Achieving Health EquityFramework and tools for quality      Camara Phyllis Jones, MD, MPH, PhD       Social Determinants o...
Achieving Health EquityFramework and tools for quality     The findings and conclusions in this presentation              ...
Our agenda   Levels of health intervention: A Cliff Analogy   The impacts of racism on health     Definition     Level...
Levels of health intervention
Addressing the                  Primary preventionsocial determinants of health                                Safety net ...
But how do disparities arise?   Differences in the quality of care received within the    health care system   Differenc...
Differences in                                         Differences in access to care                        exposures and ...
Addressing thesocial determinants of equity:Why are there differencesin resourcesalong the cliff face?Why are there differ...
3 dimensions of health intervention
3 dimensions of health interventionHealth services
3 dimensions of health interventionHealth servicesAddressing social determinants of health
3 dimensions of health interventionHealth servicesAddressing social determinants of healthAddressing social determinants o...
What is racism?A system
What is racism?A system of structuring opportunity and assigningvalue
What is racism?A system of structuring opportunity and assigningvalue based on the social interpretation of how we look(“r...
What is racism?A system of structuring opportunity and assigningvalue based on the social interpretation of how we look(“r...
What is racism?A system of structuring opportunity and assigningvalue based on the social interpretation of how we look(“r...
What is racism?     A system of structuring opportunity and assigning     value based on the social interpretation of how ...
Levels of Racism    Institutionalized    Personally-mediated    InternalizedSource: Jones CP. Levels of Racism: A Theor...
Institutionalized racism   Differential access to the goods, services, and    opportunities of society, by “race”   Exam...
Personally-mediated racism   Differential assumptions about the abilities, motives,    and intents of others, by “race” ...
Internalized racism   Acceptance by the stigmatized “races” of negative    messages about our own abilities and intrinsic...
Levels of Racism: A Gardener’s TaleSource: Jones CP. Levels of Racism: A Theoretic Framework and a Gardener’s Tale. Am J P...
Who is the gardener?                Power to decide                Power to act                Control of resources    ...
Measuring institutionalized racism    Scan for evidence of “racial” disparities        “Could racism be operating here?”...
“Reactions to Race” module   Six-question optional module on the Behavioral Risk    Factor Surveillance System since 2002...
States using the “Reactions to Race” module                         2002 to 2010 BRFSSArkansas, California, Colorado, Dela...
States using the “Reactions to Race” moduleArkansas                           2004California           2002Colorado       ...
States using the “Reactions to Race” moduleArkansas                           2004California           2002Colorado       ...
Socially-assigned “race”   How do other people usually classify you in this    country? Would you say:       White     ...
Socially-assigned “race”    On-the-street “race” quickly and routinely assigned     without benefit of queries about self...
General health status   Would you say that in general your health is:       Excellent       Very good       Good     ...
General health status by socially-assigned "race", 2004 BRFSS                          100                          80perc...
General health status by socially-assigned "race", 2004 BRFSS                          100                          80perc...
General health status by socially-assigned "race", 2004 BRFSS                                                      Report ...
General health status and “race”   Being perceived as White is associated with better    health
Self-identified ethnicity   Are you Hispanic or Latino?     Yes     No
Self-identified “race”   Which one or more of the following would you say is    your race?       White       Black or A...
Self-identified “race”/ethnicity   Hispanic     “Yes” to Hispanic/Latino ethnicity question     Any response to race qu...
Two measures of “race”                              How usually classified by others                             White    ...
Two measures of “race”                                How usually classified by others                               White...
Two measures of “race”                                How usually classified by others                               White...
General health status, by self-identified and socially-assigned "race", 2004                         100                  ...
General health status, by self-identified and socially-assigned "race", 2004                         100                  ...
General health status, by self-identified and socially-assigned "race", 2004                         100                  ...
General health status, by self-identified and socially-assigned "race", 2004                         100                  ...
Two measures of “race”                                How usually classified by others                               White...
