health equity: enriching a practice of empathy using the perinatal health...
TRANSCRIPT
HEALTH EQUITY: ENRICHING A PRACTICE OF EMPATHY USING THE PERINATAL HEALTH STRATEGIC PLAN
February 26, 2020
Jasmine Getrouw-MoorePerinatal Health Strategic Plan ConsultantNC Division of Public Health/ Women’s Health Branch
Lynae Baker, MPH(c)Intern, Perinatal Health Strategic PlanNC Division of Public Health/ Women’s Health Branch
• This training was developed by the March of Dimes North Carolina
Preconception Health Campaign, under a contract and in collaboration
with the North Carolina Division of Public Health, Women’s Health
Branch.
• Special thanks to Jasmine Getrouw Moore and Lynae Baker for their
partnership and contributions to today’s webinar.
• Wake AHEC for their support in providing continuing education credit for
this webinar
ACKNOWLEDGEMENTS
None of the presenters today, have any relationship with commercial
companies that could be perceived as a conflict of interest (within the
past 12 months).
DISCLOSURES
• Obtaining continuing education credits:
▪ If attending as a group, everyone must sign-in
on Wake AHEC Roster and email to:
▪ Must be present for whole training
▪ Complete evaluation up on receipt
• Questions
HOUSEKEEPING
Nursing: 1.5 Contact Hours
Wake Area Health Education Center (AHEC) Nursing Education is an approved provider of
continuing nursing education by the North Carolina Nurses Association, an accredited approver
by the American Nurses Credentialing Center’s Commission on Accreditation.
Wake AHEC CEU: Wake AHEC will provide 0.2 CEU to participants upon completion of this
activity.
National Association of Social Workers (NASW)
NC AHEC is a 2019 NASW-NC approved provider of distance continuing education. This
program has been approved for 1.5 contact hours
A participant must attend 100% of the webinar to receive credit. Partial session credit will not be
awarded.
Contact Hours: Wake AHEC will provide up to 1.5 Contact Hours to participants.
Wake AHEC is part of the North Carolina AHEC Program.
CREDITS
Enriching a Practice of
Empathy Using the Perinatal
Health Strategic Plan
Jasmine Getrouw-Moore, MPA
February 26, 2020
Jasmine Getrouw-Moore, MPA
Perinatal Health Strategic Plan Consultant
NC Division of Public Health/ Women’s Health Branch
Lynae Baker, MPH(c)
Intern, Perinatal Health Strategic Plan
NC Division of Public Health/ Women’s Health Branch
Objectives• Describe inequities which have major
implications for perinatal health.
• Discuss how to use the Perinatal Health
Strategic Plan as a resource for your
practice.
• Understand the relationship between
marginalized women and the health field.
• Identify how to enrich patient-provider
relationships for improved health outcomes
for North Carolinians.
NCDHHS, Division | Presentation Title | Presentation Date 10
The Perinatal Health Strategic Plan
• Framework is based on the “12-Point Plan to Close the Black-White Gap in Birth Outcomes: A Life-Course Approach” developed by Lu, Kotelchuck, Hogan, Jones, Wright, and Haflon
• Broader focus encompassing infant mortality, maternal morbidity and mortality; and the health of women and men of childbearing age
• Data driven and focused on the best evidence available
• Infused throughout with issues of health equity and social determinants of health
NCDHHS, Division | Presentation Title | Presentation Date 11
The Stakeholder Team
NCDHHS, Division | Presentation Title | Presentation Date 12
• Data and Evaluation
• Policy
• Communications
• Community and Consumer Engagement
• Village 2 Village (Consumer Work Group)
Work Groups
Data and Evaluations Work Group
Identifies data sources, develops monitoring and evaluation strategies, and supports research activities to support and inform the goals of the Perinatal Health Strategic Plan (PHSP).
NCDHHS, Division | Presentation Title | Presentation Date 14
Policy Work Group
Works to advance policies found in the Perinatal Health Strategic Plan through education and information sharing.
NCDHHS, Division | Presentation Title | Presentation Date 15
Communications Work Group
Shares the intent and goals of the Perinatal Health Strategic Plan to audiences and stakeholders across North Carolina by forging opportunities and identifying champions who are interested in promoting the plan locally. We do this by developing educational materials and promotional items using social media platforms (including our website) to promote the plan.
