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

Primary Competency Area

Moving Public Health Practice Upstream: The Role of Local Health Departments in Protecting Immigrant Health
Illustration of Colorful People

Course Objective

  • Explain the definition of “working upstream” in public health
  • Identify barriers and benefits to “working upstream”
  • Describe the “upstream” factors that impact the health of immigrants in America
  • Explain state and local strategies to promote inclusion and the role of the health department in those strategies
  • Describe the unique barriers that “new Americans” may face when accessing services in communities

Date: June 6, 2017

Presenter:
Emily Franzosa, DrPH, MA
Senior Researcher
CUNY Graduate School of Public Health and Policy


Immigrants face many unique challenges in accessing the same public services and rights that non-immigrants may take for granted. This includes challenges in accessing health care, education, public benefits, and workers rights and protections. These challenges are largely due to “upstream” factors such as governmental policies, which means that it is very important for public health professionals to also work “upstream. In this webinar, Dr. Emily Franzosa discusses the barriers and benefits of working “upstream,” specifically in relation to immigrant health. She describes some state and local strategies to promote inclusion and improved access to resources, and the role of the health department in these strategies. Examples of inclusive services through New York’s Municipal ID (NYCID) program, Nashville’s Welcoming America program, DACA, and Pre-Health Dreamers (PHC) are also discussed.

Asian Health Disparities and Hepatitis B in the Era of Elimination
Hepatitis B Vaccine Bottle

Course Objective

  • To describe health disparities that affect Asian communities
  • To describe the factors that contribute to health disparities among Asian communities
  • To list the growing health issues that affect Asian populations

Date: May 3, 2017

Presenter:
Su Wang, MD, MPH
Medical Director
Center for Asian Health, Saint Barnabas Medical Center


More than half of the people infected with hepatitis B in America are Asian, despite this population having above average education and income. This leads to their increased incidence of and mortality from liver cancer. As many as 2 out of 3 patients with chronic hepatitis B may be unaware they are infected because it is often asymptomatic and doctors are underscreening. Dr. Su Wang discusses the disparities faced by the Asian population around hepatitis B and its associated complications, with a particular focus on the Asian population in New Jersey and the community partnerships that have been formed there to increase screening, vaccination, and treatment of hepatitis in this population. These disparities are a result of a combination of factors, including language barriers, cultural health traditions, being less likely than other ethnic groups to practice preventive care, and general clinical disparities (such as the diabetes epidemic occurring in this population). Dr. Wang also details the work being done by the WHO and the World Hepatitis Alliance in the #NoHep campaign in their effort to eradicate the public health problem of hepatitis B and hepatitis C by 2030.

Structural Factors and Sexual Orientation Health Disparities in Adolescent Substance Use: A Multi-level Analysis
Male Passing Female Drugs

Course Objective

  • Explain why it is important to understand structural causes of health disparities among sexual minority youth.
  • Describe why substance use disparities might be a large and persistent cause of disparate morbidity among sexual minority youth.
  • List potential outcomes to expect for sexual orientation substance use disparities among youth given the changing political landscape.

Date: December 6, 2016

Presenter:
M. Somjen Frazer
PhD Student, ABD in Sociomedical Sciences
Columbia University Mailman School of Public Health


In this webinar, Ms. Frazer discusses the substance use disparities among sexual minority youth, specifically in the realms of tobacco, alcohol, and marijuana and other drugs. She discusses why these disparities exist, and explores what the structural determinants of these disparities are, including structural stigma and policy environments.

Critical Consciousness-based Health Promotion Interventions for Racial and Sexual Minority Populations
Two Black Men Laughing

Course Objective

  • Define Critical Consciousness
  • Describe the Mobilizing our Voices for Empowerment (MOVE) intervention for young Black gay/bisexual men living with HIV
  • Discuss current and future critical consciousness intervention research

Date: November 1, 2016

Presenter:
Patrick Wilson, PhD
Associate Professor Sociomedical Sciences
Columbia University Mailman School of Public Health


Critical Consciousness involves becoming aware of the broader social, political, and cultural forces that perpetuate oppression and inequality. Helping to raise individuals’ awareness and recognition of such forces in their daily lives can fuel empowerment, self-esteem, and other precursors to positive health behavior change. In this webinar, Dr. Patrick Wilson will discuss how critical consciousness can be used to support behavior change interventions for marginalized groups, such as black MSM youth.

Safety and Respect for All: Providing a Supportive Environment for LGBT Individuals and Families During a Disaster
Family in Therapy Session

Course Objective

  • Distinguish between sexual orientation and gender identity / expressions and identity terminology currently being used
  • Identify and promote protective factors for sexual minorities
  • List knowledge, attitudes and skills needed to create a safe and inclusive environment

Date: September 21, 2016

Presenter:
Phil McCabe, CSW, CAS
Rutgers School of Public Health and Rutgers School of Nursing


Public health emergency response activities, including disaster response such as sheltering, are a core function of local and state governmental public health. It is important that public health professionals recognize the unique needs of the many community groups they serve. With an emphasis on cultural competency, this session addresses the unique needs of the LGBTQ community, and suggests ways in which public health can work to provide a safe environment for members of that community during disasters.

