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

Primary Competency Area

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

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

Kristen Miller
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

Reviewed June 30, 2020

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

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

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

Reviewed June 30, 2020

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.

“School to Prison” to “School Again:” Preparing a New Workforce to Address Health Disparities
Handcuffs on Stack of Books

Course Objective

  • Describe what is needed to develop a public health concentration for any new program that focuses on the education and training of inmates
  • Describe how current ‘pipeline’ programs to increase the participation of underrepresented minority students can be adjusted to create a pipeline for students in prison
  • Describe how evaluation studies can assist in the creation of programs designed to alter the school-to-prison pipeline

Date: January 27, 2016

Reviewed June 30, 2020

Robert Fullilove, EdD
Professor of Sociomedical Sciences
Associate Dean, Community and Minority Affairs
Columbia University Mailman School of Public Health

Mass incarceration is one of the leading contributors of health disparities, with a disproportionately large percentage of African American and Latino men experiencing incarceration during their lifetime. Having ever served time makes finding a job, securing housing, and utilizing health care services significantly more difficult, if not impossible. While the United States prison system is meant to “rehabilitate” inmates, many who are released have no education, no job, and no home, and are forced to resort to criminal activities, leading to high recidivism rates. This webinar raises the importance of educational programs for inmates as an effective tool for improving outcomes after release and reducing recidivism. Dr. Fullilove discusses his experience with the Bard Prison Initiative and his vision for a public health prison education system that would educate and recruit inmates as community public health workers striving to improve health and reduce disparities within their own neighborhoods after their release.

From Concepts to Practice: Health Equity, Health Inequities, Health Disparities, and Social Determinants of Health
Illustration of Different Colored People Standing in a Group

Course Objective

  • Define key concepts, including health equity, health inequities, health disparities, and social determinants of health.
  • Explain the relationship between health equity, health inequities, health disparities, and social determinants of health.
  • Compare and contrast the concepts of health equity, health inequities, health disparities, and social determinants of health.
  • List appropriate strategies that public health professionals can use to address health disparities and social determinants of health in order to achieve health equity.
  • Appreciate the importance of using strategies to advance health equity.

Date: December 22, 2015

Region 2 Public Health Training Center with subject matter expertise from the Center for Health Equity at the New York City Department of Health and Mental Hygiene

This is an introductory online module on the topic of health inequities, health disparities, and social determinants of health.

Investigation of Causes of Higher Mortality among African American Breast Cancer Patients
Breast Cancer Scan

Course Objective

  • Describe how the temporal trends in breast cancer incidence and mortality compare between African Americans and European Americans in the past 30 years.
  • List the potential causes of growing racial disparity in breast cancer mortality.
  • Provide rationale for targeting patients or the health care system in order to reduce the excess breast cancer death rate among African Americans.

Date: November 10, 2015

Reviewed June 30, 2020

Kitaw Demissie, MD, PhD
Professor and Chair, Department of Epidemiology
Director, Institute for the Elimination of Health Disparities
Rutgers School of Public Health, Rutgers Biomedical Health Sciences

In this webinar, Kitaw Demissie reviews prominently cited causative factors and confounders that produce the longstanding high mortality trends seen in African American breast cancer patients as compared to Whites/European Americans. Place (urban vs suburban environment), race and ethnicity, socioeconomic status, and family history influence many African American individuals’ self-efficacy to screen for and readiness to accept a breast cancer diagnosis. Differential care and later-stage diagnoses also affect mistrust of provider ability and honesty regarding treatment regimens, becoming barriers to African American women’s uptake and adherence to breast cancer treatment. Demissie reviews quantitative research and qualitative triangulation data to assess these factors influencing diagnosis and treatment. He suggests African American breast cancer survivors may have a convincing role to play in future research and interventions directed toward encouraging adherence and early diagnosis.

Moving Public Health Practice Upstream to Reduce Inequities
Illustration of Stick Figures

Course Objective

  • Describe why public health practitioners should take on “”upstream”” or distal causes of ill health
  • Describe how public health professionals in state and local health departments can take action on “”upstream”” or distal causes of ill health
  • Describe how public health professionals can become allies of current social movements to advance the efforts for health equity

Date: September 1, 2015

Reviewed June 30, 2020

Nicholas Freudenberg, DrPH
Distinguished Professor of Public Health, Faculty Director
New York City Food Policy Center at Hunter College, City University of New York School of Public Health and Hunter College

Traditional public health focuses on downstream forces – those that influence individual behavior rather than those that put people at risk – such as housing, living conditions, air quality, income inequality. These are the things social epidemiologists call the “causes that cause”. In this webinar lecture, Dr. Freudenberg expounds five strategies public health practitioners may use to tackle upstream influences on health in order to challenge health inequities. Skill development and establishing collaborative exchanges with social movements, putting data into the hands of people who can use them in political arenas, and recognizing our own roles as citizens outside of our public health identities are a few of the suggested approaches in this talk. Dr. Freudenberg also discusses the challenges of applying these strategies in public health practice despite the substantial political and social risk often inherent in taking action.

Region 2 Public Health Training Center