community health policies

1 Defined as families without a member over age 15 who worked in all 4 months prior to the interview. Ban the box: U.S. Cities, counties, and states adopt fair-chance policies to advance employment opportunities for people with past convictions. The empirical literature has found overwhelmingly that insurance expansions improve access to medical care (Finkelstein et al., 2012; Miller, 2012; Van Der Wees et al., 2013). U.S. health in international perspective: Shorter lives, poorer health. Who benefits, and who is left behind? Are blacks and Hispanics disproportionately incarcerated relative to their arrests? The Millbank Quarterly 91(4):663–689. The U.S. Department of Agriculture (USDA), in collaboration with other organizations, released an obesity prevention tool kit, SNAP-Ed,2 for states to promote this goal. Other research concludes that living in a city with high rates of household gun ownership leads to greater odds of gun assault or gun robbery victimization (Altheimer, 2008). Washington, DC: The National Academies Press. Bendigo Central 165-171 Hargreaves Street Now open for our women's, men's and sexual health clinics on a strictly 'appointment only' basis.Call 5406 1200 if you have a question. Although the two substances are virtually identical on a molecular level, the Anti-Drug Abuse Act of 1986 stipulated a 100:1 weight ratio for powder versus crack cocaine when determining mandatory minimum sentences for. http://www.ed.gov/news/press-releases/us-department-education-takes-action-deliver-equity-students-disabilities (accessed November 23, 2016). In The City Project Blog. 2016. American Journal of Public Health 99(Suppl 3):S649–S656. In the report Can Hospitals Heal America’s Communities? The impact of minimum wage rates on body weight in the United States. Foundational assumptions of the equity and empowerment lens logic model. U.S. government. This evaluation should occur before and after enactment.” The. Continuing this work is needed to overcome discrimination and the structural barriers that affect health. Jacobs, L. R., and J. Soss. 2016b. The distribution of income is shaped by general economic conditions and by federal and state policies: most notably, taxes and government transfer programs such as Social Security, Supplemental Security Income (SSI), unemployment insurance, veterans’ benefits, food stamps, the Supplemental Nutrition Assistance Program (SNAP), and the free and reduced-price school meal program. Despite concerns around the negative impacts of potential displacement, research attempting to quantify the scale and nature of residential displacement is limited and existing studies have relatively limited time horizons (Zuk et al., 2015). Although communities individually may have little influence over state and federal policy change, they can leverage existing policies to their advantage. 2016b. In its original conception, the Triple Aim seeks to improve the individual experience of care, improve the health of populations, and reduce the per capita costs of care for populations (Berwick et al., 2008). Environmental Justice 1(4):211–216. Christensen, J. It aims to generate knowledge about how to strengthen health systems, policies and interventions in ways which preferentially benefit the poorest. (4) [R]elated information adequate for determining whether the [program] has or will have the effect of unnecessarily denying access to any person on the basis of prohibited discrimination.” 28 C.F.R. Community health services are often poorly understood by policy-makers, national and local health service leaders and staff working in other parts of the system. 2016a. exists examining the effect of the LIHTC on recipients’ living situations or health status. Cuellar, A., and D. M. Dave. Edited by R. A. Moffitt. B. In contrast, families receiving tenant-based subsidies like housing vouchers do not typically use them to move to neighborhoods that are substantially different from where they were previously living, although some research indicates that families receiving vouchers who have school-age children will move if housing is available near higher-performing schools (Ellen et al., 2016; Sanbonmatsu et al., 2011). Area health authorities are created, and joint planning and consultative committees are formed with local authorities. Students will be presented with several possible collaborative community health projects to work on as part of a group. In addition, state institutions of higher education that train health care professionals will be required to report to the Governor and General Assembly on their actions aimed at reducing health care disparities. civil rights, and environmental justice and health with changes in federal enforcement and the political landscape in the years to come.14, The U.S. Commission on Civil Rights in 2016 issued a report emphasizing the need for the U.S. Environmental Protection Agency (EPA) to comply with and enforce civil rights and environmental justice laws.15 Similarly, civil rights and environmental justice practitioners widely and strongly criticize EPA for being derelict in pursuing enforcement actions. The current policy landscape in health and especially in education warrants serious consideration of policy as a key factor in shaping local action. 2013. 2016. This is a significant development in education, a field that has been slow to make broad use of research as a basis for improving practice (West, 2016). IZA Journal of Labor Policy 3(1):26. To search the entire text of this book, type in your search term here and press Enter. Schill, M. H., and S. M. Wachter. Frequently, the pursuit of the Triple Aim is combined with an emphasis on care integration and bundled payment for services across settings in order to encourage efficiency and cost control (Berwick et al., 2008). Policies requiring healthy foods to be served at company meetings and events; Policies allowing for flextime to exercise or attend health programs ; Policies that are not specifically health-related may have health impacts on employees. 