Health Equity and Social Justice

“Any responsible attempt to define disease must account for the phenomenon's complexity. Disease is a deeply social process. Its distribution lays bare society's structures of wealth and power, and the responses it elicits illuminate strongly held values.”
New England Journal of Medicine - December 2012 The Burden of Disease and the Changing Task of Medicine

Ingham County Health Department seeks to improve the health of our entire community by working toward fair and just access to opportunities and conditions needed to achieve health and well-being.

Through intensive internal work and collaborations with community partners, we strive to remove unfair and unjust differences in healthcare and public health services, employment, education, housing, transportation and criminal justice systems. 

We also work to promote a culture of inclusion that recognizes and embraces  the validity people's experiences, cultures and orientations.

With the knowledge that inequities stem from historical factors and explicit and implicit biases, we utilize dialogue-based approaches to bridge the divide between lived experiences, perceptions, data, and common practices and ideas in our community about different groups.  

We also promote and support community development and community organizing approaches to creating health equity.

The following definitions inform the basis of this work:

  • Health Equity: a fair, just distribution of the resources and opportunities need to achieve well-being
  • Social Justice: the absence of unfair, unjust advantage or privilege based on race, class, gender or other forms of difference, and a world which affords individuals and groups fair treatment and an equitable share of the benefits of society
  • Implicit Bias: attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner




More videos from ICHD about Health Equity and Social Justice

Resources

·         "Invisible Knapsack" of White Privilege

·         3-Day Health Equity & Social Justice Workshop. With more than 900 people participating since it was first offered in 2005, this local workshop provides facilitated discussions, exercises and frameworks for helping participants understand forms of oppression and change, and learn ways to challenge and replace behaviors and practices that contribute to health disparities at personal, interpersonal, institutional and cultural levels.

What participants say:

“the single most valuable experience I have had as an ICHD employee”

“gave me the tools and words to address problematic and discriminatory behavior happening around me”

 “helped me see how institutional practices contribute to health disparities, and gave me the courage to engage institutional partners in trying new practices.”

The next series of the HESJ Workshop will be offered in late-2016 or early-2017.  To receive registration information, contact Jessica Yorko at jyorko@ingham.org or 517-272-4144.

·         Implicit Bias Self- Assessment Tool: Project Implicit ® from Harvard University offers a series of confidential Implicit Association Tests (IAT) which measure “attitudes and beliefs that people may be unwilling or unable to report”. IATs use exercises based in scientific knowledge of social cognition to help people identify and learn about how they sort and categorize different groups. You can take the various tests over time, as you are able.
 
·   The Danger of a Single Story: Watch full video and use dialogue questions for conversations with friends, family, staff and others. Story written and told by Chimamanda Ngozi Adichie. 

·         20 Cognitive Biases That Screw Up Your Decisions: created by Business Insider, this handy poster helps us understand the variety of cognitive biases that can affect our decision-making.

·         Project 60/50: project 60/50 is an ongoing series of community events and conversations being held in the Lansing area about race and justice. Initially created in 2014 to honor the 1954 Supreme Court decision to integrate schools and the passage 1964 federal Civil Rights Act, the series has continued due to its widespread popularity and participation. Those hosting social justice events can also submit a proposal to 60/50 for inclusion in the events calendar and promotional tools of the 60/50 umbrella. 

·         Bias Busters: Guides to Cultural Competence: Journalism students from Michigan State University have create a series of guides that provide 100 Questions and Answers about simple, everyday questions that people have about each other but might be afraid to ask. New guides are continually being added to the series.  

·         Bias Cleanse & Implicit Bias E-News: The Kirwin Institute offers information and tools to help people work on their biases. 

·         Environmental Justice: addresses the disproportionate environmental risks borne by low-income communities and communities of color resulting from poor housing stock, poor nutrition, lack of access to healthcare, unemployment, underemployment, and employment in the      most hazardous jobs. Lead poisoning, asthma and poor housing conditions are of particular concern in Ingham County.

·   Simple Solutions to Improve Police Practices (PDF): 1-pager adapted from guidance published by National Association of City and County Health Officials. Use to engage your police chief, commission and mayor in dialogue for change, along with encouraging officer participation in Mental Health First Aid, a class available in Mid-Michigan: http://www.ceicmh.org/community-resources/mhfa

·  Gender Identity, Expression, Presentation, and Sexual Orientation (PDF): 1-pager to understand these concepts

·  Directory of Local Civil Rights & Justice Organizationshttp://lansingtakesaction.com/resources
ICHD Version of "Welcoming Lansing" Poster (PDF)

Background

Public health organizations were originally founded in the late-1800’s as people began to recognize the important role of overall social and environmental conditions in determining the spread of disease, as opposed to illness being solely the result of individual and moral failings.              

It was with this recognition that public health departments were founded in many communities, serving to promote public sanitation (management of wastewater and solid waste) and later providing individual child and maternal health services and tracking disease and death data.

In the late-1990s, health departments began to analyze differences in health and healthcare between different groups by factors such as race, income and sexual orientation. The federal Healthcare and Research Quality Act of 1999 mandated the Agency for Healthcare Research and Quality (AHRQ) produce annual reports on health disparities and healthcare quality in the United States. These reports have been published each year since 2003, and are available online.

Michigan Public Act 653 of 2006, known as the Minority Health Bill, requires research and public education of health disparities. 

·         MDHHS Health Equity Report

·         CDC Health Disparities & Inequalities Report


A series of studies in 2009 reveal the connections between inequality and poorer health for all members of a society:

“inequalities among and within societies have been shown to be strong determinants of health and many other measures of societal function, such as rates of teen pregnancies, incarcerations, crime, educational outcomes, trust, innovation, and mental illness (Wilkinson and Pickett 2009)… perhaps a quarter of all deaths in the US may be attributed to the large income gap there (Kondo et al. 2009)”
Health Equity in the USA, Stephen Bezruchka, Social Alternatives Vol. 29 No. 2, 2010