Two measures of “race”                                How usually classified by others                               White...
General health status, by self-identified and socially-assigned "race", 2004                         100                  ...
General health status, by self-identified and socially-assigned "race", 2004                         100                  ...
General health status, by self-identified and socially-assigned "race", 2004                         100                  ...
General health status, by self-identified and socially-assigned "race", 2004                         100                  ...
General health status and “race”   Being perceived as White is associated with better    health     Even within non-Whit...
General health status and “race”   Being perceived as White is associated with better    health     Even within non-Whit...
General health status and “race”   Being perceived as White is associated with better    health     Even within non-Whit...
Key questions   Why is socially-assigned “race” associated with self-    rated general health status?     Even within no...
Racism     A system of structuring opportunity and assigning     value based on the social interpretation of how we look  ...
Could this be true in Canada?   Colour Coded Health Care: The Impact of Race and    Racism on Canadians’ Health    Sheryl...
What is [inequity] ?A system of structuring opportunity and assigningvalue based on [fill in the blank]
What is [inequity] ?A system of structuring opportunity and assigningvalue based on [fill in the blank], which Unfairly d...
Many axes of inequity   “Race”   Gender   Ethnicity   Labor roles and social class markers   Nationality, language, a...
Achieving health equity    “Health equity” is assurance of the conditions for     optimal health for all people    Achie...
ICERD: International Convention on the    Elimination of all forms of Racial Discrimination   International anti-racism t...
CERD Concluding Observations   Canada on agenda for the 80th session of CERD     Scheduled for discussion 22 and 23 Febr...
Our goal: To expand the conversationHealth services
Our goal: To expand the conversationHealth servicesSocial determinantsof health
Our goal: To expand the conversationHealth servicesSocial determinantsof healthSocial determinantsof equitySource: Jones C...
Our tasks   Put racism on the agenda     Name racism as a force determining the other social determinants      of health...
Our tasks   Ask , “How is racism operating here?”     Identify mechanisms in structures, policies, practices, norms, and...
Our tasks   Organize and strategize to act     Join in grassroots organizing around the conditions of people’s      live...
Camara Phyllis Jones, MD, MPH, PhD1600 Clifton Road NEMailstop E-33Atlanta, Georgia 30333(404) 498-1128 phone(404) 498-111...
Resources   Colour Coded Health Care: The Impact of Race and    Racism on Canadians’ Health    Sheryl Nestel    The Welle...
Resources   Report of the Secretary’s Task Force on Black and    Minority Health    Margaret M. Heckler, Secretary    U.S...
Resources   Unequal Treatment: Confronting Racial and Ethnic    Disparities in Health Care    Brian D. Smedley, Adrienne ...
Resources   Race: The Power of an Illusion    California Newsreel    http://www.pbs.org/race    http://newsreel.org/video...
Resources   3rd World Conference Against Racism, Racial    Discrimination, Xenophobia and Related Intolerance    Convened...
Resources   World Conference on Social Determinants of Health    Convened by the World Health Organization in Rio de Jane...
Resources   International Convention on the Elimination of all    forms of Racial Discrimination (ICERD)    Adopted by th...
Resources   The Gardener’s Tale podcast    CityMatCH Health Equity and Social Justice Action Group    http://www.citymatc...
Camara Phyllis Jones, MD, MPH, PhD1600 Clifton Road NEMailstop E-33Atlanta, Georgia 30333(404) 498-1128 phone(404) 498-111...
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
Achieving Health Equity: Framework and Tools for Quality
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Achieving Health Equity: Framework and Tools for Quality

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This presentation explores the ways in which we can achieve health equity.

