The NPA: Supporting Collective Impact on Health Equity Office of Minority Health, DHHS July 7 th , 2011

1. The NPA: Supporting Collective Impact on Health EquityOffice of Minority Health, DHHS July 7th, 2011

2. Presenters Mirtha R. Beadle, MPA Deputy Director Office of Minority Health Jamie Hart, PhD, MPH Senior Vice President Atlas Research Kien S. Lee, PhD Principal Associate/Vice President Community Science David R. Williams, PhD Florence Sprague Norman & Laura Smart Norman Professor of African and African American Studies and Sociology Harvard University

3. A National MovementWhy is it necessary? • Health disparities among racial and ethnic minorities and other populations are undisputed yet they are persistent and pervasive. • Health of racial and ethnic minorities and underserved populations is tied to America’s health. • No one sector can create the conditions for better health alone—a cohesive and inclusive national strategy that leverages public and private sector investments and creates critical partnerships is needed.

4. NPA Mission Increase the effectiveness of programs that target the elimination of health disparities through the coordination of partners, leaders, and stakeholders committed to action.

5. National Health Disparity Approach

6. NPA Goals • Increase awareness of disparities • Strengthen and broaden leadership • Improve health and healthcare outcomes for racial, ethnic, and underserved populations • Improve cultural and linguistic competency and diversity of the health workforce • Improve availability and diffusion of data, research, and evaluation findings

7. National Stakeholder Strategy (NSS) • Developed with input from thousands of individuals and organizations • Establishes common set of national goals and strategies • Encourages stakeholders to identify and implement strategies and actions most important for their communities

8. HHS Action Plan • Developed in response to, and complements, the NSS • Outlines goals, strategies, and actions HHS will take • Builds on Affordable Care Act • Will assess impact of policies and programs on racial and ethnic disparities • Promotes integrated approaches, evidence-based programs, and best practices

9. Implementation of the NPA

10. Implementation Framework for Achieving Health Equity

11. Implementation Phase 1

12. Implementation Phase 2

13. Infrastructure Example: FIHET • Multi-sector representatives from 12 Federal agencies • 5 subcommittees based on NPA goals: • Awareness • Leadership • Health System and Life Experience • Cultural ad Linguistic Competency • Date, Research, and Evaluation • Detailed work plans outlining: • Strategies and action steps • Leads • Required resources • Timelines • Intended outcomes

14. Implementation Support • Implementation—coordinating and facilitating meetings, consulting with FIHET subcommittee and RHEC chairs, developing content for Blueprints for Action,, and working with partners to ensure connection to implementation actions or plans. • Communications—crafting messages and content and helping disseminate NPA information to key audiences, in order to share knowledge about activities, emerging issues, priorities, and evaluation/best practices. • Evaluation—managing and monitoring evaluation activities to ensure that partners connect and contribute to the evaluation; and negotiating data use and reporting with agencies who manage data systems relevant to the NPA.

15. Evaluation of the NPA

16. NPA Evaluation To determine the extent to which the NPA has contributed to the elimination of health disparities and attainment of health equity in our nation, by ascertaining the integration and permeation of NPA’s efforts across sectors (e.g., education, housing, environmental health) and levels (i.e., federal, national, regional, state, tribal, and community).

18. Indicators of Successful Partnerships • Clear understanding of roles and responsibilities • Clear and strong connectivity with NPA • Alignment with NPA goals and strategies • Use and integration of NPA materials and messages • Focus on health disparities • First-time actions • Goal attainment • Mutual sharing of information and data between NPA and partners • Mutual leveraging of funds for the NPA or partners

19. A Timely Moment to Act

20. The Status Quo is Not Sustainable • For the first time in history, we are raising children that will live sicker, shorter, lives than their parents • Doubling of obesity since 1987 accounts for almost 30% of the increase in health care costs • If current trends continue, more than 44 million American will have diabetes in 25 years • And the costs of treating diabetes will triple • Too many Americans are sick and dying young – and it is hurting all of us Williams et al., Health Affairs, 2010

21. The Big Picture • U.S. ranks near the bottom of the industrialized countries on health, and we are losing ground. • 1980 = 11th on Life Expectancy • 2006 = 33rd, tied with Slovenia • U.S. ranked behind Cyprus, United Arab Emirates, South Korea, Costa Rica and Portugal • And it is not just the minorities doing badly • In 2006, White America would be 30th • In 2006, Black America would be 58th • ALL of us could be doing better in terms of health

22. Large Economic Impacts • Racial/Ethnic inequalities in health costs the U.S. economy $309 Billion annually • If all Americans had the health of college graduates the U.S. economy would save $1 trillion per year • It is time to address disparities in health • Improving health for all will not only improve our economy, but also the quality of life for millions of Americans LaVeist et al. 2009, Joint Center for Political & Economic Studies; Schoeni et al., AJPM, 2011

23. Building on the Affordable Care Act • Improved access to health care is essential, but it will not make us a healthy nation • An individual’s chances of getting sick are largely unrelated to the receipt of medical care • Where we live, learn, work, play, and worship determine our opportunities and chances for being healthy • We need to make the healthy choice the easy choice • We need to work across traditional policy silos to engage in cross-sector partnerships and solutions

24. We Need to Work Together • Living healthier requires the creation of a culture of health • We need to better incorporate health into our homes, schools, neighborhoods, workplaces • Safety and wellness needs to be integrated into every aspect of community life • Health, therefore, needs to be factored into all policy making • Public and private resources need to be combined

25. All the Pieces are in Place • The NPA represents a departure from business as usual • It reflects a coordinated national response to ending health disparities • Builds on promising approaches from around the country • We need to bring public and private resources together in a concrete focus to create opportunities for everyone to be healthier • We need explicit attention to those farthest behind

26. Opportunities Abound • Promote 20 strategies for action linked to five NPA goals • Commit to help develop, plan, and implement efforts to reduce or eliminate health disparities • Conduct at least one substantial activity consistent with NPA goals • Develop a campaign/program to raise awareness of health disparities and promote healthy living • Share promising practices • Take steps to improve coordination and use of research and outcome evaluation, even of your own health disparities activities • Reach out to and coordinate with federal, state, and county agencies

27. A Call to Action “The only thing necessary for the triumph [of evil] is for good men to do nothing.” Edmund Burke, Irish Philosopher