WIN Measures Update:
Measuring Health Equity
Supported by Well-being and Equity (WE) in the World
�Thursday, May 19, 2022
Presenters: �
Anna Yang, PhD, Postdoctoral Researcher, Center for Health Equity Transformation, Northwestern University
Jennie Chin Hansen, MS, Immediate Past CEO, American Geriatrics Society and Past President of AARP
Miamon Queeglay, Manager of Community Engaged Research and Outreach, Center for Antiracism Research for Health Equity, University of Minnesota’s School of Public Health
Carmenlita Chief, MPH, Sr. Research Associate & Alexandra E.S. Longorio, RDN, Sr. Research Coordinator, Center for Health Equity Research, Northern Arizona University
Welcome and Introductions
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As you join the meeting, please share your name, affiliation, and one item that is on your health equity data wish list in the chat box.
Session Agenda
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Measuring Health Equity
Welcome & Land Acknowledgement
Together, we acknowledge indigenous peoples, on whose ancient and sacred land we live, work, and play. As a community, we recognize the ever-present systemic inequities that stem directly from past wrongdoings, and we commit ourselves indefinitely to respecting and reconciling this long history of injustice.
In the chat, please tell us where you reside!
Who
A strategic network of organizations, individuals, and communities united by common purpose
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Goals
How
We aim to catalyze change through:
What is the Well-Being in the Nation (WIN) Network?
WIN Measure Domains
By applying a racial justice frame to the WIN Measures, we aim to prioritize, develop and restore Black, Indigenous, People of Color (BIPOC) communities using data that tells a complete and transparent story. In order to be effective and explicitly anti-racist, we must go beyond the identification of disparate outcomes across racial groups. We seek to include measures that:�8
8�Further, we seek to disaggregate data, where possible, and apply an intersectional perspective in order to highlight the unique needs and characteristics of each racial and ethnic group.
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What do we mean by racial justice?
By applying an intergenerational wellbeing lens to the WIN measures, we intend to recognize:
�In doing so, we will reflect the complex intersectional nature of the domains, that addressing disparities and inequities will require strategies which will have long term impact over generations, and of the need to develop multi-generational longitudinal measuring strategies.
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What do we mean by intergenerational well-being?
WIN Measures Update Process
Phase 1 Information Gathering | Phase 2 Rate and Prioritize | Phase 3 Refine and Alignment | Phase 4 Report |
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CORE HEALTH MEASURES |
Overall health: % of adults self-reporting fair or poor general health |
Healthy days/month: average # of days in the past 30 days when both physical and mental health were good |
Functional status: # of days where health was reported as a limitation of usual activities |
% of children limited or prevented in any way in their ability to do the little things most children of the same age can do |
Healthy life expectancy (years) |
Deaths due to drug overdose, alcohol, or suicide (# per 100,000 population) |
Infant mortality rate (# deaths per 1,000 live births) |
Low birthweight: % of live births where baby weighted less than 2,500 grams |
% of adults with obesity (BMI 30+) |
% of adults 18+ who smoke, does not include other forms of tobacco |
% of population without medical insurance |
Additional Health Measures | |
Overall health: % of adults self-reporting very good or excellent general health | Depression: % of older adults (Medicare beneficiaries) diagnosed with depression |
Physical health: % of adults self-reporting physical health “not good” for >14 days during the past 30 days | Mental health: % of adults experiencing serious mental health issues/mental illness |
Mental health: % of adults self-reporting mental health “not good” for >14 days during the past 30 days | Childhood vaccination rates: % of children with age-appropriate vaccination between ages 19-35 months |
Physical health: average # of days during the past 30 days adults’ self-reported physical health was not good | Medicare beneficiaries with primary care visit: % of older adults (Medicare beneficiaries) with 1+ preventive care visit within past year |
Mental health: average # of days during the past 30 days adults’ self-reported mental health was not good | Adults with no leisure-time physical activity: % of adults who did not participate in leisure-time physical activities or exercise in the past month |
Maternal mortality rate (# of deaths per 100,000 live births) | % of adults engaging in advance care planning (discussions, proxy selected, advance directive on file) |
Teen pregnancies: % of females age 15-19 who gave birth within the past 12 months | % of residents <65 without health insurance |
Heart disease prevalence: % of older adults (Medicare beneficiaries) diagnosed with heart disease | # of primary care doctors per 100,000 population |
Cancer prevalence: % of older adults (Medicare beneficiaries) diagnosed with cancer | # of dentists per 100,000 population |
Childhood trauma: % of children 0-17 who have 1 or more adverse childhood events (ACEs) | # of mental health providers per 100,000 population |
Public Safety Pre-readings
Health
�As you reflect on the presenters’ remarks today, we would like for you to consider
�What are the opportunities the current moment offers us in terms of health equity measurement?
Reflection: Racial Justice and Intergenerational Well-being
Anna Yang, PhD�Postdoctoral Researcher, Center for Health Equity Transformation�Northwestern University
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Speaker
Live Tweet using #LiftHealthforAll
How we define health equity…
Health equity is the prioritization of historically marginalized and disenfranchised groups in order to extend and provide the fair and just opportunity for access and use of quality health and non-health social services (e.g. housing, education, etc.) that are usually given to privileged persons without discrimination, racism, and additional undue burdens that create and sustain obstacles to health.
Understanding: How does inequity manifest, and what are its root causes?
🡪 What are the social, political, and structural factors contributing to inequity?
Addressing: What progress have we made? What interventions are the most effective?
🡪 How much investment (monetary, labor, and time) is made into ideation, implementation, and evaluation?
How do we understand and measure equity? How can we create equitable systems?