Camara Phyllis Jones, MD, MPH, PhD

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Achieving Health Equity: Framework and Tools for Quality

  1. 1. Achieving Health EquityFramework and tools for quality Camara Phyllis Jones, MD, MPH, PhD Social Determinants of Health and Equity Health Equity Grand Rounds Mt. Sinai Hospital Toronto, Ontario, Canada February 7, 2012 Office of Surveillance, Epidemiology, and Laboratory Services Epidemiology and Analysis Program Office
  2. 2. Achieving Health EquityFramework and tools for quality The findings and conclusions in this presentation are those of the author,and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention. Office of Surveillance, Epidemiology, and Laboratory Services Epidemiology and Analysis Program Office
  3. 3. Our agenda Levels of health intervention: A Cliff Analogy The impacts of racism on health  Definition  Levels of racism: A Gardener’s Tale  Data Achieving health equity
  4. 4. Levels of health intervention
  5. 5. Addressing the Primary preventionsocial determinants of health Safety net programs and secondary prevention Medical care and tertiary prevention
  6. 6. But how do disparities arise? Differences in the quality of care received within the health care system Differences in access to health care, including preventive and curative services Differences in life opportunities, exposures, and stresses that result in differences in underlying health status
  7. 7. Differences in Differences in access to care exposures and opportunitiesDifferences in quality of care(ambulance slow or goes the wrong way)
  8. 8. Addressing thesocial determinants of equity:Why are there differencesin resourcesalong the cliff face?Why are there differencesin who is foundat different parts of the cliff?
  9. 9. 3 dimensions of health intervention
  10. 10. 3 dimensions of health interventionHealth services
  11. 11. 3 dimensions of health interventionHealth servicesAddressing social determinants of health
  12. 12. 3 dimensions of health interventionHealth servicesAddressing social determinants of healthAddressing social determinants of equitySource: Jones CP et al. J Health Care Poor Underserved 2009.
  13. 13. What is racism?A system
  14. 14. What is racism?A system of structuring opportunity and assigningvalue
  15. 15. What is racism?A system of structuring opportunity and assigningvalue based on the social interpretation of how we look(“race”)
  16. 16. What is racism?A system of structuring opportunity and assigningvalue based on the social interpretation of how we look(“race”) Unfairly disadvantages some individuals and communities
  17. 17. What is racism?A system of structuring opportunity and assigningvalue based on the social interpretation of how we look(“race”) Unfairly disadvantages some individuals and communities Unfairly advantages other individuals and communities
  18. 18. What is racism? A system of structuring opportunity and assigning value based on the social interpretation of how we look (“race”)  Unfairly disadvantages some individuals and communities  Unfairly advantages other individuals and communities  Saps the strength of the whole society through the waste of human resourcesSource: Jones CP. Confronting Institutionalized Racism. Phylon 2003;50(1-2):7-22.
  19. 19. Levels of Racism Institutionalized Personally-mediated InternalizedSource: Jones CP. Levels of Racism: A Theoretic Framework and a Gardener’s Tale. Am J Public Health 2000;90(8):1212-1215.
  20. 20. Institutionalized racism Differential access to the goods, services, and opportunities of society, by “race” Examples  Housing, education, employment, income  Medical facilities  Clean environment  Information, resources, voice Explains the association between social class and “race”
  21. 21. Personally-mediated racism Differential assumptions about the abilities, motives, and intents of others, by “race” Differential actions based on those assumptions Prejudice and discrimination Examples  Police brutality  Physician disrespect  Shopkeeper vigilance  Waiter indifference  Teacher devaluation
  22. 22. Internalized racism Acceptance by the stigmatized “races” of negative messages about our own abilities and intrinsic worth Examples  Self-devaluation  White man’s ice is colder  Resignation, helplessness, hopelessness Accepting limitations to our full humanity
  23. 23. Levels of Racism: A Gardener’s TaleSource: Jones CP. Levels of Racism: A Theoretic Framework and a Gardener’s Tale. Am J Public Health 2000;90(8):1212-1215.
