Category Archives: health equity

NACCHO Annual 2018: Take a Glimpse into New Orleans Public Health

Interview by Taylarr Lopez, Communications Specialist, NACCHO

Torrie Harris, Dr.P.H., MPH is a Health & Equity Strategist at the New Orleans Health Department (NOHD). In the following post, she discusses her role within the department, shares how NOHD is addressing the public health burdens of maternal and infant issues and mental health, and highlights the fun things NACCHO Annual 2018 conference attendees can do during their visit to New Orleans.

What is your role within the New Orleans Health Department? What does a typical day look like for you?

I am the health and equity strategist and my role is to train and educate our workforce on equity and to develop an implementation strategy through the programs delivered through the department. I am currently working with our Information Technology and Service Innovation departments to develop a method for tracking and mapping social determinants of health. A lot of my time is spent doing community health outreach and also by working across departments throughout the city on health equity and health strategies. For example, I recently did a presentation to our Department of Public Works about health equity and the health in all policies approach. I’m also responsible for our violence prevention portfolio, which includes trauma-informed schools and our domestic violence initiative.

Please tell us about the community your department serves.

The department serves the entire population of Orleans Parish, while also collaborating with surrounding parishes. Like many local health departments across the country, NOHD transitioned from being mainly a health service delivery provider to a department with a stronger focus on health system improvement, health policy, and health promotion and programming. However, NOHD does operate one Federally Qualified Health Center, Healthcare for the Homeless Clinic (HCH), which offers primary care services to adults in the city of New Orleans and surrounding parishes regardless of ability to pay.

HCH also offers dental services to adults and children. The HCH site offers the Women, Infant, and Children (WIC) program and other wrap-around services such as laboratory services, behavioral health, and a pharmacy. Additionally, NOHD provides support to low-income families through Healthy Start, a prenatal/postnatal health education program that offers free baby supplies, links to employment resources, individual and family counseling, and legal assistance.

Moreover, NOHD contributes to the monitoring and surveying of health ordinances that were established by our city council, such as our recent smoke-free and noise pollution ordinances.

What are some of the most pressing public health burdens your community is facing? How is your health department addressing those challenges?

The most pressing health priority is access to mental and behavioral health services, as there is limited access and a need for integration into the primary care health system. The city’s other most pressing public health burden is infant mortality. According to the March of Dimes, as of 2014, the infant mortality rate among African Americans is 9.8 per 1000. The department is also working to address opioid use through a prevention strategy program that is making strides in reducing the burden of misuse.

NOHD coordinates the Behavioral Health Council, which convenes behavioral and mental health agencies and professionals to achieve a high-functioning health system that works collaboratively to meet the needs of vulnerable populations across the life span. To address infant mortality, NOHD works with Healthy Start, WIC, and leverages partnerships with the National Birth Equity Collaborative and the New Orleans Breastfeeding Center.

The department uses a Health in All Policies approach to ensure residents have access to clean, safe, and affordable housing in the city. We work with different departments in the city to discuss equitable strategies and how housing relates to health. We use an equity lens to educate faculty, leadership, and area schools about managing trauma to reduce infections and improve the quality of life of the area’s students.

The department is working with police officers and other emergency personnel to better identity risk factors when responding to domestic violence and sexual assault calls. NOHD also has behavioral health programs that convene public health professionals across the city to develop a strategy for providing better mental health services.

We are working to mitigate the burden of obesity and chronic disease in our community by partnering with the city’s recreation department. Through this partnership, Fit NOLA was established; a residual of former United States First Lady Michelle Obama’s “Let’s Move” campaign. The program focuses on physical activity and nutrition, and offers classes to those interested in adopting or maintaining a healthy lifestyle.

What can other health departments learn from the work you are doing?

Events such as Hurricane Katrina, the passage of the Affordable Care Act, and subsequent Louisiana Medicaid Expansion, reshaped the structure and function our health department. NOHD now has a comprehensive and coordinated team that works alongside EMS, state emergency preparedness agencies, and all other health and safety response teams to assure preparation for potential disaster and respond swiftly. The devastation of Hurricane Katrina also precipitated the importance of community resilience and involvement.

