This resource guide contains and references a variety of documents designed to strengthen organizational and chapter efforts to more effectively have input in the national and local health care delivery system.
Advocacy is necessary to achieve economic, social, health, and racial equity. These resources will assist in a guided pathway to move data to action with supportive tools to guide advocacy for policy reform.
WHAT IS ADVOCACY?
Health advocacy can take various forms. The Robert Wood Johnson Foundation (RWJF) defines advocacy as necessary multi-step process for reaching equity:
– Identify an issue
– Organize and build a coalition
– Make a case through facts and data
Draw attention to the issue to work towards a solution Read more
HOW TO CREATE A CULTURE OF HEALTH ACTION AND EQUITY?
First, advocate must value racial equity as an essential and necessary component of health equity. Additionally, to catalyze a national and local movement toward improved health, well-being, and equity we must:
HOW TO LEVERAGE THE NAHSE NETWORK?
NAHSE is a non-profit association of Black health care executives comprised of members representing over 500 companies including approximately 10 of the largest health systems in the United States and over 30 federally qualified health centers.
Our membership represents over 45 states and nearly 200 countries equating to 20 million patient population. Membership ranges from C-suite and senior executives to students. Opportunities for advocacy includes:
– Affiliations with a NAHSE local chapter for local education and
– Access to NAHSE’s Annual Educational Conference
– Programming for CEO/Senior Executive
RWJF advocacy explained: https://www.rwjf.org/content/dam/farm/toolkits/toolkits/2012/rwjf72841
RWJF building a culture of health action framework to catalyze a national movement toward improved health, well-being, and equity:
-Making Health a Shared Value
-Fostering Cross-Sector Collaboration
-Creating Healthier, More Equitable Communities
-Strengthening Integration of Health Services and Systems
-Improved Population Health, Well-being, and Equity
2.Infant mortality has long been viewed as a synoptic indicator of the health and social condition of a population.
Gortmaker, S. L., & Wise, P. H. (1997). The first injustice: socioeconomic disparities, health services technology, and infant mortality. Annual Review of Sociology, 23(1), 147-170.
3.There are substantial race and ethnic disparitiesin fetal and infant mortality and preterm birth, with non-Hispanic black women at greatest risk of unfavorable birth outcomes, followed by American Indian and Puerto Rican women.
MacDorman, M. F. (2011, August). Race and ethnic disparities in fetal mortality, preterm birth, and infant mortality in the United States: an overview. In Seminars in perinatology (Vol. 35, No. 4, pp. 200-208). WB Saunders.
4.In the United States, the infant mortality rate is 6.7 deaths per 1,000 live births, the stillbirth rate is 6.2 per 1,000 deliveries, and the preterm birth rate is 12.8% of live births. The rates among non-Hispanic African Americans are dramatically higher, nearly double the infant mortality at 13.4 infant deaths per 1,000 live births, nearly double the stillbirth rate at 11.1 stillbirths per 1,000 deliveries, and one third higher with preterm births at 18.4% of live births.
Spong, C. Y., Iams, J., Goldenberg, R., Hauck, F. R., & Willinger, M. (2011). Disparities in perinatal medicine: preterm birth, stillbirth, and infant mortality. Obstetrics & Gynecology, 117(4), 948-955.
5.There has never been a time, in the history of the country, that the health status of minorities has been equal to that of Caucasians (Geiger, 2003; Byrd and Clayton, 2000; National Center of Health Statistics, 2003). Minorities live six years shorter than a person of the social majority born at the same time in the same place (National Center for Health Statistics, 2003). Yet, the difference in DNA between one human to any other human on the planet is only half of a percent (Berg et al., 2015). The disparity in health care is not attributed to physical or biological differences between races, but to social and cultural barriers.
6.Racial/Ethnic Comparison of Infant Mortality. Note. Data from T. J. Mathews, F. Menacker, & M. F. MacDorman. (2004). Infant mortality statistics from the 2002 period linked birth/infant death data set. National Vital Statistics Reports, 53(10). Copyright 2004 by the National Center for Health Statistics.
7.“Social inequalities in infant mortality have persisted and remained marked, with the disadvantaged ethnic and socioeconomic groups and geographic areas experiencing substantially increased risks of mortality despite the declining trend in mortality over time. Widening social inequalities in infant mortality are a major factor contributing to the worsening international standing of the United States.”
Singh, G. K., & Stella, M. Y. (2019). Infant mortality in the United States, 1915-2017: large social inequalities have persisted for over a century. International journal of MCH and AIDS, 8(1), 19.
8.The fact that the risk of a pregnancy-related death for black women in some regions of the United States is similar to risk for women in some developing countries has alarmed health professionals, patients, and policy makers. The American College of Obstetricians, and Gynecologists, Society for Maternal Fetal Medicine, the Council on Patient Safety in Women’s Health Care, and Maternal Child Health Bureau are a few of the many health advocacy and health professional organizations now committed to policies to reduce these disparities.
Council on Patient Safety in Women’s Health Care. Alliance for Innovation on Maternal Health (AIM) [Accessed August 26, 2017]; Safe Health Care for Every Woman. 2015 http://www.safehealthcareforeverywoman.org/aim.php.
9.To date a great deal of research has demonstrated that nearly half of severe maternal morbidity events and maternal deaths are preventable making quality of healthcare a critical lever to address racial and ethnic disparities in their occurrence.
Braveman P. What are health disparities and health equity? We need to be clear. Public Health Reports. 2014;129(1_suppl2):5–8.
10.The model highlights the importance of social determinants and includes patient factors (e.g., socioeconomic status, race and ethnicity, gender, behaviors, beliefs, biology, genetics), community and neighborhood factors (e.g., social networks and built environment, housing,), provider factors (e.g., knowledge, implicit bias, communication) and system factors (e.g., access to high quality care, structural racism, social and political policies, healthcare institutions).
Warnecke RB, Oh A, Breen N, et al. Approaching health disparities from a population perspective: The National Institutes of Health Centers for Population Health and Health Disparities. Am J Public Health. 2008 Sep;98(9):1608–1615.
Kilbourne AM, Switzer G, Hyman K, Crowley-Matoka M, Fine MJ. Advancing Health Disparities Research Within the Health Care System: A Conceptual Framework. Am J Public Health. 2006 Dec 1;96(12):2113–2121.
11.The persistence of racial inequities in health should be understood in the context of relatively stable racialized social structures that determine differential access to risks, opportunities, and resources that drive health. This system of racism, chiefly operating through institutional and cultural domains, is a basic or fundamental cause of racial health inequalities.
Link, B. G., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of health and social behavior, 80-94.
12.Many studies have examined potential determinants of these disparities, ranging from individual level-factors such as sociodemographic or economic characteristics and health behaviors to contextual factors such as county-level poverty, residential racial segregation, or availability of health services.
MacDorman MF, Mathews TJ. The challenge of infant mortality: have we reached a plateau? Public Health Rep. 2009; 124:670–681.
Hauck FR, Tanabe KO, Moon RY. Racial and ethnic disparities in infant mortality. Semin Perinatol. 2011; 35:209–220.
Sparks PJ, McLaughlin DK, Stokes CS. Differential neonatal and post-neonatal infant mortality rates across US counties: the role of socioeconomic conditions and rurality. J Rural Health. 2009; 25:332–341.