  24. 24. Who is the gardener?  Power to decide  Power to act  Control of resources  Dangerous when  Allied with one group  Not concerned with equity
  25. 25. Measuring institutionalized racism Scan for evidence of “racial” disparities  “Could racism be operating here?”  Routinely monitor opportunities as well as outcomes by “race” Identify mechanisms  “How is racism operating here?”  Structures: the who?, what?, when?, and where? of decision-making  Policies: the written how?  Practices and norms: the unwritten how?  Values: the why?Source: Jones CP. Confronting Institutionalized Racism. Phylon 2003;50(1-2):7-22.
  26. 26. “Reactions to Race” module Six-question optional module on the Behavioral Risk Factor Surveillance System since 2002  “How do other people usually classify you in this country?”  “How often do you think about your race?”  Perceptions of differential treatment at work or when seeking health care  Reports of physical symptoms or emotional upset as a result of “race”-based treatment
  27. 27. States using the “Reactions to Race” module 2002 to 2010 BRFSSArkansas, California, Colorado, Delaware, District of Columbia, Florida, Georgia, Indiana, Kentucky,Massachusetts, Michigan, Mississippi, Nebraska, New Hampshire, New Mexico, North Carolina,Ohio, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, Washington, Wisconsin
  28. 28. States using the “Reactions to Race” moduleArkansas 2004California 2002Colorado 2004Delaware 2002 2004 2005District of Columbia 2004Florida 2002Georgia 2010Indiana 2009Kentucky 2010Massachusetts 2006Michigan 2006Mississippi 2004Nebraska 2008 2009New Hampshire 2002New Mexico 2002North Carolina 2002Ohio 2003 2005Rhode Island 2004 2007 2010South Carolina 2003 2004Tennessee 2005Vermont 2008Virginia 2008Washington 2004Wisconsin 2004 2005 2006
  29. 29. States using the “Reactions to Race” moduleArkansas 2004California 2002Colorado 2004Delaware 2002 2004 2005District of Columbia 2004Florida 2002Georgia 2010Indiana 2009Kentucky 2010Massachusetts 2006Michigan 2006Mississippi 2004Nebraska 2008 2009New Hampshire 2002New Mexico 2002North Carolina 2002Ohio 2003 2005Rhode Island 2004 2007 2010South Carolina 2003 2004Tennessee 2005Vermont 2008Virginia 2008Washington 2004Wisconsin 2004 2005 2006
  30. 30. Socially-assigned “race” How do other people usually classify you in this country? Would you say:  White  Black or African-American  Hispanic or Latino  Asian  Native Hawaiian or Other Pacific Islander  American Indian or Alaska Native  Some other group
  31. 31. Socially-assigned “race” On-the-street “race” quickly and routinely assigned without benefit of queries about self-identification, ancestry, culture, or genetic endowment Ad hoc racial classification, an influential basis for interactions between individuals and institutions for centuries Substrate upon which racism operatesSource: Jones CP, Truman BI, Elam-Evans LD, Jones CA, Jones CY, Jiles R, Rumisha SF, Perry GS. Using “socially assigned race”to probe White advantages in health status. Ethn Dis 2008;18(4):496-504.
  32. 32. General health status Would you say that in general your health is:  Excellent  Very good  Good  Fair  Poor
  33. 33. General health status by socially-assigned "race", 2004 BRFSS 100 80percent of res pondents 60 40 20 58.3 43.7 41.2 36.1 0 White Blac k Hispanic AIAN Report excellent or very good health
  34. 34. General health status by socially-assigned "race", 2004 BRFSS 100 80percent of res pondents 60 40 20 58.3 43.7 41.2 36.1 0 White Blac k Hispanic AIAN Report excellent or very good health
  35. 35. General health status by socially-assigned "race", 2004 BRFSS Report fair or poor health 100 13.9 21.5 20.9 22.1 80percent of res pondents 60 40 20 58.3 43.7 41.2 36.1 0 White Blac k Hispanic AIAN Report excellent or very good health
  36. 36. General health status and “race” Being perceived as White is associated with better health
  37. 37. Self-identified ethnicity Are you Hispanic or Latino?  Yes  No
  38. 38. Self-identified “race” Which one or more of the following would you say is your race?  White  Black or African-American  Asian  Native Hawaiian or Other Pacific Islander  American Indian or Alaska Native  Other Which one of these groups would you say best represents your race?
