on Health Disparities and the Montgomery County Department of Health and Human Services Minority Health Initiatives, we would like to thank all who attended and supported our conference. The conference was a success not only because it offered opportunities to learn and share with one another, but also because a great number of individuals from health care and non-health sectors alike participated actively in the event. In the pages to follow, we have provided a list of all the conference attendees, their respective organizations, and their contact email addresses. We encourage continuing knowledge-sharing and partnering among individuals and across organizations from both within the health sector and across non-health sectors to reduce the impact of health disparities. Join us as we Partner Toward a Healthier Future!

CONFERENCE ATTENDEES LIST


Conference Attendees List



Last Name First Name Organization Email

Adeyemi Adebayo Adventist Healthcare AdebayoAdeyemi@ adventisthealthcare.com

Aguirre Luis Latino Health Initiative [email protected]

Akindana Adeola Health Beam Outreach

Alam Naila University of Maryland [email protected]

Alfaro Jennie Primary Care Coalition of Montgomery County

[email protected]

Amaya Jose Latino Health Initiative [email protected]

Amutah-Hardrick

Ndidi Morgan State Univer-sity/W.K.Kellogg

Foundation

[email protected]

Anise Ayodola The Brookings Institution

[email protected]

Araneta Ted UMB School of Nursing/AH&W

[email protected]

Archie Tammie MIMRP Minority Infant Mortality Reduction

Project

Tammie.archie@ montgomerycountymd.gov

Artiles Ligia NIMHD [email protected]

Arunan Shelvan Adventist Healthcare [email protected]

Asfaw Thewodros Adventist Healthcare [email protected]

Assani-Uva Adeline Genesis HealthCare [email protected]

Awkard Kathy Montgomery College [email protected]

Azam Irim Non-applicable [email protected]

Baker Bruce CHEER [email protected]

Balkwill Mary Holy Cross Hospital [email protected]

Ballenger Keith Adventist Healthcare [email protected]

Bankins Kieva University of Maryland School of Social Work

[email protected]

Battle Yusef The Fit Solution [email protected]

Bawa Julie US DHHS-HRSA [email protected]

Beane Mary Montgomery County DHHS

[email protected]




Clark Roger Novartis Pharmaceuticals

[email protected]

Cogan Mary Adventist Healthcare [email protected]

Coleman Andrea Montgomery County DHHS

Andrea.coleman@ montgomerycountymd.gov

Colombus Norma Latino Health Initiative—Montgomery

County

Gianina.hasbun@ montgomerycountymd.gov

Colon Sara-May Adventist Healthcare [email protected]

Cooper Jeffrey CooperSoft [email protected]

Courtney Barbara Adventist Healthcare [email protected]

Cunningham Jennifer Univ. at Shady Grove [email protected]

Dale Karen DCHSI [email protected]

Dankwa-Mullan

Irene NIMHD [email protected]

Dasgupta Debarati Adventist Healthcare [email protected]

Dashiell Terrie Lifebridge Health [email protected]

Davis Kate Montgomery General Hospital

[email protected]

Dawes Daniel Premier Healthcare Alliance

[email protected]

DeCosmo Jeanne Maryland Hospital Association

[email protected]

Delgado Rosalinda Hispanic Chamber of Commerce MC

[email protected]

DeStefano Ken Adventist Healthcare [email protected]

Devilbiss Donna Frederick County Health Department

[email protected]

Dhru Karishma Asian American Health Initiative

Karishma.dhru@ montgomerycountymd.gov

Dorsey Rashida Department of Health and Human Services

[email protected]

Douge Jackie Frederick County Health Department

[email protected]




Driver Monika Holy Cross Hospital [email protected]

Dupuy Jannette HRSA [email protected]

Edwards Tiffany Adventist Healthcare [email protected]

Emery Susan Circle of Rights, Inc. [email protected]

Eng Kellie Universities at Shady Grove

[email protected]

Everett Jonathan MedStar Health [email protected]

Fatogun Oluwatoyin Maryland Office of Minority Health and

Health Disparities

[email protected]

Fernan-Zegarra Paola Montgomery County DHHS

Paola.fernan-zegarra@ montgomerycountymd.gov

Fleurant Cherline FCPS [email protected]

Flood Sharon MCDHHS/PHS/DENNIS AVE

HEALTH CENTER

Sharon.flood@ montgomerycountymd.gov

Ford Tierra Pfizer, Inc. [email protected]

Fowler Michelle Greater Baden Medical Sevices, Inc.

