Category: Health Disparities, Health Equity, Social Determinants of Health

Primary Competency Area

A public health perspective on dismantling systemic racism: What role for health departments?

Course Objective

  • Explain why state and local health departments have the opportunity, mandate, capacity and imperative to take action to dismantle elements of systemic racism that harm health
  • Give examples of specific actions health departments can take to interrupt pathways by which racially disparate access to healthy food, criminal justice policies, and educational policies contribute to the health burdens of Black, Latinx, indigenous, and other populations of color.
  • Identify one or more ways that they can take action now within their institution to strengthen its actions designed to dismantle systemic racism

Date: September 1, 2020

Presenters
Nicholas Freudenberg, DrPH, MPH

Erinn Bacchus, MPH

Craig Willingham, MPH

City University of New York Urban Food Policy Institute


In this month’s Log-in2Learn, participants learn about three distinct approaches to address the intersections between public health and systemic racism in the United States. Dr. Nicholas Freudenburg, DrPH, MPH, discusses the relationship between the key determinants of health and racism and the need to end the inequitable provisions of education, housing and healthcare by creating communities of opportunity. Errin Bachhus, MPH, addresses racism in the criminal justice system and the role of public health organizations. In light of recent incidents of police brutality, she highlights the need to reevaluate the role of police departments and the best ways for health departments to intervene through programs and policy. Craig Willingham, MPH, examines how food policy can be crucial in increasing racial equity. He reviews the Good Food Purchasing Program and other city-wide efforts and shares how they can be targeted at minority groups to help alleviate inequities. Lastly, the speakers suggest a to-do list for public health organizations to actively make changes to current structures, provide creative examples to inspire action and recommend books to further broaden perspectives.

Participants will be able to:

  1. Explain why state and local health departments have the opportunity, mandate, capacity and imperative to take action to dismantle elements of systemic racism that harm health
  2. Give examples of specific actions health departments can take to interrupt pathways by which racially disparate access to healthy food, criminal justice policies, and educational policies contribute to the health burdens of Black, Latinx, indigenous, and other populations of color.
  3. Identify one or more ways that they can take action now within their institution to strengthen its actions designed to dismantle systemic racism.
Buprenorphine Treatment for Opioid Use Disorder during the COVID-19 Pandemic

Course Objective

  • Explain regulatory updates regarding buprenorphine treatment during a public health emergency
  • Describe practice-level changes in buprenorphine treatment throughout COVID-19
  • Discuss common issues affecting patients in buprenorphine treatment during COVID-19

Date: July 7th, 2020

Presenter:
Tiffany Lu, MD, MS
Assistant Professor of Medicine
Montefiore Medical Center / Albert Einstein School of Medicine


In this month’s Log-in2Learn Dr. Tiffany Lu provides an overview of buprenorphine treatment prior to the COVID-19 pandemic and the challenges associated with treatment for opioid use disorder during the COVID-19 pandemic. Dr. Lu describes the communities hardest hit by the COVID-19 pandemic and how the pandemic paved the way for regulation updates regarding buprenorphine treatment such as reduced restrictions and an increased use of telemedicine to treat opioid use disorders. The webinar also addresses some other measures put in place with buprenorphine treatment due to the public health emergency, including: longer prescriptions, halted urine drug testing (self reports), access to naloxone and harm reduction supplies. The presenter also shares available resources to support clinical providers as they face the challenges associated with buprenorphine treatment during the COVID-19 pandemic.

Participants will be able to:

  1. Explain regulatory updates regarding buprenorphine treatment during a public health emergency
  2. Describe practice-level changes in buprenorphine treatment throughout COVID-19
  3. Discuss common issues affecting patients in buprenorphine treatment during COVID-19
Reducing Obesity and Diet-Related Diseases by Limiting Predatory Marketing of Unhealthy Food

Course Objective

Learning Objectives for Part I: Understanding Predatory Marketing

  • Define targeted and predatory marketing.
  • Distinguish between different types of predatory marketing, with examples.
  • Describe digital media avenues used for predatory marketing.
  • Explain how targeted marketing of unhealthy food leads to negative health outcomes, particularly for certain populations.