New Orleans has nearly 72 neighborhoods with their own character, which community residents self-identified. Thus, understanding the culture and needs of each community has been the driving force in how NOHD plans and develops programs. Community resilience has been important to the sustainability of our city, as was seen in the recent election of our first female and African American mayor, LaToya Cantrell. Her passionate and genuine grassroots work as a city council member, where she developed a connection to the community by listening to their voices and concerns, led to her historic triumph. Mayor Cantrell also led the city to a smoke-free ordinance which includes bars and casinos.

New Orleans is a known for being a place to have a good time, but we are also serious about having a healthy quality of life for our families and children. It’s all about balance. Thus, NOHD has done a good job incorporating both in the work we do, which can be seen through our Fit NOLA program where we have public-private partnerships to encourage physical activity and healthy eating. This program offers free fitness programming, nutrition programs, and farmer’s market vouchers. NOHD also worked with the former administration to support Healthy Corner Store Initiatives. People in New Orleans know we are a unique city and with that notion, NOHD recognizes the need to really utilize community voice in everything we do. There is still much work to do, but NOHD is dedicated to making New Orleans a healthy city in addition to being a place where you can have a good time.

What are some fun things you recommend NACCHO Annual 2018 attendees do while in New Orleans?

I suggest going beyond Bourbon Street to see what else the city has to offer. People can take the street car to the Audubon Zoo. It is a very popular attraction. It’s beautiful and in the Uptown area of New Orleans. Visitors should also check out all of our wonderful New Orleans restaurants. I also recommend heading to Frenchman Street. It’s off the beaten path of Bourbon Street and not quite as risque. There you will also find artist markets and jazz clubs there that you can walk into for free.

City Park is where you’ll find the New Orleans Museum of Art, botanical gardens, and Morning Call, where you can eat beignets and drink café au lait. New Orleans is a very walkable city. You can walk almost anywhere from the conference location. For shopping, Magazine Street is a great place for boutiques and dining. You can eat your heart away in New Orleans and then walk it off!

To learn more about the New Orleans Health Department and the services it offers, visit their website.

Local Public Health Spreads Importance of Good Oral Health during Children’s Dental Health Month

By Umair A. Shah, MD, MPH, NACCHO President and Executive Director of Harris County Public Health in Houston, Texas

The oral cavity, including the teeth and surrounding structures, are necessary for adequate nutrition, proper speech and a positive self-image.  Although tooth decay is largely preventable, it continues to be the most common chronic disease of early childhood.1  Dental health can impact school performance when a child has untreated tooth decay with resulting pain that affects their ability to concentrate, sleep at night or even attend school, “more than 51 million school hours are lost each year to dental related illness.”2 Taxpayers share approximately 11% of the $113.5 billion spent nationally on dental care expenditures, a percentage that has increased over the years as dental care utilization continues to increase among children.3  Children with cavities in their primary (baby) teeth are three times more likely to develop cavities in their permanent (adult) teeth which could contribute to broader health problems including diabetes and cardiovascular disease.4 Continue reading

Health Equity Matters: Bridging the Gap between Underserved Populations and Access to Care

By Umair A. Shah, MD, MPH, NACCHO President and Executive Director of Harris County Public Health in Houston, Texas

What is Health Equity?

Public health is built on the foundation that all people have a right to health. Health equity is the principle that every person should have the opportunity “to attain their full health potential,” regardless of social, economic or environmental conditions. Achieving health equity requires valuing all individuals and populations equally, acknowledging and repairing historical injustices, and investing in those communities. Across the United States, state and local jurisdictions have made it their mission to reduce and eliminate health inequities in their communities. There are many root causes of health inequities, including racism, class-based oppression, gender inequity, and other forms of systematic injustices. These create societal conditions that influence an individual’s health such as: the quality of education, housing, neighborhood environment, and employment opportunities leading to disproportionate health outcomes, to name a few. Continue reading

Mass Incarceration and Racism Policy

By LaMar Hasbrouck, MD, MPH, Executive Director, NACCHO

According to civil rights attorney and former Stanford University Law Professor Michelle Alexander, author of The New Jim Crow: Mass Incarceration in the Age of Colorblindness, there are currently more black men in prison or jail, on probation, or on parole than were enslaved in 1850, before the Civil War began.