NCDHHS, Division | Presentation Title | Presentation Date 16
Community and Consumer Engagement Work Group
Comprised of a diverse group of community members to be a part of a joint effort by providing feedback regarding the North Carolina Perinatal Health Strategic Plan (PHSP) strategies, publications and services. The Work Group designs and implements capacity building training for community and Village 2 Village participants (consumers) by engaging in interactive, empowering activities. We seek to strengthen relationships and share background knowledge on the Plan.
NCDHHS, Division | Presentation Title | Presentation Date 17
The Perinatal Health Strategic Plan is a
complex roadmap to health equity.
NCDHHS, Division | Presentation Title | Presentation Date 18
Defining Terms within the Perinatal Health Strategic Plan
• Health Equity
• Life Course Perspective
• Social Determinants of Health
Health Equity
Reference: NC Office of Minority Health and Health Disparities North Carolina Equity Report 2018
The opportunity for everyone to have good health.
NCDHHS, Division | Presentation Title | Presentation Date 20
What is the difference between “equality” and
“equity”?
The Life Course Perspective
The Life Course Perspective offers a way of looking at health, not as disconnected stages unrelated to each other, but as an integrated continuum. This perspective suggests that the many facets of life contribute to health outcomes across the course of one’s life. It builds on public health and social science literature which highlight the influence of each stage of life on the next and shows how social, economic, and physical environments interact to have a profound impact on individual and community health.
Reference: City MatCH
Social Determinants of Health
Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school, church, workplace, and neighborhood) have been referred to as “place.”
NCDHHS, Division | Presentation Title | Presentation Date 24
NCDHHS, Division | Presentation Title | Presentation Date 25
Prioritizing Preconception Health
Goal 1 - Improving Health Care for Women and Men
Point 2. Increase access to preconception health and health care to women and men
• 2A. Expand the college-based Preconception Peer Education (PPE) Program to reach additional women and men in colleges, universities, graduate schools, community colleges and adult learning programs
• 2B. Integrate preconception health (PCH) care and messages into primary care for women of reproductive age
• 2C. Integrate the use of evidence-based and evidence-informed curricula with adolescent and young adult populations in educational and community settings
• 2D. Implement the North Carolina Preconception Health Strategic Plan and Supplement
NCDHHS, Division | Presentation Title | Presentation Date 26
Prioritizing Reproductive Health
Goal 2 - Strengthening Families and Communities
Point 7. Support coordination and cooperation to promote reproductive health within communities
• 7A. Promote reproductive life planning
• 7B. Expand community stakeholder involvement and community engagement in service design and implementation
• 7D. Promote utilization of evidence-based strategies to prevent all forms of violence and promote coordinated community response
Prioritizing Healthy Equity with information sharing and high quality
trainingGoal 3 – Addressing social and economic inequities
Point 9. Close the education gap
• Strategy 9D. Promote and increase access to early childhood education
• Strategy 9E. Disrupt the school to prison pipeline, beginning with pre-school
Point 12. Undo racism
• Strategy 12B. Promote high quality training about institutional and structural racism and its impact on poor communities and communities of color
U.S. Infant Mortality Rates by Race and Ethnicity, 2016
Non-Hispanic Black: 11.4
American Indian/Alaska Native: 9.4
Native Hawaiian or other Pacific Islander: 7.4
Hispanic 5.0
Non-Hispanic white: 4.9
Asian: 3.6
Data Source: CDC Reproductive Health
Infant Mortality in NC
African American babies 2.4 times more likely to die than white babies
American Indian babies 1.7 times more likely to die than white babies
Data Source: NC DHHS, 2018
NCDHHS, Division | Presentation Title | Presentation Date 30
We have looked at the data, now let’s delve deeper into
some of the issues.
30
2/26/2020
NCDHHS, Division | Presentation Title | Presentation Date 31
Sexual Violence and Medical Experimentation
Illustration of Dr. J. Marion Sims with Anarcha by Robert Thom.
