Affirming Our Commitment: “A Nation Free of Health and Health Care Disparities”

1. UVI Caribbean Exploratory Research Center Fifth Annual Health Disparities Institute Affirming Our Commitment: “A Nation Free of Health and Health Care Disparities” J. Nadine Gracia, MD, MSCEDeputy Assistant Secretary for Minority Health (Acting) Office of Minority Health U.S. Department of Health and Human Services October 19, 2012 • The conclusions in this presentation are those of the author and do not necessarily represent the official position of the U.S. Department of Health and Human Services.

2. OUTLINE • Snapshot of National Initiatives to Address Health Disparities and Social Determinants of Health • Key Strategies and Actions • Building on Partnerships and Collaboration

3. Health Disparities and Social Determinants of Health • Globally, approximately 1/4 of diseases, and more than 1/3 of disease burden among children, results from modifiable or preventable factors in the environment • In U.S., cost of diseases in children attributed to environmental factors (e.g., asthma) estimated at $76.6 billion in 2008 • Dampness and mold estimated to contribute to 21% of asthma cases (4.6 million) in U.S. at annual cost $3.5 billion • Persistence of health disparities among racial and ethnic minorities • Minorities more likely to live in counties with particulate matter and ozone levels that exceed air quality standards and highest odds of living in inadequate housing

4. A National Movement Improving the Health of all Americans

5. Healthy People 2020 Overarching Goals • Attain high quality, longer lives free of preventable disease, disability, injury, and premature death. • Achieve health equity, eliminate disparities, and improve the health of all groups. • Create social and physical environments that promote good health for all. • Promote quality of life, healthy development, and healthy behaviors across all life stages. www.healthypeople.gov/2020/

6. National Prevention Strategy: Moving the Nation Toward Prevention and Wellness • National Prevention Council: 17 Federal agencies, chaired by the U.S. Surgeon General • Overarching Goal: Increase the number of Americans who are healthy at every stage of life http://www.healthcare.gov/prevention/nphpphc/strategy/

7. HHS Action Plan to Reduce Racial and Ethnic Health Disparities • Goals • Transform Health Care • Strengthen the Nation’s Health and Human Services Infrastructure and Workforce • Advance the Health, Safety, and Well-Being of the American People • Advance Scientific Knowledge and Innovation • Increase Efficiency, Transparency, and Accountability of HHS Programs Vision: “A Nation free of disparities in health and health care” www.minorityhealth.hhs.gov

8. HHS in Action • Goal • Advance the Health, Safety, and Well-Being of the American People • Action • Build community capacity to implement evidence-based policies and environmental, programmatic, and infrastructure change strategies • Example • CDC Community Transformation Grants • More than $100 million in prevention funding has been awarded to 61 states and communities serving approximately 120 million Americans. • Approximately $70 million was awarded to 40 communities that will directly impact about 9.2 million Americans. • www.cdc.gov/communitytransformation/

9. 2012 HHS Environmental Justice Strategy • Strategic Elements • Policy Development and Dissemination • Education and Training • Research and Data Collection, Analysis, and Utilization • Services Vision: “A Nation that equitably promotes healthy community environments and protects the health of all people ”

10. HHS in Action • Strategic Element • Education and Training • Action • Expand and promote educational outreach on health and environmental justice, including continuing education programs, to primary health care and behavioral health care providers, other health professionals, public health professionals and the human services workforce • Examples • HRSA Centers of Excellence for Environmental and Occupational Health • ATSDR Pediatric Environmental Health Specialty Units • www.atsdr.cdc.gov/emes/health_professionals/pediatrics.html

11. Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities Guiding Principles • Coordinate and collaborate across federal agencies, other levels of government, and community partners • Build on existing and effective federal programs and partnerships • Do more of what we know works. Emphasize activities that address the preventable factors that impact asthma disparities www.epa.gov/childrenstaskforce/index.html

12. The National Partnership for Action (NPA) Purpose: To mobilize a nationwide, comprehensive, and community-driven approach to combating health disparities. Five Goals of the NPA: • Awareness • Leadership • Health System and Life Experience • Cultural and Linguistic Competency • Data, Research, and Evaluation National Stakeholder Strategy (NSS): A product of the NPA that offers 20 specific strategies for reaching NPA goals and assists federal, regional, tribal, state, and local stakeholders in adopting effective strategies for their communities. http://minorityhealth.hhs.gov/npa/

13. Making the Connection: Advancing Environmental Justice Through Strategy, Partnership and Action

14. Office of Minority Health U.S. Department of Health and Human Services www.minorityhealth.hhs.gov (800) 444-6472