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

Primary Competency Area

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.

#NYCHealthEquity – Advancing Racial and Social Justice
New York City

Course Objective

  • Describe the roles institutions have played in fostering, exacerbating and perpetuating racism and other forms of oppression
  • List the ways institutions can work with neighborhoods and communities to amplify their inherent power to heal together
  • Describe the role public health practitioners have in leveraging their power and privilege to embolden larger movements and coalitions seeking to name injustice and liberate oppressed groups

Date: February 20, 2018

Presenter:
Aletha Maybank, MD, MPH
Deputy Commissioner and Founding Director
Center for Health Equity at the New York City Department of Health and Mental Hygiene (DOHMH)


For one to have a true commitment to health equity, it is critical to engage with the political, social, and historical context of structural racism within our society. The history of slavery and segregation is deeply embedded within public policies which has fostered neighborhood underdevelopment, increased incarceration rates, and health disparities among minority and ethnic populations. Dr. Aletha Maybank, Deputy Commissioner and Founding Director of the Center for Health Equity at the New York City Department of Health and Mental Hygiene (DOHMH) discusses the work of the Center for Health Equity to decrease health disparities and create an equitable and thriving city for all. The DOHMH and Center for Health Equity use a racial justice lense to build organizational capacity to advance racial equity through data visualization, community engagement, neighborhood investment, and public policy. Dr. Maybank discusses a neighborhood place-based approach which leverages past public health practices by implementing evidence-based interventions to provide coordinated health promotion services, clinical services, and community resources to increase community access to goods and services and close coverage gaps. Dr. Maybank discusses the importance of working with sister agencies to advance the health equity agenda and emphasizes the importance of multi-sectoral partnerships to promote community change.

Moving Beyond ‘Socioeconomic Status’ to Social Class Processes in Public Health
Scale with Illustrated People on Both Sides

Course Objective

  • To distinguish between socioeconomic status and class
  • To describe stratificationist, Weberian, and Marxian theoretical approaches to social inequality
  • To describe what it means to apply a class perspective to psychiatric epidemiology research
  • To explain the impact of social inequality on mental health from multiple theoretical perspectives

Date: September 5, 2017

Presenter:
Seth Prins, PhD, MPH
Postdoctoral Research Fellow
Department of Sociomedical Sciences and Department of Social Work, Columbia University


It is well known that there is a “social gradient of health,” or an inverse relationship between socioeconomic status and physical and mental health. However, most public health professionals conceptualize socioeconomic status using a stratificationist theoretical approach, but this neglects critical factors. In this webinar, Dr. Seth Prins discusses two other relational theoretical approaches to conceptualizing socioeconomic status: Weberian and Marxian. He discusses how these approaches impact our understanding of socioeconomic status and class on mental health, including depression and anxiety, and some of their mechanisms and causal pathways. Dr. Prins also describes epidemiological research into mental health and and how these social determinants of health manifest in the modern workforce.

Engaging Across Sectors and Disciplines to Build Community and Capacity for Health Equity
Illustration of Diverse Occupations

Course Objective

  • Define community
  • Engage in multi-sectoral partnerships and interventions for health equity
  • Implement strategies within your organization to advance health equity

Date: September 5, 2017

Presenter:
Dr. Renata Schiavo, PhD, MA, CCL
Founder and President
Health Equity Initiative


Disparities in health and healthcare are connected to population health and affect the delivery, access and quality of care, especially for vulnerable populations. There are social determinants (i.e. housing, built environment, age) that can negatively affect health outcomes. Dr. Renata Schiavo, Founding President of the Health Equity Initiative (HEI), discusses how professionals across sectors and disciplines can collaborate to build healthier communities. The term health equity is defined and framed as a human rights and social justice issue that will provide individuals with the same opportunities to stay healthy and cope with crises, regardless of socioeconomic factors and other social determinants. Regardless of status, Dr. Schiavo views health equity as a priority for all and uses case studies to exemplify how multi-sector partnerships can effectively mobilize communities to reduce health disparities and healthcare costs. By working with communities and using community engagement approaches, these multi-sector partnerships can foster community ownership and sustainability of health innovations. Dr. Schiavo also provides methods and strategies to bring multidisciplinary stakeholders together in order to develop sustainable, equitable solutions.

Strategies to Advance Health Equity: How Health Departments Can Grow a Healthy Public Food Sector
Black Women and young Girl in Produce Section Smiling

Course Objective

  • Explain and define the scope of the public, the private (market) and the non-profit (civil society) sectors in making healthy food more available and affordable.
  • Identify the various functions that the public sector plays in making healthy food available and affordable including: procurement, institutional food, taxation, enforcing food safety standards, regulating retail food outlets and restaurants , and providing food benefits(e.g., SNAP,WIC and school food).
  • Distinguish roles of local, state and federal governments in public sector food and identify food-related responsibilities of various government sectors including health, education, agriculture, environmental protection, economic development, zoning and land use, and consumer protection.
  • Describe innovative practices, policies and programs of state and local health departments in supporting public sector initiatives to increase access to healthy affordable food and reduce racial/ethnic, socioeconomic and other inequalities in diet-related diseases.
  • Describe governance mechanisms for engaging citizens, social movements, advocacy groups and others in using the public sector to shape healthier food environments.
  • Assess the scope and strengths and weaknesses of their own health department’s food portfolio and identify ways their department could use existing resources and mandates to strengthen the public sector’s role in making healthy food more affordable and accessible.

Date: August 17, 2017

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

Fen Yee Teh
MPH Candidate
City University of New York School of Public Health


This self-paced, interactive module prepares public health professionals working in state and local health departments to develop or support food policy changes in their communities to encourage healthy food systems. The session begins with a discussion of why the public sector should be involved in developing policies around food and how local health agencies can lead the charge. Next, learners will learn about food system goals that can promote health and how to achieve those goals. Finally, learners will explore case studies that demonstrate how public health agencies have planned and implemented changes to their food systems.

Strategies to Advance Health Equity: How Health Departments Can Protect the Health of Immigrants
Father with Son on Shoulders

Course Objective

  • Describe evidence documenting major health challenges facing immigrants in the United States
  • Explain the pathways by which immigration policy can influence the health of immigrant populations
  • Identify specific strategies that state and local health agencies can adopt to improve health for immigrant populations
  • Describe at least three specific local or state initiatives designed to improve the health of immigrant populations that could be adapted to the participant’s community
  • Explain how LHDs can leverage “upstream” strategies, including partnering with other agencies, social movements and community organizations, to design implement these initiative

Date: August 4, 2017

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

Eleni Murphy
MPH Candidate
City University of New York School of Public Health


This self-paced, interactive module prepares public health professionals working in state and local health departments to develop or support health care, social services, and public health programs to protect the health of immigrants. This session begins with an introduction to immigration policy and its relationship to health as well as local strategies to protect immigrant health. Next, learns will explore three case studies that highlight real policy changes governments have implemented to create more immigrant inclusive communities. During these case studies, learners will have time to reflect on ways their organization can partner with government agencies to support immigration health.

Region 2 Public Health Training Center