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Leandris C. Liburd, PhD, MPH Associate Director for Minority Health and Health Equity Centers for...

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Leandris C. Liburd, PhD, MPH Associate Director for Minority Health and Health Equity Centers for Disease Control and Prevention October 18, 2012 October 18, 2012 Health Equity and the Elimination of Cardiovascular Disease Disparities Office of Minority Health & Health Equity Office of the Director Slide 2 CDCs Office of Minority Health (OMH) CDC's Office of Minority Health (OMH) was established by the CDC Director on August 8, 1988 as a small coordination office, set up in response to Secretary Hecklers 1985 landmark report on minority health. Slide 3 Patient Protection and Affordable Care Act, PL 111-148 (2010) Select Provisions Related to Minority Health and Health Disparities The heads of the Centers for Disease Control and Prevention, Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, Agency for Healthcare Research and Quality, Food and Drug Administration, and the Centers for Medicare and Medicaid Services shall establish an office to be known as the Office of Minority Health. Slide 4 Office of Minority Health and Health Equity Mission To accelerate the work of CDC and its partners in improving health by eliminating health disparities, promoting conditions conducive to health, and achieving health equity. Slide 5 Presentation Objectives Provide an overview of the Office of Minority Health and Health Equitys Strategic Priorities (2012 2015) Define health disparities, health equity, health inequities, and the social determinants of health Explore how achieving health equity will reduce disparities in heart disease and stroke particularly among African Americans Pose questions that will inform the continued development, implementation, and refinement of population-based strategies to reduce CVD and stroke Slide 6 OMHHEs Strategic Priorities Reframe eliminating health disparities as achievable Facilitate the implementation of policies across CDC that promote the elimination of health disparities Assure implementation of proven strategies across CDC programs that reduce health disparities in communities at highest risk Advance the science and practice of health equity Collaborate with national and global partners to promote the reduction of health inequalities Slide 7 2011 CDC Health Disparities and Inequalities Report (CHDIR) Slide 8 Program Response to the 2011 CDC Health Disparities and Inequalities Report (CHDIR) 2013 Program Response to the 2013 Slide 9 Health Equity Matters E-Newsletter http://www.cdc.gov/minorityhealth/newsletter/current.htm l Slide 10 Conversations in Equity Blog http://blogs.cdc.gov/healthequity/ Slide 11 Whats the difference? Slide 12 Defining Health Disparities Health disparities are differences in health outcomes and their determinants between segments of the population, as defined by social, demographic, environmental, and geographic attributes. Slide 13 Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion. Slide 14 Defining Health Equity Health Equity is attainment of the highest level of health for all people. Slide 15 Defining Health Equity Health Equity is attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and healthcare disparities. Slide 16 Defining Health Inequities Health inequities are those health disparities that are avoidable and unfair. Slide 17 Social Determinants of Health Conditions in the social, physical, and economic environment in which people are born, live, work and age that influence health outcomes. Health Care Environment Neighborhood Education Food Security Transportation Jobs Social Context Slide 18 Cardiovascular Disease Disparities In the 4574 age group, black women and men have much higher coronary heart disease (CHD) and stroke mortality than women and men of the three other races: Findings from the CDC Health Disparities and Inequalities Report United States, 2011 WomenMen BlackWhiteBlackWhite Died of CHD, %37.919.461.541.5 Died of stroke,%39.017.360.731.1 Slide 19 The big five CVD risk factors + 3 Diet [high fat, high sodium] Physical [in]activity Cigarette smoking [uncontrolled] high blood pressure [high] cholesterol Diabetes Depression Psychosocial stress Slide 20 Social determinants of heart disease & stroke Saturation of fast food restaurants, vendors of alcoholic beverages, and vendors of tobacco products Limited opportunities for recreational physical activity Limited access to major grocery chains, farmers markets, and whole-food markets Aggressive marketing of unhealthy products Chronic stress Slide 21 Reducing health disparities in cardiovascular disease Surveys and surveillance systems: large-scale community-based designed to monitor the health status of minority populations Strategies : community- specific, culturally tailored that include system, environmental, and individual level interventions http://www.cdc.gov/Features/dsREACHUS/ Current CDC activities: Heart Disease and Stroke Atlases, WISEWOMEN, and Racial and Ethnic Approaches to Community Health (REACH), Million Hearts Slide 22 Reducing health disparities in cardiovascular disease Individual level interventions: healthy diet regular physical activity not smoking healthy weight; adherence to medication CDC Division of Heart Disease and Stroke Prevention Slide 23 Reducing health disparities in cardiovascular disease System and community interventions: Continuing education health care providers Health promotion programs that use community health workers Health communications campaigns Focus is on tobacco-free living Focus on sodium and trans fats in the food supply http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_aian.htm TRANS FAT Slide 24 Moving toward Health Equity In addition to monitoring the health status of minority populations, how might we monitor and report on the social determinants of heart disease and stroke? In contemporary, culturally diverse communities, how can we engage community members in identifying, implementing and evaluating strategies to reduce heart disease and stroke? How can our communications campaigns represent heart healthy living in more inviting ways? How can we accelerate our understanding of how cultures change and use this knowledge to promote heart health? Slide 25 It is in justice that the ordering of society is centered. Aristotle Slide 26 For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: [email protected] Web: www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Thank You For Your Time Office of the Director Office of Minority Health & Health Equity

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