Learning Objectives for Part II: What Health Departments Can Do to Combat Predatory Marketing

  • Describe ways to increase awareness of predatory marketing in communities.
  • Describe how local, state and federal governments can regulate predatory marketing.
  • List at least 2 actionable strategies for communities to decrease predatory marketing practices.
  • List 3 policy measures that could be taken to limit predatory marketing of unhealthy food at the city/local, state OR national level.

Launch Date: June 30th, 2020

Presenter:
Nicholas Freudenberg, DrPH, MPH
Distinguished Professor of Public Health, CUNY Graduate School of Public Health and Health Policy
Director, CUNY Urban Food Policy Institute


Unhealthy food is the leading cause of premature death and preventable illness around the world today. Predatory marketing makes a significant contribution to this burden. Public health professionals can play an important role in reducing the prevalence and exposure to predatory marketing. This two-part training module develops an understanding of the current landscape of predatory marketing of unhealthy food and beverages, and how it promotes negative health outcomes particularly for vulnerable populations. This program will define the role of health departments in addressing predatory marketing, outline ways health departments can help document predatory marketing in their communities, and provide recommendations and examples of policy engagement activities public health professionals can get involved in.

Learning Objectives for Part I: Understanding Predatory Marketing

  • Define targeted and predatory marketing.
  • Distinguish between different types of predatory marketing, with examples.
  • Describe digital media avenues used for predatory marketing.
  • Explain how targeted marketing of unhealthy food leads to negative health outcomes, particularly for certain populations.

Learning Objectives for Part II: What Health Departments Can Do to Combat Predatory Marketing

  • Describe ways to increase awareness of predatory marketing in communities.
  • Describe how local, state and federal governments can regulate predatory marketing.
  • List at least 2 actionable strategies for communities to decrease predatory marketing practices.
  • List 3 policy measures that could be taken to limit predatory marketing of unhealthy food at the city/local, state OR national level.
Social Inequality and Health Disparities in the COVID-19 Pandemic

Course Objective

  • Identify key trends in health disparities during the COVID-19 pandemic to date
  • Describe how the pandemic exacerbates existing social inequalities
  • Examine several proposed interventions to address health disparities in the pandemic response

Date: June 2nd, 2020

Presenter:
Alexandra Zenoff, MPH.
Senior Program Manager
East-West Management Institute, Inc. (EWMI)


In this month’s Log-in2Learn webinar Alexandra Zenoff discusses the role of structural racism in health disparities, how this affects health outcomes and the need to address it. The COVID-19 pandemic has exacerbated social inequalities and considering the social determinants of health is crucial to alleviating this issue. Drawing insights from historic and current public health efforts can help with designing responses to the COVID-19 pandemic. The importance of building on existing best practices like community consultations and appropriate data collection is discussed. Participants are provided with articles for further learning and resources such as the COVID-19 racial tracker and CDC’s Social Vulnerability Index.

Participants will learn about the following:

  1. Identify key trends in health disparities during the COVID-19 pandemic to date
  2. Describe how the pandemic exacerbates existing social inequalities
  3. Examine several proposed interventions to address health disparities in the pandemic response
COVID19: Using a Health Equity and Human Rights Lens to Protect Vulnerable Populations during this Pandemic and Beyond

Course Objective

  • Discuss why COVID-19 is a health equity issue
  • Identify key principles of the health equity and human rights frameworks to protect vulnerable and marginalized populations during the COVID-19 pandemic and beyond
  • Describe the role of community engagement and advocacy during this pandemic and beyond
  • List sample strategies for transformative and long-lasting change

