January 16 2017

Pathways to health report cover tileThe Committee on Community Based Solutions to Promote Health Equity in the United States has released its report called Communities in Action: Pathways to Health Equity.

The Committee highlights the Endowment’s Building Healthy Communities (BHC) initiative as “a noteworthy example” of a multi-sector intervention to achieve health equity. This 10-year, 14-community strategy has, at its 5-year mark, achieved improved health coverage for the underserved, as grantees and partners fought for and supported the successful implementation of the Affordable Care Act and the expansion of Medicaid in California.

Furthermore, there has been stronger health coverage policy for undocumented residents through the #Health4All Campaign, paving the way for state-supported health coverage for undocumented children.

There have been school climate, wellness, and equity improvements as grantees, partners, and youth have led or supported efforts across the state to reform harsh school discipline and suspension policies, to successfully implement school equity funding formulas, and to support physical education in public schools.

A key objective is to channel savings from a reduced need for prisons into prevention strategies largely due to the passage and implementation of Prop 47 in California.

Grantees have joined with other coalitions supporting young men of color, bringing improved public policy and civic attention to the issue and resulting in the creation of the Select Committee on the Status of Boys and Men of Color in the state legislature.

To date, the BHC initiative has been a catalyst for more than 100 local policies and system changes promoting a culture of health that emphasizes such community resources as more walkable neighborhoods, fresh food access, park space, and access to safe drinking water.

The Endowment also helped fund one of the nine best practice examples highlighted in the report, Mandela MarketPlace’s Harvest to Market loan program. The program includes under-resourced farmers of color who operate within 200 miles of the Bay Area and who have access to flexible, no-interest loans that can be repaid with produce. (Chapters 5 & 8).

The report includes a section called “Physical Education in Public Schools” that highlights the need to alleviate physical education disparities in public schools, the physical education tool kit and MAP (Model Action Plan) published by the Los Angeles County Department of Public Health with diverse allies, compliance with case law and legislation on physical education, and shared use of schools, pools, and parks (Chapter 8.)  The Endowment has supported community action in each of these areas.

The Committee reports in brief:

1 Health equity is crucial for the well being and vibrancy of communities
2 Health is a product of multiple determinants
3 Health inequities are in large part a result of poverty, structural racism, and discrimination
4 Communities have the capacity to promote health equity
5 Supportive public and private policies (at all levels) and programs facilitate community action
6 The collaboration and engagement of new and diverse (multi-sector) partners is essential to promote health equity
7 Tools and other resources including civil rights laws exist to translate knowledge into action to promote health equity.

The Endowment has funded work on how to use civil rights tools to alleviate health disparities. The Committee similarly concludes that civil rights strategies are necessary in conclusions 6-1 and 6-2, and recommends that foundations support education, compliance, and enforcement related to civil rights laws (recommendation 7-1):

  • Civil rights approaches have helped mitigate the negative impacts of many forms of social and health discrimination. Continuing this work is needed to overcome discrimination and the structural barriers that affect health.
  • Using civil rights approaches in community solutions to promote health equity can guard against unjustified and unnecessary discriminatory impacts in programs that affect health.

Download the full report Communities in Action: Pathways to Health Equity, as well as the highlights, recommendations, and social media tool kit, and press release.

The report was published by the National Academies of Sciences, Engineering, and Medicine.



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