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9/19/2019
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Roots of Health InequityDialogues
Designing Staff Development to Strengthen
Health Equity Practice in Cook CountySeptember 12, 2019 10:15 a.m. – 11:45 a.m.
Illinois Public Health Association 78th Annual Conference Springfield, Illinois
Jim Bloyd, MPHRegional Health Officer
Cook County Department of Public Health
Rachel Rubin, MD, MPH, FACPSenior Public Health Medical Officer
Cook County Department of Public Health
Terry Mason, MDChief Operating OfficerCook County Department of Public Health
“Advancing health equity in suburban Cook County requires
that we change the way we think about and practice public
health. In order to do this, we must develop staff capacity on
the application of health equity principles in their work.” 10/2017
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Strategic Plan: Health Equity
• Health equity strategies: “Across the agency;” “Each Unit”
• “Strengthen internal practices & processes”
• “Voice” for oppressed populations
• Collaborate to promote public policy advancing health equity
Summary
• Training of 22 in-house staff Facilitators (early-mid 2017)
• Dialogue groups convene (Nov 2017-Oct 2018)
• Emphasis on dialogue & staff knowledge (not lecture)
• 12 Small groups (7-20 staff)
• RootsofHealthInequity.org Online curriculum material
• Evaluation
• 5-person Coordinating Committee
• Value emphasis: social justice
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Theory of Change (Kellogg 2004)5. STRATEGIES
1. PROBLEM
6. ASSUMPTIONS
4. INFLUENTIAL FACTORS 3. DESIRED RESULTS
2. ASSETS
PREPARE CO-FACILITATORS
PREVENTABLE HEALTH INEQUITIES
CCDPH PRIORITY
APPLY PRINCIPLES IN PRACTICE
ORGANIZATIONS, INITIATIVES
MOTIVATED STAFF
PREVIOUS USE OF ‘ROOTS’
COMMON UNDERSTANDING OF CONCEPTS
DIALOGUE ON ‘DIFFICULT TOPICS’
STAFF SUGGEST APPLICATION & OPPORTUNITIES
LEADERSHIP SUPPORT
INCREASING SOCIALINEQUALITY
HI QUALITY OF NACCHO‘ROOTS’ COURSE
CO-FACILITATORS DEVELOPSKILLS
CCDPH LEADERSHIP ARE CO-FACILITATORS
COMMUNICATE
AGENCY COMMITMENTSUFFICIENT TO OVERCOMEOBSTACLES
TRANSFORMATION DOES NOT REQUIRE MONEY
8 Small group meetings 60-90 minutes
• Meeting 1: Intro & Register online www.Rootsofhealthinequity.org
• Meetings 2-6: Create dialogue on content following syllabus
• Meetings 7-8: Apply insights; generate staff suggestions for change at 3 levels• Individual,
• Unit,
• Agency-wide
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Guidelines for Positive Dialogues
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Supporting Materials--Syllabus
Supporting Materials--Syllabus
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Informed by WHO Commission on the Social Determinants of Health
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Praxis
Supplementing with local data
Report on evictions in Cook County (LEFT); Interview with Mathew Desmond, author of book “Evicted” on YouTube—7 mins (ABOVE)
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Staff suggestions from sessions 7 & 8
1. Over 80 easel pages
2. Belia Ramirez, DarcineScales, Bettye Silas compiled to Word
3. Jim Bloyd analyzed the qualitative data
4. Themes & patterns identified from text.
Staff Suggestions Examples: How to Apply New Understanding
Individual Level Unit Level CCDPH Agency Level
Communicate Health Equity
Communicate: Internal & External Communication
“Explain race is not the problem, racism is.”
Build Community Relationships
“Effectively communicate how community can impact policy.”
Build RelationshipsEducate People
“Break each department out with 2 individuals with community
involvement (coalitions, community building).”
Policy StatementsDecide Strategy
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Evaluation
• Pre-Test Post-test
• Sign In Sheets
• Participant Feedback Forms
• Co-Facilitator Check ins, feedback on training
• Preliminary findings
“Advancing health equity in suburban Cook County requires that we change the way we think about and practice public health.” Dr. Terry Mason 10/16/17
Unit change
Equity Praxis Work Group
Health Equity & Social Justice Coordinator
Unit Leadership
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Exercise 1: Voices of Public Health
• Listen to the public health practitioner Dr Linda Rae Murray
• Follow along with the text
• With a partner, discuss your answers to the questions on the handout.
Exercise 1: Voices from the Field (From Unit 2)
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Exercise 2: Doak Bloss Slides
Exercise 2. Redefining Questions
• Work with your partner next to you.
• Look at the handout Contesting Frames, Redefining Q’s Guide
• Together fill out the “Social Justice Frame” blank area
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Back-of-the-envelope Plan….
• Register at RootsofHealthInequity.org
• Become familiar with one or more of the ‘Roots’ Units
• Identify 1 interested person
• Tell them of your interest over coffee or lunch
• Identify an agency event or meeting with a 30-60 minute agenda opening—pick a ‘Roots’ activity for it
• Identify support for ‘Roots’ in your mission, strategic plan, or agency priority
• Consider partnering with a community agency or organization
• Describe what other health departments are doing? What are their experiences?
ReferencesBloss, D. (2019). Revealing Oppression [slides] Washington, DC: National Association of County & City Health Officials.
Cook County Department of Public Health. (2017). Roots of Health Inequity Dialogues: Syllabus.
Cook County Health and Hospitals System, & Cook County Department of Public Health. (2018). Cook County Department of Public Health Strategic Plan. Chicago: CCHHS.
Human Impact Partners. (2018). Advancing Health Equity in Health Department’s Public Health Practice: Recommendations for the Public Health Accreditation Board. Oakland, California.
Human Impact Partners. (2017). Strategic Practices and Actions to Advance Health Equity in Local Health Departments. Oakland, California: Human Impact Partners.
W. K. Kellogg Foundation. (2004). Logic Model Development Guide. Logic Model Development Guide.
Mason, T. (2017). Memo Re: Agency-wide Health Equity Training. Cook County Department of Public Health.
NACCHO. (2018). Advancing Public Narrative for Health Equity and Social Justice. Washington, DC: National Association of County and City Health Officials.
The Praxis Project [web page] 2019. https://www.thepraxisproject.org/our-history
Solar, O., & Irwin, A. (2010). A Conceptual Framework For Action On The Social Determinants Of Health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). Geneva: World Health Organization.
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Thank you!
Jim Bloyd, MPH
Regional Health Officer
Cook County Department of Public Health
708-633-8314
Rachel Rubin, MD, MPH, FACP
Senior Public Health Medical Officer
Cook County Department of Public Health
(708) 836-8642
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