205 N. Michigan Ave., Suite 1200 The two objectives per subgroup that received the most votes were selected. Local economic development can revitalize blighted neighborhoods and create more jobs, but it can also lead to the displacement of low-income residents. The HEZ pilot program is still under way and will be formally evaluated. In 1963, a federal court of appeals struck down “separate but equal” under the Act in Simkins v. Moses H. Cone Memorial Hospital. 17 See, for example, Rosemere Neighborhood Association v. U.S. Environmental Protection Agency, 581 F.3d 1169 (9th Cir. Hyattsville, MD: National Center for Health Statistics. Los Angeles, CA: The City Project. a requirement may place on schools already facing economic and infrastructure challenges. 2014b. Communities can work with attorneys and public health experts together to promote a better understanding of the civil rights dimension of the challenge of health disparities and to show how to address these civil rights concerns for their communities to ensure that civil rights laws against discrimination in health and other publicly funded programs and activities are strengthened and not rolled back. Planning for health equity needs to take place early enough in the process to meaningfully guide the decision-making process and outcomes. The increasing value of education to health. As one strategy to support a focus on health disparities, the Centers for Medicare & Medicaid Services could undertake research on payment reforms that could spur accounting for social risk factors in the value-based payment programs it oversees. The community health center (CHC) in the United States is the dominant model for providing integrated primary care and public health services for the low-income and uninsured, and represents one use of federal grant funding as part of the country's health care safety net.. CHHP graduates will be able to conduct research that informs public health program and policy development … The following section briefly reviews selected features of the ACA and discusses both how these features affect communities and how federal policy could be changed to affect health equity at the community level. Can hospitals heal America’s communities? 15 U.S. Commission on Civil Rights, Environmental Justice: Examining the Environmental Protection Agency’s Compliance and Enforcement of Title VI and Executive Order 12898 (September 2016). Share this action-oriented guide with policymakers representing your community. Also in 1954, the Supreme Court held the Equal Protection Clause protects against discrimination based on race, color, national origin, ancestry, or descent in Hernandez v. Texas, 347 U.S. 475 (1954). While the facts of the case involved narrowly tailored race conscious admissions to promote the compelling state interest of diversity in a university, the value of diversity and the need for data are analogous in promoting health equity. 14 For example, California Government Code 11135 et seq. As discussed in Chapter 3, income has been identified as one of many drivers of population health and health inequity over the life course, along with factors that are closely related to income such as education, occupation, and place of residence (Adler and Rehkopf, 2008; Chow et al., 2006; Cutler and Lleras-Muney, 2006). Thus, policies and practices to increase academic achievement and reduce education disparities make a critical contribution to reducing health inequities. The educational level of adults, particularly maternal educational achievement, is linked to their children’s health and wellbeing. Code §§ 75001 et seq. This is partly because they are delivered ‘behind closed doors’ and partly because of the diversity of services and complex patterns of provision and commissioning described above. Proposition 84 and Assembly Bill (AB) 31—implement-ing legislation for the proposition—defined “park poor” and “income. When East Harlem was announced as a neighborhood for a possible rezoning, with the goal of creating new affordable housing, community stakeholders and leaders, including the Office of City Council Speaker Melissa Mark-Viverito, Manhattan Community Board 11, Community Voices Heard, and the Manhattan Borough President Gale A. Health care and services were segregated, and this segregation resulted in health disparities in the pre-Civil Rights South. NASEM. Community Plan Policies View the current policies … Frequently, community health initiatives, including collaborative activities, sometimes limit their vision and advocacy to policy changes related to health care and perhaps social services (Whittington et al., 2015). Race and Social Problems 1(4):187–199. Annual Review of Political Science 13(1):341–364. Groups will comprise approximately five students, in partnership with members from the outside organization (eg, CBO, health department, health center), and with guidance from the instructor. Cambridge, MA: National Bureau of Economic Research. Beatty, A., and D. Foster. 2006. The recommendations of a recent IOM and National Research Council report that calls for more research on the potential efficacy of gun control policies in preventing firearm violence in U.S. communities continue to resonate (IOM and NRC, 2013). Health behaviors, such as obesity and. A difference-in-differences analysis of health, safety, and greening vacant urban space. found that from 1984 to 2004, benefits to single mother households and non-employed1 families declined by 19 and 21 percent, respectively, while benefits going to employed families, the elderly, and the disabled grew by 61 percent, 12 percent, and 15 percent, respectively (Ben-Shalom et al., 2011). One component includes a joint initiative between the Maryland Community Health Resources Commission and the Maryland Department of Health and Mental Hygiene initiative around “health enterprise zones” (HEZ). The programs vary significantly in the size of their benefits and in the number of people they reach. 