Two part measure:
How do we understand and measure equity? How can we create equitable systems?
Current WIN Measure (sample) | Questions to ask include: |
What is the infant mortality rate throughout the US? |
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Understanding: How do we assess levels of inequality and understand the WHY and HOW? A Community-Based Research Perspective
Measuring social determinants of health: integrating qualitative & quantitative
🡪 1000+ protocols and measures of physical, mental, and social health for
the general population and with individuals living with chronic conditions
🡪 evaluate various SDoH measures including food insecurity, housing
insecurity, transportation barriers, language barriers, health literacy, etc
🡪 critical to yield a rich, robust landscape of lived experiences
🡪 this is where we get to parse out the WHY and HOW
🡪 further breakdown of population-level data
What qualitative data can reveal:
Current WIN Measure (sample) | A fuller picture can look like: |
What percentage of Americans lack health insurance coverage? |
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Addressing: What are major roadblocks in addressing social determinant of health barriers and to achieving equity?
Serious Gaps in:
Adequate screening
Resolution of barriers
Bridge community & research
Greater funding needed
Clinical Level
Structural Level
Case Studies from the Center for Health Equity Transformation
Our qualitative research is characterized by a community-based, design-thinking approach that centers and empowers stakeholders to lift health for all.
🡪 Long-term partnerships with CBOs and FQHCs
🡪 Iterative design, qualitative interview stage before multi-year intervention
🡪 Formulation of community advisory boards to center stakeholder
voices on an ongoing basis, with time and labor compensation
Case Studies from CHET
Novel patient navigation models to address healthcare barriers | |
ELP Immigrants
| BIPOC Mothers
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Live Tweet using #LiftHealthforAll
Thank you!
Jennie Chin Hansen, MS�Immediate Past CEO, American Geriatrics Society�Past President of AARP
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Speaker
Miamon Queeglay�Research Project Manager�University of Minnesota, School of Public Health
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Speaker
Multidimensional Measure of Structural Racism
WIN Measures Listening Session�May 19, 2022
Miamon Queeglay
Manager of Community Engaged Research and Outreach
Center for Anti Racism Research for Health Equity (CARHE)
Measuring and Operationalizing Racism for health Equity
(MORhE) Lab
@MiamonQueegs
@CARHEUMN
The Brooklyn's’ | Brooklyn Park + Brooklyn Center
CARHE's Core Team
Rachel Hardeman, PhD, MPH
Founding Director
Miamon Queeglay
Manager, Community Engaged Research & Outreach
Alyssa Fritz, MPH
Manager of Strategic Partnerships, Policy & Research
Keelia Silvis, MPH
Manager of Communications, Education & Engagement
Raquel Motachwa
MORhELab Coordinator & Graduate Research Assistant
J’Mag Karbeah, MPH
Research Advisor and Doctoral Candidate
Bert Chantarat,
PhD, MPH
Postdoctoral Fellow
Andre Le Blanc, MHA
Deputy Director
Anna Hing PhD, MPH
Postdoctoral Associate
Ladan Mohamed
CARHE Office Manager
Asha Hassan, MPH
Graduate Research Assistant
Katy Kozhimannil, PhD, MPA
Senior Advisor
Paris Adkins-Jackson, PhD, MPH
Senior Fellow
Shekinah Fashaw- Walters, PhD, MSPH
Faculty Affiliate
Odichinma Akosionu, MPH
Graduate Research Assistant
Brigette Davis, PhD, MPH
UCSF Affiliate
Hadija Steen Mills, MPH
Graduate Assistant
Watch: https://youtu.be/Z68qexeAYZo
Structural Racism and Health Inequity
“Macro-level systems, social forces, institutions, ideologies, and processes that interact with one another to generate and reinforce inequities among racial and ethnic groups”
Powell (2008)
Source: Twin Cities Habitat for Humanity
Sources: Twin Cities Habitat for Humanity
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b.
Community Conversations to inform the measurement of structural racism in Minnesota
Framing & Background
Facilitate Community Convenings to discuss what structural racism means for Black people in the Twin Cities urban areas and how it plays out in their lives and elicit critical feedback on the dimensions of the MMSR to understand if they are representative of the lived experience
Objectives
Facilitate community convenings to:
Community-Based Facilitation
When you hear the term structural racism what comes to mind?
Do you believe the availability, or lack thereof, of resources in your community, is a result of structural racism?
Measuring Structural Racism
Multidimensional Measure of Structural Racism
Chantarat T, Van Riper DC, Hardeman RR. The intricacy of structural racism measurement: A pilot development of a latent-class multidimensional measure. EClinicalMedicine. 2021; 101092.
Mutual Aid
Changing the Narrative:
Focusing on Racism, not Race
Thank You!
© 2017 Regents of the University of Minnesota. All rights reserved. The University of Minnesota is an equal opportunity �educator and employer. This material is available in alternative formats upon request. Direct requests to 612-624-6669.
Alexandra E.S. Longorio, RDN�Sr. Research Coordinator�Center for Health Equity Research, Northern Arizona University
Carmenlita Chief, MPH�Sr. Research Associate
Center for Health Equity Research, Northern Arizona University
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Speaker
Breakout Discussion
What key ideas and recommendations emerged during your small group discussion?
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Report Out
We invite you to remain actively involved!
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Domain Listening Session
Topic: Environment & Infrastructure
June 16th, 2022
1:00 pm - 2:30 pm ET
Upcoming Meetings
Transportation
Stay informed about the WIN Measures update process and register for future listening sessions:
https://winnetwork.org/win-measures-updates �
Learn more about the WIN Measures: https://www.winmeasures.org/
Environment & Infrastructure