[email protected]

Frelick Talya Center on Health Disparities at Adventist

Healthcare

[email protected]

Friar Wendy Holy Cross Hospital [email protected]

Garvey Carol Garvey Associates, Inc. [email protected]

Gary-Williams Gene National Society of Allied Health

[email protected]

Gayer Rabbi Elie Adventist Healthcare [email protected]

Gerald Tonya DECO Recovery Man-agement

[email protected]

Glass Rachel MCAEL [email protected]

Glazer Emily Health Education Consultants

[email protected]

Glover Susan Adventist Healthcare [email protected]

Gobern Nailah Primary Care Coalition [email protected]




Goldwater Shannon Pfizer, Inc. [email protected]

Gomez Maria Mary’s Center for Maternal and Child Care

[email protected]

Goodwin Jana University of Maryland School of Nursing

[email protected]

Goodwin Bill Montgomery Co. Dept. of Health and Human

Services

Bill.goodwin@ montgomerycountymd.gov

Goudeaux Lauren Science Educational Equity Program

[email protected]

Gould-Kostka Jeanine Montgomery County DHHS/PHS

[email protected]

Grant Pat NCNW, Montgomery County, MD

[email protected]

Guerrero Portillo

Astrid Self Employed [email protected]

Hall Christopher Adventist Healthcare [email protected]

Harris Marcus Breath of Life SDA [email protected]

Harvey Ana DHHS-Latino Health Initiative

[email protected]

Harwood Robin HHS/HRSA/MCHB [email protected]

Hasbun Gianina Latino Health Initiative (Montgomery County

DHHS)

Gianina.hasbun@ montgomerycountymd.gov

Hastings Diane SGA Radiation Oncology Center

[email protected]

Henderson LaMar SAMHSA [email protected]

Herlihy Francisca DHHS/Public Health Aleida.herlihy@ montgomerycountymd.gov

Hernandez Jose Adventist Healthcare [email protected]

Herron Diane African American Health Program

Diane.herron@ montgomerycountymd.gov

Higgins Shelby Frederick County MD Health Department

[email protected]

Highsmith Keisher DHHS/HRSA [email protected]

Hiner Kimberly DHMH [email protected]




Hodge Mark Montgomery County DHHS

Mark.hodge@ montgomerycountymd.gov

Hodge Edmund Adventist Healthcare [email protected]

Holt Eusi BETAH Associates, Inc. [email protected]

Huang Susan Human Health Service Montgomery County

Susan.huang@ montgomerycountymd.gov

Ibidapo Oluwaseyi University of North Caroline—Chapel Hill,

NC

[email protected]

Illig Debra Adventist Healthcare [email protected]

Ireland Jane Montgomery County Health and Human

Services

[email protected]

Irving Shalon Morgan State University [email protected]

Jackson Saundra The African American Health Program

Saundra.jackson@ montgomerycountymd.gov

Jackson Arva African-American Health Program

[email protected]

James-Taylor Terrie Montgomery Hospice [email protected]

Jarquin Myrna Montgomery County Government

Myrna.jarquin@ montgomerycountymd.gov

Jenkins Rosa Montgomery County Health Department

Rosa.jenkins@ montgomerycountymd.gov

Jenkins Cheryl Lynn Montgomery County Dept. of Health and

Human Services

Cheryl.l.jenkins@ montgomerycountymd.gov

Jepson Robert Adventist Healthcare [email protected]

Johnson Kim MCDHHS/PHS-CHN Kim.johnson@ montgomerycountymd.gov

Kaempfer Lisa Hillcrest SBHC [email protected]

Kaleko-Kravitz Esther Adventist Healthcare [email protected]

Kamus Abdulaziz MCC Medical Clinic [email protected]

Kanamori Mariano University of Maryland College Park

[email protected]

Kaplan Elyse Adventist Healthcare [email protected]




Kaseman Mansfield CTIS [email protected]

Kaufmann Barbara Montgomery County Department of Economic

Development

Barbara.kaufmann@ montgomerycountymd.gov

Kelly Evelyn CASA de Maryland, Inc. [email protected]

Kessel, MD, MPH

Woodie University of Maryland [email protected]

Khalil Shaiza Asian American Health Initiative

Shaiza.khalil@ montgomerycountymd.gov

Knirr Sandra Adventist Healthcare [email protected]

Ko Ko Gyi Jean AAHI [email protected]

Lam Betty Montgomery County DHHS

[email protected]

Lazo Reina Adventist Healthcare [email protected]

Lee James Adventist Healthcare [email protected]