  39. 39. Self-identified “race”/ethnicity Hispanic  “Yes” to Hispanic/Latino ethnicity question  Any response to race question White  “No” to Hispanic/Latino ethnicity question  Only one response to race question, “White” Black  “No” to Hispanic/Latino ethnicity question  Only one response to race question, “Black” American Indian/Alaska Native  “No” to Hispanic/Latino ethnicity question  Only one response to race question, “AI/AN”
  40. 40. Two measures of “race” How usually classified by others White Black Hispanic AIAN ... White 98.4 0.1 0.3 0.1 1.1How self-identify 26,373 Black 0.4 96.3 0.8 0.3 2.2 5,246
  41. 41. Two measures of “race” How usually classified by others White Black Hispanic AIAN ... White 98.4 0.1 0.3 0.1 1.1How self-identify 26,373 Black 0.4 96.3 0.8 0.3 2.2 5,246 Hispanic 26.8 3.5 63.0 1.2 5.5 1,528
  42. 42. Two measures of “race” How usually classified by others White Black Hispanic AIAN ... White 98.4 0.1 0.3 0.1 1.1How self-identify 26,373 Black 0.4 96.3 0.8 0.3 2.2 5,246 Hispanic 26.8 3.5 63.0 1.2 5.5 1,528
  43. 43. General health status, by self-identified and socially-assigned "race", 2004 100 80percent of respondents 60 58.6 53.7 39.8 40 20 0 Hispanic-Hispanic Hispanic-White White-White Report excellent or very good health
  44. 44. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: That there is no difference in proportions reporting excellent or very good health 80 Hispanic-Hispanic versus White-White p < 0.0001percent of respondents 60 58.6 39.8 40 20 0 Hispanic-Hispanic White-White Report excellent or very good health
  45. 45. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: That there is no difference in proportions reporting excellent or very good health 80 Hispanic-Hispanic versus Hispanic-White p = 0.0019percent of respondents 60 53.7 39.8 40 20 0 Hispanic-Hispanic Hispanic-White Report excellent or very good health
  46. 46. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: That there is no difference in proportions reporting excellent or very good health 80 Hispanic-White versus White-White p = 0.1895percent of respondents 60 58.6 53.7 40 20 0 Hispanic-White White-White Report excellent or very good health
  47. 47. Two measures of “race” How usually classified by others White Black Hispanic AIAN ... White 98.4 0.1 0.3 0.1 1.1How self-identify 26,373 Black 0.4 96.3 0.8 0.3 2.2 5,246 Hispanic 26.8 3.5 63.0 1.2 5.5 1,528 AIAN 47.6 3.4 7.3 35.9 5.8 321
  48. 48. Two measures of “race” How usually classified by others White Black Hispanic AIAN ... White 98.4 0.1 0.3 0.1 1.1How self-identify 26,373 Black 0.4 96.3 0.8 0.3 2.2 5,246 Hispanic 26.8 3.5 63.0 1.2 5.5 1,528 AIAN 47.6 3.4 7.3 35.9 5.8 321
  49. 49. General health status, by self-identified and socially-assigned "race", 2004 100 80percent of respondents 60 58.6 52.6 40 32 20 0 AIAN-AIAN AIAN-White White-White Report excellent or very good health
  50. 50. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: That there is no difference in proportions reporting excellent or very good health 80 AIAN-AIAN versus White-White p < 0.0001percent of respondents 60 58.6 40 32 20 0 AIAN-AIAN White-White Report excellent or very good health
  51. 51. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: That there is no difference in proportions reporting excellent or very good health 80 AIAN-AIAN versus AIAN-White p = 0.0122percent of respondents 60 52.6 40 32 20 0 AIAN-AIAN AIAN-White Report excellent or very good health
  52. 52. General health status, by self-identified and socially-assigned "race", 2004 100 Test of H0: That there is no difference in proportions reporting excellent or very good health 80 AIAN-White versus White-White p = 0.3070percent of respondents 60 58.6 52.6 40 20 0 AIAN-White White-White Report excellent or very good health
  53. 53. General health status and “race” Being perceived as White is associated with better health  Even within non-White self-identified “race”/ethnic groups
  54. 54. General health status and “race” Being perceived as White is associated with better health  Even within non-White self-identified “race”/ethnic groups  Even within the same educational level
  55. 55. General health status and “race” Being perceived as White is associated with better health  Even within non-White self-identified “race”/ethnic groups  Even within the same educational level Being perceived as White is associated with higher education
  56. 56. Key questions Why is socially-assigned “race” associated with self- rated general health status?  Even within non-White self-identified “race”/ethnic groups  Even within the same educational level Why is socially-assigned “race” associated with educational level?