2015. Health insurance and the consumer bankruptcy decision: Evidence from expansions of Medicaid. APA's Healthy Communities Policy Guide identifies policy ideas for local, state, and federally elected officials aimed at improving community health and quality of living through planning. Evaluate policies for their impact on public health and health equity Apply principles of leadership, governance and management, which include creating a vision, empowering others, fostering collaboration and guiding decision making Other studies have found that the income gradient also exists across racial and ethnic groups and that the relationship between income and health is stronger than between race and health (Woolf et al., 2015). Hamad, R., and D. H. Rehkopf. Accord, Executive Order 12898 on Environmental Justice, Sec. Race and Social Problems 1(4):183–186. San Francisco: Federal Reserve Bank of San Francisco and Low Income Investment Fund. individual income taxes ($1.6 trillion) and payroll taxes ($1.1 trillion), with corporate income taxes ($300 billion) and other taxes playing smaller roles ($309 billion) (CBO, 2016). Communities, when appropriate, can work with civil rights attorneys to use problem-solving strategies, including coalition building, planning, data collection and analysis, media, negotiation, policy and legal advocacy out of court, and access to justice through the courts. Washington, DC: U.S. Department of Housing and Urban Development Office of Policy Development and Research. IOM and NRC (National Research Council). The United States today has the highest rate of incarceration in the world, with a cost to states and the federal government of $80 billion in 2010 alone (DOJ, 2013). But policies in a variety of areas, ranging from education to land use and housing, the environment, and criminal justice, can be relevant to health disparities. Thus, over 35 years, incomes at the top increased by 192 percent compared with an increase of 46 percent at the bottom. Research Department, Federal Reserve Bank of Philadelphia 40. NASEM (National Academies of Sciences, Engineering, and Medicine). Journal of Public Economics 75(1):99–124. Howard and Norris wrote that by “addressing these social determinants of health through their business and non-clinical practices (for example, through purchasing, hiring, and investments), hospitals and health systems can produce increased measurably beneficial impacts on population and community health” (Howard and Norris, 2015, pp. withheld federal subsidies for a proposed warehouse project in response to significant local community action, pending a full study under the civil rights and environmental justice laws to consider a park alternative and the impact on people of color and low-income people. You're looking at OpenBook, NAP.edu's online reading room since 1999. poor” standards to prioritize the investment of $1.3 billion in local impact funds for park, water, and coastal projects (Garcia et al., 2016).21 Fully 88 percent of the $400 million in funds invested under the AB 31 standards were invested in communities that are disproportionately of color and low-income. The criminal justice system plays an important role in shaping health equity through multiple mechanisms. Recognizing the role that local policies play in marginalizing those with a criminal record, some communities have advocated for laws aimed at reducing the barriers to reentry for the formerly incarcerated. 2016. Hu, L., R. Kaestner, B. Mazumder, S. Miller, and A. Wong. American Journal of Epidemiology 183(9):775-784. existing infrastructure of policies and programs within the education sector with an eye toward how this infrastructure might be strengthened, modified, or expanded in the interest of improving health outcomes. In practice, this meant that 5 grams of crack, for example, mandated the same sentence (5 years in prison) as 500 grams of cocaine. Box 6-2 describes an economic analysis of a policy intervention that advanced health equity. 2016. 2016. Community health Information about Victoria’s community health services, including registration and governance, the Community Health Program, demand management, service improvement and services targeted at population Ridgeway, G., and J. MacDonald. The federal government increased the minimum wage to $7.25 in 2009. Harris, C. T., D. Steffensmeier, J. T. Ulmer, and N. Painter-Davis. East Harlem neighborhood plan. 2015 (unpublished). The largest of these programs is Medicaid, which is discussed later in the chapter. Gupta, R. A., K. J. Kelleher, K. Pajer, J. Stevens, and A. Cuellar. Health in All Policies: Ways of Working There are many ways of applying the Health in All Policies (HiAP) approach to ensure health, wellbeing, sustainability and equity issues are explicitly addressed through policies or decision Chan School of Public Health. 