Lesesne Evette Montgomery County MD DHHS

[email protected]

Li Ned CCACC [email protected]

Litchy Judy Adventist Healthcare [email protected]

Lipsy Barry Adventist Healthcare [email protected]

Lockley Brenda Montgomery County DHHS

Brenda.lockley@ montgomerycountymd.gov

Long Loretta IMPACT—Silver Spring [email protected]

Lowery Carolyn CommonHealth ACTION

[email protected]

Lydic Brent Adventist Healthcare [email protected]

Lynk Marilyn Center on Health Disparities at Adventist

Healthcare

[email protected]

Madrid Dina Adventist Healthcare [email protected]

Malone Christine Universities at Shady Grove

[email protected]

Manners Laurie Montgomery County DHHS

Lauries manners@ montgomerycountymd.gov




Manning Leticia DHHS/HRSA [email protected]

Martin Ruth Montgomery County DHHS

Ruth.martin@ montgomerycountymd.gov

Martin Emeobong Center on Health Disparities at Adventist

Healthcare

[email protected]

Martinez Luis MC Dept. of Health and Human Services

Luis.martinez@ montgomerycountymd.gov

Mathews Patricia Northern Virginia Health Foundation

[email protected]

Mbollo Suzanne MC Department of Health and Human

Services

Suzanne.mbollo@ montgomerycountymd.gov

McBride Kimberly Holy Cross Hospital [email protected]

McCann Monica Maryland Office of Minority Health

[email protected]

McCoy Judy Inova Health Systems [email protected]

McElveen Nicole National Quality Forum [email protected]

Medina Ruby CareFirst BlueCross BlueShield

[email protected]

Mendizabal Mark Adventist Healthcare [email protected]

Molinolo Gabriela University of Maryland [email protected]

Moore Amy Community Clinic, Inc. [email protected]

Mora Sonia DHHS Latino Health Initiative

[email protected]

Morgan Geoff Adventist Healthcare [email protected]

Mosby LaJoy OMH Resources Center [email protected]

Moskowitz Dan Moskowitz & Associates [email protected]

Munoz Emma Language Matters [email protected]

Mukherjea Arnab Center for Tobacco Control Research and

Education

[email protected]

Musa Jengo Adventist Healthcare [email protected]

Nathan Joy BETAH Associates, In. [email protected]




Norman Regina University of the District of Columbia

[email protected]

O’Bryon Margaret Consumer Health Foundation

[email protected]

O’Connor Sheilah Montgomery County DHHS

[email protected]

O’Connor Mary Governor’s Workforce Investment Board

[email protected]

O’Neill Kevin Adventist Healthcare [email protected]

Onukwugha Eberechukwu University of Maryland School of Pharmacy

[email protected]

Ostrowski Jacqueline Adventist Healthcare [email protected]

Pangilinan Caterina Adventist Healthcare [email protected]

Pauk Jennifer Primary Care Coalition [email protected]

Pearre Collette Hillcrest SBHC [email protected]

Pesquera Marcos Center on Health Disparities at Adventist

Healthcare

[email protected]

Pichardo Angeles Latino Health Initiative Gianina.hasbun@ montgomerycountymd.gov

Pittman Aisha Maryland Health Care Commission

[email protected]

Pitts Ben Novartis [email protected]

Portillo Martin MAPMG-KPMAS [email protected]

Portillo Sonia Center on Health Disparities at Adventist

Healthcare

[email protected]

Quasem Sanjana Asian American Health Initiative

Sanjana.quasem@ montgomerycountymd.gov

Ramsey Gloria Uniformed Services University of the Health

Science

[email protected]

Rankin Kamila Howard University [email protected]

Rawls Charles Student [email protected]




Rehr Rebecca University of Maryland School of Public Health

[email protected]

Reinhart Doris Adventist Healthcare [email protected]

Rice Morrisa HRSA Office of Women’s Health

[email protected]

Rodovskava Liya Univ. at Shady Grove [email protected]

Rodriguez Cecily Virginia Dept. of Behavioral Health and Development

[email protected]

Roof Greg Adventist Healthcare [email protected]

Ryan Smith Colleen Montgomery County DHHS/PHS

Colleen.ryan-smith@ montgomerycountymd.gov

Saenz Carmen Latino Health Initiative, Montgomery County DHHS

Carmen saenz@ montgomerycountymd.gov

Salem Catherine Adventist Healthcare [email protected]

Sama-Titanji Marion Frederick County Health Department

[email protected]