Date: April 7th, 2020

Presenter:
Renata Schiavo, PhD, MA, CCL
Senior Lecturer, Columbia University Mailman School of Public Health, Department of Sociomedical Sciences
Founder and President, Board of Directors, Health Equity Initiative


In this month’s Log-in2Learn Webinar Dr. Renata Schiavo discusses the challenges faced during COVID-19 through a health equity lens. Pandemics are complex circumstances that thrive on inequalities and weak health and social systems. Vulnerable populations are not able to adequately adhere to safety measures and bear the burden of pandemic impacts. The webinar explores how a Social Determinants of Health approach should be implemented to address inequalities during a pandemic.The course also highlights risk communication, community engagement and advocacy as key strategies to support this agenda.

Participants will will be able to:

      1. Discuss why COVID-19 is a health equity issue
      2. Identify key principles of the health equity and human rights frameworks to protect vulnerable and marginalized populations during the COVID-19 pandemic and beyond
      3. Describe the role of community engagement and advocacy during this pandemic and beyond
      4. List sample strategies for transformative and long-lasting change
A Systems Approach to Understanding Childhood Obesity

Course Objective

By the end of this module, you should know how to:

  • Describe public health as part of a larger inter-related system of organizations that influence the health of populations at local, national, and global levels.
  • Describe different stakeholders with the power to address childhood obesity.
  • Explain how local health departments (LHDs) can use systems thinking approaches while planning intersectoral initiatives to reduce inequities in childhood obesity.

…and see how you can incorporate these concepts in your practice to address a major public health crisis.

This module developed by the Region 2 Public Health Training Center (PHTC) aims to explore how to use problem solving approaches inspired by systems thinking to reduce inequities in childhood obesity.* Systems thinking is a methodological approach that helps us better understand how complex systems operate, and how we can identify leverage points within systems to influence behavior. Since this is a foundational module, our goal is just to introduce how a systems thinking lens can be applied to a major public health issue.

In this module, you will learn how to identify the characteristics of a system in a public health context.

*To learn more about systems thinking, please enroll in the course ‘Introduction to Systems Thinking’, part of the Strategic Skills training series also offered by the Region 2 Public Health Training Center.

Strategies to Advance Health Equity: State and Local Health Departments’ Role in Building Pathways to Higher Education
Group of Diverse Graduates

Course Objective

  • Explain the rationale for expanding public health practice to promote health and equity by supporting access to high-quality, affordable education
  • Summarize evidence documenting how high school and college completion can improve health
  • Describe structural, social, political, and economic barriers to high school and college completion
  • Identify three specific strategies designed to support high school completion, transition to higher education, and college completion to advance health equity
  • Explain how LHDs can leverage “upstream” strategies to support these initiatives, including partnering with other agencies, social movements and community organizations

Date: September 24, 2018

Presenter:
Nicholas Freudenberg
Distinguished Professor of Public Health
City University of New York School of Public Health

Emily Frazosa
Senior Researcher
City University of New York School of Public Health


The relationship between health and education is well documented. However, not everyone in the United States has the same access to high-quality education, which creates wide disparities in high school and college graduation rates and future life success. Additionally, people with more education live longer lives and have lower rates of chronic disease and less drug use, less smoking and better birth outcomes. Advancing health equity means we must work to make sure everyone in our communities has access to equitable, high-quality, affordable educational opportunities. In this module, participants will explore specifically on how high school and college completion influence health, and what prevents students from earning a degree. While high school and college each present some challenges that are different, you’ll see that many of them overlap. Also, learners will review barriers that keep students from academic success, and the public health tools we have to break down those barriers. Lastly, learners will look at real-world examples of how schools, governments and health departments are working to help all students succeed.

Health Disparities in HIV: Supporting Adolescents through the HIV Care Continuum
Hands Hold Red Ribbon

Course Objective

  • Define the adolescent specific HIV-related health disparities in the United States.
  • Describe the individual and structural level factors impeding youth’s progress through the HIV Care Continuum.
  • Identify potential individual and structural level intervention points to support the health of youth living with HIV.