Supportive Housing to Address Social Determinants: Cross-sector Collaborations and Funding Possibilities
Man Sleeping Outside on Ground

Course Objective

  • Gain a better understanding of housing as a key social determinant and the impact housing interventions have had in healthcare outcomes and costs
  • Learn about strategies to effectively understand, target and define frequent user population for population health interventions
  • Identify key stakeholders to implement a frequent user initiative including key lessons learned, challenges and best practices

Date: September 6, 2016

Presenter:
Kristen Miller
Director
Corporation for Supportive Housing


In this webinar, Kristen Miller, Director of Corporation for Supportive Housing, discusses housing as a social determinant of health, describes the supportive housing model, and provides examples of how to use data to identify and target individuals in need of supportive housing.

Strategies to Advance Health Equity: How Health Departments Can Promote Living Wages
Words on a Page

Course Objective

  • Explain the rationale for expanding public health practice to change living conditions to promote health and equity;
  • Consider action on living conditions to be part of their scope of work;
  • Identify some of the conceptual and organizational obstacles state and local health departments face in addressing living conditions;
  • Explain how to apply the “upstream” strategies to define and achieve feasible goals in their own practice.

Date: August 8, 2016

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


The social determinants of health, or the structures and economic systems that shape patterns of wellness and illness, can be considered “upstream” that then influence downstream factors like obesity and teen pregnancy. Upstream factors are broad, deeply entrenched in our society, and can appear daunting to change. While public health often focuses on individual-level health behaviors, this approach requires a high level of effort from the targeted individual and has little influence on widespread population health. Health departments are increasingly moving upstream to tackle the core issues that affect the communities they serve. Income is one upstream factor that has a large impact on health and wellbeing. This module details how raising the minimum wage is a public health issue and provides a case study of one health department that used research, communication, and advocacy to influence an upstream factor of health.

Housing as an Intermediary Determinant of Health and Points of Intervention to Reduce Disparities
Person Sleeping on Bench by Water

Course Objective

  • Understand the importance of housing and housing systems as intermediary determinants of health.
  • Identify opportunities for public health policy and programmatic points of action in housing and housing systems to improve individual and community health.
  • Learn from cross-sectoral initiatives involving local and state health departments that have targeted housing and residential environments as strategic points of intervention.

Date: July 5, 2016

Presenter:
Angela Aidala, PhD
Research Scientist, Sociomedical Sciences
Columbia University Mailman School of Public Health

Robert E. Fullilove, EdD
Professor, Sociomedical Sciences
Columbia University Mailman School of Public Health


Housing is where our economic, social, and personal lives come together. In this webinar, Dr. Angela Aidala and Dr. Robert Fullilove discuss housing as an intermediary social determinant of health and health equity. Fundamental determinants of health are macro-level cultural and economic policies, practices and dynamics that affect the socioeconomic position of individuals, groups and communities. These determinants operate directly on us through more proximal ‘intermediary’ determinants like housing to shape health outcomes. Housing links upstream fundamental determinants of health to the more immediate physical and social environments in which we live our lives.

Sex Differences in the Relationship between Social Stressors and Obesity
Person Stepping on Scale

Course Objective

  • Describe the challenges in defining social stressors across the life course
  • Explain the importance of examining sex differences and the effect of social stressors on obesity
  • List the potential mechanisms by which social stressors impact obesity

Date: April 5, 2016

Presenter:
Shakira F. Suglia, ScD, MD
Associate Professor, Epidemiology
Columbia University Mailman School of Public Health


In this webinar, Dr. Suglia provides an overview of the physiological responses to stressors and their relationship to obesity. Stressors have a significant impact on mental and physical health, with high levels of stress associated with eating disorders and obesity. There is also a sociodemographic gradient within this relationship, meaning that individuals with low SES experience a greater number of social risk factors and suffer more frequently from obesity. This disparity is also seen between genders, with girls and women experiencing more stress than their male counterparts.

Breast Cancer Screening and other Health Behaviors among Latinas
Breast Cancer X-Ray

Course Objective

  • Explain why it is important to consider the heterogeneity of Latino groups in the United States
  • Describe some of the challenges inherent in the concept of acculturation
  • Describe the controversies regarding fatalism and cancer screening

Date: March 1, 2016

Presenter:
Ana Abraido-Lanza, PhD
Associate Professor, Sociomedical Sciences
Columbia University Mailman School of Public Health


In this webinar, Dr. Ana Abriado-Lanza gives an overview of the break down of the Latino population living in the United States, linking these statistics to breast cancer screening disparities between Latinas and non-Hispanic whites. Through description of relevant evidence-based literature and her own research, Dr. Lanza identifies cultural and structural factors that impact screening rates and breast cancer morbidity and mortality. She concludes by specifying rich areas for future research in addressing Latino health disparities related to cancer screening, smoking, and physical activity.

Region 2 Public Health Training Center