  57. 57. Racism A system of structuring opportunity and assigning value based on the social interpretation of how we look (“race”), which  Unfairly disadvantages some individuals and communities  Unfairly advantages other individuals and communities  Saps the strength of the whole society through the waste of human resourcesSource: Jones CP. Confronting Institutionalized Racism. Phylon 2003;50(1-2):7-22.Source: Jones CP, Truman BI, Elam-Evans LD, Jones CA, Jones CY, Jiles R, Rumisha SF, Perry GS. Using “socially assigned race” to probeWhite advantages in health status. Ethn Dis 2008;18(4):496-504.
  58. 58. Could this be true in Canada? Colour Coded Health Care: The Impact of Race and Racism on Canadians’ Health Sheryl Nestel The Wellesley Institute http://www.wellesleyinstitute.com/wp- content/uploads/2012/02/Colour-Coded-Health-Care-Sheryl- Nestel.pdf Public launch this evening 6:00 pm at The 519 Church Street Community Centre Free and open to the public
  59. 59. What is [inequity] ?A system of structuring opportunity and assigningvalue based on [fill in the blank]
  60. 60. What is [inequity] ?A system of structuring opportunity and assigningvalue based on [fill in the blank], which Unfairly disadvantages some individuals and communities Unfairly advantages other individuals and communities Saps the strength of the whole society through the waste of human resources
  61. 61. Many axes of inequity “Race” Gender Ethnicity Labor roles and social class markers Nationality, language, and legal status Sexual orientation Disability status Geography ReligionThese are risk markers, not risk factors
  62. 62. Achieving health equity “Health equity” is assurance of the conditions for optimal health for all people Achieving health equity requires  Valuing all individuals and populations equally  Recognizing and rectifying historical and contemporary injustices  Providing resources according to need Health disparities will be eliminated when health equity is achievedSource: Jones CP 2010, adapted from the National Partnership for Action to End Health Disparities.
  63. 63. ICERD: International Convention on the Elimination of all forms of Racial Discrimination International anti-racism treaty adopted by the UN General Assembly in 1965 http://www2.ohchr.org/english/law/cerd.htm Canada signed in 1966 Canada ratified in 1970 19th and 20th periodic report submitted by Canada to the UN Committee on the Elimination of Racial Discrimination (CERD) in 2011 http://www2.ohchr.org/english/bodies/cerd/cerds80.htm
  64. 64. CERD Concluding Observations Canada on agenda for the 80th session of CERD  Scheduled for discussion 22 and 23 February 2012 9-page document (25 May 2007) available online http://www2.ohchr.org/english/bodies/cerd/cerds70.htm Concerns and recommendations include:  Paucity of disaggregated data (para 11)  Use of term “visible minorities” (para 13)  Racial profiling for national security (para 14)  Disproportionate use of force and incarceration (para 19)  Violence against Aboriginal women (para 20)  Dramatic inequality in living standards (para 21)
  65. 65. Our goal: To expand the conversationHealth services
  66. 66. Our goal: To expand the conversationHealth servicesSocial determinantsof health
  67. 67. Our goal: To expand the conversationHealth servicesSocial determinantsof healthSocial determinantsof equitySource: Jones CP et al. J Health Care Poor Underserved 2009.