Date: June 5, 2018

Presenter:
Dr. Amanda Tanner
Associate Professor
University of North Carolina Greensboro


This webinar explores the specific challenges associated with ensuring adolescents are able to access HIV screening and treatment. Dr. Amanda Tanner provides background on adolescent’s biological, cognitive, social, and legal changes as they progress to adulthood as well as the disparities of HIV diagnosis and care among adolescents, especially minority youth. This presentation continues with an overview of two studies that investigate care linkage and engagement for youth with newly diagnosed HIV as well as the HIV-related healthcare transition at adolescent clinics. Dr. Tanner provides recommendations for future interventions that will help adolescents know their HIV status, become linked with appropriate care, and maintain viral suppression

Strategies to Advance Health Equity: State and Local Health Departments’ Role in Improving Food Access among Immigrants
Vegetables Spilled Out of Brown Bag

Course Objective

  • Explain the rationale for expanding public health practice to promote health and equity by supporting immigrant access to healthy, affordable food
  • List the major public anti-hunger programs and summarize the eligibility rules that apply to different legal categories of immigrants
  • Describe how individual beliefs, organizational practices, and policies contribute to inequitable access to healthy food and public food benefits between immigrant and US-born populations
  • Explain at least two specific local or state Health Department initiatives designed to improve access to healthy food and food benefits among immigrant populations that could be adapted to the participant’s community
  • Explain how local health departments can leverage “upstream” strategies, including partnering with other agencies, social movements and community organizations, to protect and expand immigrant access to food benefits and services

Date: May 19, 2018

Presenter:
Nicholas Freudenberg
Distinguished Professor of Public Health
City University of New York School of Public Health

Emily Franzosa
Senior Researcher
City University of New York School of Public Health

Emilia Vignola
PhD Candidate
City University of New York School of Public Health


There are currently more than 40 million immigrants living in the US, contributing to our society as workers, taxpayers, caretakers, and neighbors. Many of these immigrants are more likely to be poor than US-born people because of cultural, language, and legal barriers that influence their living and working conditions and access to services. One consequence of this poverty is food insecurity, or not having enough healthy food, which has serious implications for health. As public health professionals, we work to prevent harm and reduce health inequities. When members of our communities struggle to access healthy food, they are at risk for health problems. But they are also limited in their ability to contribute meaningfully to society, which affects all of us. To meet our national health goals, local health departments must work to ensure that everyone in our communities has the opportunities and resources they need for good health – regardless of immigration status.

In this module, participants will:

  • Explore specific challenges immigrants may face in accessing healthy food at the individual, organizational, and policy levels
  • Consider real-world examples of how local health departments can partner with other agencies, community organizations, and activists to overcome these barriers and help immigrants access healthy, affordable food for themselves and their families
  • Strategize about how to adopt similar initiatives in their community and organization
Addressing Unconscious Bias in our Language
Two Thought Bubbles on Blue Background

Course Objective

  • Evaluate your thoughts or behaviors for unconscious bias
  • Explain ways that language use can intentionally or unintentionally contribute to health disparities
  • Describe ways that your organization can work to examine, expand, and alter language regarding patients and clients to provide more equitable care and services

Date: April 3, 2018

Presenter:
Anne Marie Liebel, EdD
Founder and President
Health Communication Partners LLC


As health professionals, it is critical that we reflect and address unconscious bias in our language, especially when working with patient populations. Dr. Anne Marie Liebel discusses how uttering subtle microaggressions can have a cumulative negative effect on health and wellness. Dr. Liebel presents research on the linkages between microaggressions and health disparities. In particular, microaggressions from healthcare providers can negatively impact patient health related behaviors and utilization of health services. Thus, as we recognize our own microaggressions, Dr. Liebel provides individual and organizational strategies to examine, expand, and alter language to provide more equitable care and services.

Region 2 Public Health Training Center