advancing equity: a leadership mandate...health equity and the social determinants of health in...
TRANSCRIPT
Advancing Equity:
A Leadership Mandate
Renée Branch Canady, PhD, MPA
CEO MPHI
Vermont Care Partners
March 15, 2018
Engagement of / Advocacy by community
members who want to create change
Staff empowered to
respond, challenges
to status quo
encouraged and
welcomed;
organizational
readiness
Endorsement /
Mandate by
leadership
Leadership
Community
Workforce &
Organizational
Capacity
Collective Impact:
“Three are greater than One”
Leadership
Community
Workforce
Leaders in Public Health are:
• Generally driven by a profound and
fundamental sense of mission.
• A sense of purpose motivates them to
leave the comfort of the sidelines and
wade into controversy
Koh & Jackson (2009) Fostering PH Leadership, Journal of PH, 31 (2), 1999
Mission & Controversy!
“Public health problems pose special
challenges. They are generally enormous
in scale, stem from numerous and highly
complex causes, play out in the public,
impact a vast array of stakeholders, and
require unusually long-term solutions.”
Koh & Jackson (2009) Fostering PH Leadership, Journal of PH, 31 (2), 199
The practice of Leadership through a HE Lens
is not for the faint at heart!
Self Assessment:
Getting out of our Own Way!
Unconscious
Incompetence
Conscious
Incompetence
Unconscious
Competence
Conscious
Competence
COMPETENCE
CO
NSC
IOU
SN
ES
S
Introducing:
Dialogue-based Health Equity Assessment
Tool
Practice: Leadership
1 2 3 4Leaders
intentionally
avoid
considering
health equity
and the social
determinants of
health in
decision-
making.
Leaders do
not consider
health equity
and the social
determinants
of health in
determining
policy
positions,
allocation of
work force,
and budget
decisions.
There is
evidence of
leaders using
health equity
and the social
determinants of
health as
criteria in
determining
policy positions,
allocation of
work force, and
budget
decisions.
Leaders
explicitly use
health equity
and the social
determinants of
health as criteria
in determining
policy positions,
allocation of
work force, and
budget
decisions.
TONE AT THE TOP
“Starting with WHY”
Why bother?
Why have we made time to talk about
health equity?
Why would you be open to embracing
this work in your leadership role?
A Health Equity Lens
• Seeks out what is unfair in order to reverse or avoid it
• Aspires to apply justice in serving individuals and families
• Recognizes the impact of social resources on the care and
behavior of individuals and families
• Identifies and facilitates social opportunities for individuals
and families to readily/easily attain well-being
“SEEING DIFFERENTLY”
Health Equity Leadership is framed
not from having all the answers,
but from asking the right questions
“SAYING DIFFERENTLY”
Changing the Questions
Instead of only asking:
Why do people smoke?
Perhaps we should also ask:
What social conditions and economic
policies predispose people to the
stress that encourages smoking?
Who lacks health care
coverage and why?
What policy changes would redistribute
health care resources more equitably in
our community?
How do we connect isolated
individuals to social supports?
What institutional policies and practices
maintain rather than counteract people’s
isolation from social supports?
Who lacks access to healthy food
options and why?
What policy changes would redistribute
healthy food resources more equitably in our
community?
“This requires removing obstacles to health such as poverty,
discrimination, and their consequences, including
powerlessness and lack of access to good jobs with fair pay,
quality education and housing, safe environments, and health
care.” -RWJF/Paula Braveman, UCSF
• The Opportunity(personal / interpersonal)
• “Doing Your Own Work”
• The Mandate (institutional / cultural)
• The courage to take Risks
“DOING DIFFERENTLY”
• In all that you saw and heard here, what stands out for you as particularly relevant or stimulating in terms of your work?
• As you see yourself trying to apply these ideas, what challenges do you envision experiencing?
• What would you need to overcome these challenges?
• As a leader, how can you help create the world you want to work/live in?
“Be not weary in well-doing, for in
due season you will reap if you faint
not!”
The Apostle Paul