  68. 68. Our tasks Put racism on the agenda  Name racism as a force determining the other social determinants of health  Routinely monitor for differential exposures and opportunities as well as outcomes by “race”
  69. 69. Our tasks Ask , “How is racism operating here?”  Identify mechanisms in structures, policies, practices, norms, and values  Attend to both what exists and what is lacking
  70. 70. Our tasks Organize and strategize to act  Join in grassroots organizing around the conditions of people’s lives  Identify the structural factors creating and perpetuating those conditions  Link with similar efforts across the country and around the world
  71. 71. Camara Phyllis Jones, MD, MPH, PhD1600 Clifton Road NEMailstop E-33Atlanta, Georgia 30333(404) 498-1128 phone(404) 498-1111 faxcdj9@cdc.govFor more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.govThe findings and conclusions in this report are those of the authors and do not necessarily represent the officialposition of the Centers for Disease Control and Prevention. Office of Surveillance, Epidemiology, and Laboratory Services Epidemiology and Analysis Program Office
  72. 72. Resources Colour Coded Health Care: The Impact of Race and Racism on Canadians’ Health Sheryl Nestel The Wellesley Institute http://www.wellesleyinstitute.com/wp- content/uploads/2012/02/Colour-Coded-Health-Care-Sheryl- Nestel.pdf
  73. 73. Resources Report of the Secretary’s Task Force on Black and Minority Health Margaret M. Heckler, Secretary U.S. Department of Health and Human Services http://collections.nlm.nih.gov/ext/heckler/8602912V1/PDF/86029 12V1.pdf
  74. 74. Resources Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Brian D. Smedley, Adrienne Y. Stith, Alan R. Nelson, Editors Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care Institute of Medicine of the National Academies http://www.nap.edu/openbook.php?isbn=030908265X
  75. 75. Resources Race: The Power of an Illusion California Newsreel http://www.pbs.org/race http://newsreel.org/video/RACE-THE-POWER-OF-AN-ILLUSION Unnatural Causes: Is Inequality Making Us Sick? California Newsreel http://www.unnaturalcauses.org
  76. 76. Resources 3rd World Conference Against Racism, Racial Discrimination, Xenophobia and Related Intolerance Convened by the United Nations in Durban, South Africa in 2001 http://www.un.org/WCAR/ RACE – Are We So Different? American Anthropological Association http://www.understandingrace.org/home.html
  77. 77. Resources World Conference on Social Determinants of Health Convened by the World Health Organization in Rio de Janeiro, Brasil in 2011 http://www.who.int/sdhconference/en/ Closing the gap in a generation: Health equity through action on the social determinants of health WHO Commission on Social Determinants of Health http://www.who.int/social_determinants/thecommission/finalrep ort/en/index.html
  78. 78. Resources International Convention on the Elimination of all forms of Racial Discrimination (ICERD) Adopted by the United Nations General Assembly in 1965 http://www2.ohchr.org/english/law/cerd.htm Committee to Eliminate Racial Discrimination (CERD) Office of the United Nations High Commissioner for Human Rights http://www2.ohchr.org/english/bodies/cerd/
  79. 79. Resources The Gardener’s Tale podcast CityMatCH Health Equity and Social Justice Action Group http://www.citymatch.org/UR_tale.php
  80. 80. Camara Phyllis Jones, MD, MPH, PhD1600 Clifton Road NEMailstop E-33Atlanta, Georgia 30333(404) 498-1128 phone(404) 498-1111 faxcdj9@cdc.govFor more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.govThe findings and conclusions in this report are those of the authors and do not necessarily represent the officialposition of the Centers for Disease Control and Prevention. Office of Surveillance, Epidemiology, and Laboratory Services Epidemiology and Analysis Program Office
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