One State’s Perspectives on the NCHHSTP Strategic PlanCDC Symposium of Social Determinants of HealthOctober 19, 2010Johnnie (Chip) Allen, MPHHealth Equity CoordinatorOffice of Healthy OhioOhio Department of Health

Presentation Goals Briefly comment on the NCHHSTP SDH White Paper &Strategic Plan (Goal 3). Provide considerations for implementation in the planfor state health departments. Highlight the importance of partnerships.

Rationale Statement of Goal“The concept of health equity is aspirational and focuses onthe distribution of resources and other processes that drive aparticular kind of health disparity . It is important to examinethe structural drivers of health disparities in addition toindividual behaviors. “ NCHHSTP & CDC must describe health equity in concrete terms. Work towards a common definition of health equity within theagency. Connect major funding/programmatic decision to structuraldrivers of health disparities.

Objective 3ADevelop, implement and evaluate a surveillance and publichealth prevention research agenda for addressing healthdisparities and fostering health equity in HIV/AIDS, viralhepatitis, STDs, and TB through comprehensive and multilevel approaches including addressing the socialdeterminants of health. Must implement this beyond the Center. Extent to which surveillance and research drive theallocation of resources.

Syndemic Orientation of Health SystemsSyndemic orientation is defined as a way of thinking aboutpublic health work that focuses on connections among healthrelated problems, considers those connections when developinghealth policies, and aligns with other avenues of social changeto ensure the conditions in which all people can be healthy.

Objective 3BMobilize partners and stakeholders to promote health equityand social determinants of health as it relates to HIV, viralhepatitis, STD, and TB prevention. Emphasis must be placed on “fostering collaboration withinCDC and among other federal and Department of Health andHuman Services agencies to facilitate the conduct of publichealth research to eliminate health disparities and tointegrate studies of social determinants of health. What could these partnerships actually look like?

Objective 3CIdentify which social determinants of health are important toaddress to reduce health disparities in HIV/AIDS, viralhepatitis, STDs, and TB and develop and advance appropriateplans for addressing these social determinants in NCHHSTPprogrammatic and scientific work. Key to Success: “Develop strategic, multidisciplinary, andcollaborative activities to facilitate novel cross-programmaticactivities to reduce health disparities due to various socialdeterminants of health.” Central Challenge: “Develop or refine methodologies forobtaining, analyzing and presenting data on socialdeterminants of health” .

Strategy for Objective 3CMethodologies for obtaining, analyzing and presenting data on social determinants of healthfor NCHHSTP diseases using existing or novel supplemental surveillance systems.

Displaying Social Determinants of HealthExtreme Poverty, Atlanta Geogia

Data on Social Determinants of HealthExtreme Poverty (Households Below Poverty Level)Less than 9th Grade Education

Selecting Priority PopulationsExample: Concentration of African-American Males 15-34

Demographic Overview

Social Determinants of Health

Reaching Target Audiences

Social Commentary or Public Health Reality?

Social Commentary or Public Health Reality?

3 Dimensional Organizational Structural to Address SDOH.

Assessing Organizational Structural to Effectively Address SDOH NCHHSTP consist of 1,300 FTEs Ohio Department Health employs 1,465 FTEs Both agencies are large and complex. Considerations should be made enhancing infrastructure toAddress SDOH.

Promote, support, and evaluate evidence-based approaches onrecommended hepatitis A and B and HPV vaccinations, andscreening for HIV, viral hepatitis, and STDs for providers whoserve predominately disproportionately affected populations inpublic and private healthcare settings

Prioritize investments with explicit goals in programs andinterventions to eliminate health disparities and promote healthequity among all populations by working in collaboration withthe NCHHSTP divisions and branchesImplementing Systemic Policy Change for Health Equity

Tools to Support Health Equity