Leandris C. Liburd, PhD, MPHAssociate Director for Minority Health and
Health EquityCenters for Disease Control and Prevention
October 18, 2012
Health Equity and the Elimination of Cardiovascular Disease Disparities
Office of Minority Health & Health EquityOffice of the Director
CDC’s 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 Heckler‘s 1985 landmark report on minority health.
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. “
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.
Presentation Objectives
Provide an overview of the Office of Minority Health and Health Equity’s 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
OMHHE’s 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
2011 CDC Health Disparities and Inequalities Report (CHDIR)
Program Response to the 2011 CDC Health Disparities and
Inequalities Report (CHDIR)
2013 Program Response to the
2013
Health Equity MattersE-Newsletter
http://www.cdc.gov/minorityhealth/newsletter/current.html
Health dispariti
es
What’s the difference?
Minority Health
Health equity
Health inequitie
s
Social determinants of health
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.
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.
Defining Health Equity
Health Equity is attainment of the highest level of health
for all people.
Defining Health Equity
Health Equity is attainment of the highest level of health
for all people.
Achieving health equityrequires 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.
Defining Health Inequities
Health inequities are those health disparities that are avoidable and unfair.
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
EnvironmentNeighborho
od
Education Food Security
Transportation
Jobs
Social Context
Cardiovascular Disease Disparities
In the 45–74 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
Women Men
Black White
Black White
Died of CHD, %
37.9 19.4 61.5 41.5
Died of stroke,%
39.0 17.3 60.7 31.1
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
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
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
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
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
TRANSFAT
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?
“It is in justice that the ordering of society is centered.”
Aristotle
For 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: [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 DirectorOffice of Minority Health & Health Equity
