Category: Systems Thinking

Strategic Skill Area

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
Is Gun Violence a Public Health Issue?
Shadow of Someone Pointing a Gun

Course Objective

  • Describe and explain firearm violence as a major social and health problem
  • Describe how conceptual models (e.g. Haddon Matrix, social ecological model, etc.) are used to portray the multiple factors underlying violence
  • Identify factors that influence the likelihood and severity of violence

Date: November 15, 2017

Presenter:
Bernadette C. Hohl, PhD, MPH
Assistant Professor
Rutgers School of Public Health


In 2016, the AMA adopted policy calling gun violence “a public health crisis” requiring a comprehensive public health response. In 2012 the American Academy of Pediatrics reaffirmed and expanded 2 older policy statements on gun violence. But is gun violence a public health issue? This presentation will describe the issue of gun violence using a public health approach: that includes: defining the problem, identifying risk and protective factors, and evidence based interventions.

Auditing as a Tool for Managing Environmental Improvement
Person Looking at Graph

Course Objective

  • Identify key components of an environmental compliance auditing regimen
  • Understand the impact of compliance auditing on environmental quality

Date: September 28, 2017

Presenter:
Howard N. Apsan, Ph.D.
University Director
Environmental, Health, Safety, and Risk Management, City University of New York


CUNY entered into a five-year audit and disclosure agreement with the U.S. Environmental Protection Agency. This forced CUNY to adjust to the rigors of an intensive compliance auditing regimen, but it also helped make environmental quality an integral part of the CUNY culture. Today, long after the original commitments were fulfilled, CUNY continues to conduct audits—now including health and safety and environmental management system components, as well—and uses the audit process as a fundamental tool for continual improvement.

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.

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.

Crossing the Quality Chasm in Public Health
Illustration Showing Efficiency, Cost and Quality

Course Objective

  • Define the components of continuous quality improvement (CQI) and describe its applications.
  • Articulate the rationale for recent promotion of quality improvement frameworks in public health policy and practice.
  • Identify resources, including online training opportunities, to assist in the incorporation of CQI into your public health practice .

Date: December 21, 2016

Presenter:
Thomas I. Mackie
Assistant Professor, Department of Health Systems and Policy
Rutgers University School of Public Health


This presentation will provide an introduction to a continuous quality improvement framework, the rationale for promotion of quality improvement in policy and practice, and tools and resources to facilitate incorporation into your public health practice.

Public Health and Mental, Emotional, and Behavioral Health Webinar Series, Part IV: Transformation of New York Mental Health System to A Medicaid Managed Care Model
Paper Cut Out

Course Objective

  • Describe the role of managed care and behavioral health integration for addressing the needs of individuals with mental health challenges.
  • Identify critical elements for health plan engagement with mental health services in Managed Care.
  • Explain Health and Recovery Plans (HARP Services) in Medicaid Managed Care and how community work force can work to integrate HARP Services into health care.

Date: September 22, 2016

Presenter:
Glenn Liebman
CEO
Mental Health Association in New York State, Inc.


In this webinar, Glenn Liebman of the Mental Health Association in New York State discusses the transformation of the New York State mental health system into a Medicaid managed care model. Mr. Liebman provides a historical context for the reform, describes the changes that will occur to funding streams as a result of the reform, and implications of these changes.

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.

Region 2 Public Health Training Center