Sandberg Gwen Women’s Cancer Control Program

Gwendolyn.sandberg@ montgomerycountymd.gov

Schaffer Howie Cook Ross Inc.—CultureVision [email protected]

Schneider Myra Commonhealth Action [email protected]

Scott Donna Adventist Healthcare [email protected]

Sebastian Shahin Cross Cultural Infotech [email protected]

Seleznow Eric National Skills Coalition [email protected]

Sheedy Kathleen Montgomery County HHS Kathleen.sheedy@ montgomerycountymd.gov

Sheehan Terrence Adventist Healthcare [email protected]

Shell Donald Prince George’s County Health Department

[email protected]

Shelly Donna Parent-Child Consultation [email protected]

Shivers Ayanna Uniformed Services University [email protected]

Reeves Iris MD State Mental Hygiene Ad-ministration

[email protected]




Shul Jaclyn Adventist Healthcare [email protected]

Silva Izione Primary Care Coalition of Montgomery County

[email protected]

Simmons Carol Adventist Healthcare [email protected]

Smith Nancy University of Maryland [email protected]

Smith Pamela Pfizer, Inc. [email protected]

Snyder Annette The Hilltop Institute at UMBC

[email protected]

Statland Samuel Statland & Katz, Ltd [email protected]

Stento Jenna Avalere Health [email protected]

Stephenson David We Interpret.net [email protected]

Swann Wayne SL Swann Enterprises, LLC

[email protected]

Swanson Christy Adventist Healthcare [email protected]

Talavera Melina Adventist Healthcare [email protected]

Tang Shelly Holy Cross Hospital [email protected]

Taper Darlene School Health Services Montgomery County

Darlene.taper@ montgomerycountymd.gov

Taylor Michelle BETAH Associates, Inc. [email protected]

Thomas Alicia Grantmakers in Health [email protected]

Tinney Sarah Adventist Healthcare [email protected]

Todd Jennifer University of Maryland College Park

[email protected]

Toruno Brigitta UNO Communications [email protected]

Truxillo Debra Adventist Healthcare [email protected]

Umukoro Iyabode Delmarva Foundation for Medical Care

[email protected]

Uran Peter AAH [email protected]

Vaflor Rhodora Adventist Healthcare [email protected]

Vaughn Deborah Adventist Healthcare [email protected]




Vazquez Marty Jo Vazquez Consulting [email protected]

Vivian Christie Universities at Shady Grove

[email protected]

Warner Timothy Montgomery County Government

[email protected]

Washington Robert Montgomery Hospice [email protected]

Washington Deidre Center on Health Disparities at Adventist

Healthcare

dwashin2@adventisthealthcare

Watson Maria Rosa Primary Care Coalition of Montgomery County

Mariarosa_watson@ primarycarecoalition.org

Weimer-Elder Barbette Adventist Healthcare [email protected]

Weng Jamie Asian American Health Initiative, Mont. Co

DHHS

[email protected]

Wenk Jennifer Adventist Healthcare [email protected]

Wessel Lois Association of Clinicians for the Underserved

[email protected]

Westley Peggie HRSA [email protected]

Whitehurst Jennifer DHMH MHHD [email protected]

Widerlite Paula Adventist Healthcare [email protected]

Williams Lavonne California State University, Sacramento

[email protected]

Williams Sonja National Center for Health Statistics

[email protected]

Williamson Louise Adventist Healthcare [email protected]

Wilson Tarsha HRSA Office of Women’s Health

[email protected]

Winternitz Shaina Suburban Hospital [email protected]

Woo Violet HRAS/BHPr [email protected]

Woolf Gail MCPS [email protected]

Woynicz Pam Adventist Healthcare [email protected]




Wright H. Marcel Adventist Healthcare [email protected]

Yee Kristina Asian American Health Initiative

[email protected]

Young Pamela Sinai Hospital [email protected]

Yu Helen CCACC Pan Asian Health Clinic

[email protected]

Please contact us: Center on Health Disparities 1801 Research Boulevard Suite 200 Rockville, MD 20850 Phone: 301.315.3184 Fax: 301.315.3118

Learn more on the web: www.adventisthealthcare.com/disparities Friend us on Facebook: http://www.facebook.com/HealthDisparities

1801 Research Boulevard ● Suite 200 ● Rockville, MD 20850 Phone: 301.315.3184 ● Fax: 301.315.3118

2010 Annual Health Disparities Conference Proceedings

Documents

Transcript of 2010 Annual Health Disparities Conference Proceedings