The United States holds the dubious distinction of incarcerating more individuals than any other nation. According the latest Department of Justice (DOJ) statistics, approximately 2.2 million men and women are currently imprisoned. The U.S. rate is nearly 5 to 10 times higher than rates in Western Europe and other democracies. Continue reading

LHD of the Year Award Winner Harris County Public Health Focuses on Closing the Gap on Health Inequity in its Community

lhdaward-fornaccho-lowresBy Taylarr Lopez, Communications Specialist, NACCHO

NACCHO is pleased to recognize Harris County Public Health (HCPH) as a recipient of the 2016 Local Health Department of the Year Award. This award recognizes and honors outstanding accomplishments of local health departments (LHDs) across the country for their innovation, creativity, and impact on communities.

HCPH provides comprehensive public health services to Harris County, Texas—the third most populous county in the United States. It has an annual budget of over $80 million and a workforce of more than 700 employees.

HCPH’s serves approximately 2.2 million people within the county’s unincorporated areas and 33 independent municipalities (excluding the city of Houston). For certain public health services such as mosquito control, Ryan White HIV/AIDS Program Part A, and refugee health, HCPH’s jurisdiction encompasses the entirety of the county, including the city of Houston, for a total population of more than 4 million. Continue reading

LHD of the Year Award Winner, the Kansas City Missouri Health Department, Works Toward Health Equity and Social Justice

lhdaward-fornaccho-lowresBy Taylarr Lopez, Communications Specialist, NACCHO

NACCHO is pleased to recognize the Kansas City (MO) Health Department as a recipient of the 2016 Local Health Department of the Year Award. This award recognizes and honors outstanding accomplishments of local health departments (LHDs) across the country for their innovation, creativity, and impact on communities.

Kansas City, MO, is a diverse urban community in the heart of the Midwest with a population of 459,787 people. The Kansas City Missouri Health Department (KCMOHD) has protected the population’s health for 150 years and operates with a mission to promote, preserve, and protect the health of Kansas City residents and visitors. KCMOHD employs 200 staff through various programs, some which are active in both Missouri and Kansas. Programs and services strive to prevent illness and injuries, improve health services, enforce public health laws, and support policy development to build a healthier community. Continue reading

NACCHO Annual Preview: Targeting Neighborhood Poverty, Education, and Health Burden through Policy and Prevention

logo_na2016_pms274This is the second in a series of NACCHO Annual preview posts, which feature interviews with and essays from presenters in advance of NACCHO Annual 2016. In this post, Gary Cox, JD, shares insights from his session, “Targeting Neighborhood Poverty, Education, and Health Burden through Local Public Health Policy and Prevention across Oklahoma County.” Cox brings more than 35 years of public health experience and leadership skills to his role as executive director of the Oklahoma City-County Health Department. He is a past president of both NACCHO and the Oklahoma Public Health Association. Below Cox shares his advice for LHDs pursuing health equity and his experience forging partnerships with local entities committed to improving community health.

NACCHO: You open your presentation with the idea that health outcomes are influenced by complex social and physical indicators. How do you address this reality in your health department’s pursuit of a culture of health equity?

Gary Cox: We have a basic philosophy as a local health department that we should analyze data and look at where we have inequities and disparities in our community. We have what we call a wellness score: It is about 22 data points, ranging from educational attainment and graduation rates to crime rates, mortality/morbidity rates, hospital room visits, hospital discharge data, and so on. It comes from a very wide variety of sources gathered together to create a cumulative comparative index, zip code by zip code, of our county.

Continue reading