2016. Healthy Schools Campaign. Moving to opportunity for fair housing demonstration program--final impacts evaluation. Philadelphia, PA: Federal Reserve Bank of Philadelphia. See our COVID-19 FAQ for visitor guidelines and more. Long-term benefits of the Supplemental Nutrition Assistance Program. Healthy Communities Collaborative Chair Cailean Kok, AICP, discusses why elected officials and planners should use this set of policies to promote and build healthy communities. inequities by requiring standard approaches for identifying, disciplining, and supporting students with disabilities, particularly students of color with disabilities (ED, 2016c). describe services addressing health-related social needs, including transportation and housing (Alley et al., 2016). Massachusetts health care reform: A look at the issues. For example, Multnomah County, Oregon, applies an “equity and empowerment lens” to local policy (Multnomah County, 2014a, b, n.d.), and Seattle–King County implemented an “equity in all policies” approach to all decision making and annually reports on what it terms “the determinants of equity” in the county (Beatty and Foster, 2015). Develop new tools for the preservation of culture, economy, and neighborhood character. 2009) (EPA failed to process a single complaint from 2006 or 2007 in accordance with its regulatory deadlines); Lawyer: EPA Has Failed Civil Rights Law: Attorney Marianne Engelman Lado argues that the Environmental Protection Agency should enforce civil rights law in the low-income communities of color that she says carry the burden of pollution, NBC News (August 2, 2015). Washington, DC: The National Academies Press. Washington, DC: Center for Studying Health System Change. Cambridge, MA: National Bureau of Economic Research. The impact of family income on child achievement. For example, Title VI of the Civil Rights Act of 1964 and corresponding regulations prohibit discrimination based on race, color, or national origin and promote equity in programs and activities by recipients of federal financial assistance.9 The Fair Housing Act of 1968 prohibits discrimination and promotes equal opportunity in housing.10 The ACA includes a provision, Section 1557, against health discrimination in federally funded or supported health programs or activities. 2015. Planning for health requires government at all levels to address determinants of chronic disease early by integrating health considerations in planning. (2016) examined more than 1 billion income tax and Social security records to report the association between income level and life expectancy from 1999 through 2014. MPH in Community Health Sciences This program will prepare you to engage in the planning, administration, and evaluation of public health programs and policies in the U.S. and abroad. Urban Studies 43(1):23–57. Prop 84 is the Safe Drinking Water, Water Quality and Supply, Flood Control, River and Coastal Protection Bond Act of 2006, Pub. States, such as Massachusetts, also focus on Triple Aim outcomes: for example, through the Massachusetts Quality and Cost Council (AHRQ, 2016b; Holahan and Blumberg, 2006). Finally, one of the most important components of ESSA pertains to its state and local accountability provisions. 1030 15th St., NW Suite 750 West Because more serious crimes occur in poor neighborhoods, police patrol them more densely. Household food insecurity is associated with greater growth in body mass index among female children from kindergarten through eighth grade. Los Angeles, CA: The City Project. Morbidity and Mortality Weekly Report Supplements 55(2):34–38. 3 For more information, see http://choicesproject.org (accessed December 19, 2016). Many of the greatest public health successes in the United States are the result of legal or policy interventions, such as smoke-free air laws and mandatory seatbelt laws.1Yet many people may not be aware of the precise impact these interventions and approaches can have on population health. 2014b. The City Project. Yet people of color and low-income people throughout California disproportionately lack access to parks, beaches, and recreation areas. 20 On the values at stake, see, for example, NPS, Healthy Parks, Healthy People Community Engagement eGuide at page 15 (2014). 34 Alley et al. Voluntary compliance with and enforcement of equal justice laws and policies can be preferable to court action as a means to achieve equal justice goals, including health equity. APA's Healthy Communities Policy Guide identifies policy ideas for local, state, and federally elected officials aimed at improving community health and quality of living through planning. See Box 6-1 for an example of a community-driven neighborhood plan designed to make some of these changes. This includes, for example, numerical disparities for people of color or women based on statistical studies or anecdotal evidence.22 Two recent cases by the U.S. Supreme Court emphasize the need to address civil rights compliance, enforcement, and data analysis by public agencies.23 Federal entities such as the U.S. Department of Justice address the need for data collection and analysis in their regulations and guidance documents.24. State and federal Medicaid policies can affect the available funding for health care services for these groups. Cuellar, A. E., and S. Markowitz. and corresponding regulations promote equal justice and prohibit discrimination by state agencies and state-funded programs and activities for specified classes, parallel to federal civil rights laws such as Title VI. https://www.eitc.irs.gov/EITC-Central/eitcstats?_ga=1.80629535.982617637.1477348670 (accessed December 19, 2016). ChangeLab Solutions. Many states have developed special programs for youth, including mentoring, mental health counseling, education supports, and family reunification supports, to facilitate successful reintegration and the transition to adulthood, and some have. The current era of mass incarceration can be understood as a powerful policy intervention in the lives of the poor and people of color (Pettit and Western, 2004). Gross, T., and M. J. Notowidigdo. More recently, others have called for a “triple aim for health equity” that broadens the focus and embeds health care in a community-based. 2015. 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