Anarcha was subjected to 30 experimental surgeries. Pearson
Museum, Southern Illinois University School of Medicine
_________________________________________________________
Image and Text Source: NPR
NCDHHS, Division | Presentation Title | Presentation Date 32
Tuskegee Syphilis Project
Image Source: CDC
NCDHHS, Division | Presentation Title | Presentation Date 33
Eugenics
Image Source: Indy Week “American Eugenics Movement After World War II”
NCDHHS, Division | Presentation Title | Presentation Date 34
Eugenics cont.
• “Both the Civil Rights and post-Civil Rights eras have been characterized by overt and subtle forms of racism in the U.S. healthcare system. Legal segregation in healthcare continued through the mid-1960s until Congress passed the Civil Rights Act of 1964.51 Shortly thereafter, the Medicaid program forced many hospitals to adhere to the Civil Rights Act and to hire doctors who would treat patients of all races, although unequally.51 Federal funding supported coerced sterilization, and some African American women were threatened with denial of medical care or termination of welfare benefits if they did not undergo sterilization” (2018)
2/26/2020
34
NCDHHS, Division | Presentation Title | Presentation Date 35
Eugenics + North Carolina
• “Debra Blackmon (left) was sterilized by court order in 1972, at age 14. With help from her niece, Latoya Adams (right), she's fighting to be included in the state's compensation program.” (Image and caption source: NPR)
• A Reproductive Justice Issue
2/26/2020
NCDHHS, Division | Presentation Title | Presentation Date 36
Why is this relevant today?
36
2/26/2020
NCDHHS, Division | Presentation Title | Presentation Date 37
Implications for Health Outcomes
Kira’s StoryCharles Johnson Lost His Wife Suddenly in Child
Birth — Now He Wants Change | NowThis
https://youtu.be/iWM2Rm72uQc
Reference: CDC Reproductive Health
NCDHHS, Division | Presentation Title | Presentation Date 41
Human Rights Centered Care: Equity Infused in System of Care
Ensure strategies focus on culturally and contextually appropriate, evidence based careEnsure
Ensure equitable access to effective careEnsure
Support quality education and training for providers and administrative staffSupport
NCDHHS, Division | Presentation Title | Presentation Date 42
Human Rights Centered Care: A Reproductive Justice Framework
Non-traditional partnerships:
Tap into your resource persons, i.e., Women’s Health Branch, March of Dimes
Racial Equity Training
Implicit Bias Training
Learning continuum
Patient-centered care
Taking time to explain procedures and medical care
Encouraging Q&A with compassion and empathy
Listening to voices of patients
Cultural humility
Practicing non-judgmental and supportive care
Ask Questions to understand patients needs
Re-route from assumptions about patients needs
Human Rights Centered Care: Tune into Your Patient
43
2/26/2020
Listen to your patients’ stories
Commit to engage your patients
Build a relationship founded in authenticity, care and trust
NCDHHS, Division | Presentation Title | Presentation Date 44
How will you implement today’s webinar in your
practice?
Do you want to learn more about the Perinatal Health Strategic Plan?
Website: https://whb.ncpublichealth.com/phsp/
Email: [email protected]
Helpful Resources
References and Helpful Resources
• NC Perinatal Health Strategic Plan
• NC Early Childhood Action Plan
• NC Social Determinants of Health by Regions
• Payments Start For N.C. Eugenics Victims, But Many Won't Qualify
• NC Health Equity Report 2018
• Healthy People 2020
• CityMatCH
• Advancing Holistic Maternal Care for Black Women Through Policy
• To Prevent Women from Dying in Childbirth, First Stop Blaming Them
• Racism, African American Women, and Their Sexual and Reproductive Health: A Review of Historical and Contemporary Evidence and Implications for Health Equity
• Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology
• The American eugenics movement after World War II (part 1 of 3)
North Carolina National
OUR TEAM!
Brenda Stubbs, Triad Regional Coordinator
Danielle Little, Eastern Regional Coordinator
Fiorella Horna, Latina Sana Campaign Coordinator
Rocío Anderson, State Director
Kelli McNair,Communication Coordinator
Drea Mora,Western Regional Coordinator
QUESTIONS?
This Photo by Unknown author is licensed under CC BY-NC.
53