A Roundtable on Cross-Sector Collaboration and Resource Alignment for Health Equity: Meeting Summary

Cross-sector collaboration is a highly recommended strategy to eliminate health inequities nationally and globally. In the federal sector, it is evolving into an important approach for solving complex social problems, as evidenced by its steady proliferation the past few decades. Despite the increased adoption of cross-sector collaboration, it is still not a default strategy or preeminent option for managing complex social problems. In September 2015, the Federal Interagency Health Equity Team (FIHET) hosted a Roundtable event to discuss opportunities and strategies to foster widespread adoption of cross-sector collaboration and resource alignment. The Roundtable featured several expert panelists and participants from the government sector, foundations, and communities, and explored issues, barriers, and innovation in this area of practice. Key recommendations from the Roundtable centered on mission alignment, increasing investments in infrastructure and capacity building, establishment of common language and goals, and embracing innovation to overcome institutional barriers. Participants also offered recommendations to improve funding infrastructure and requirements, increase information access, and foster cross-sector collaboration at the local level

Mapping the Alignment of Programmatic Mission, Functions and Outcomes with the Attainment of Health Equity: An Overview of the Approach and Initial Outcomes through the Lens of the USDA’s CYFAR SCP Program

Eliminating health disparities is a priority across national agenda and initiatives such as the National Partnership for Action to End Health Disparities (NPA), the National Prevention Strategy, and Healthy People 2020. To advance this priority under the NPA, the Federal Interagency Health Equity Team (FIHET), which is an NPA federal cross-sector and collaborative platform, initiated a voluntary pilot “health equity mapping” exercise in 2014. This exercise served as a strategy to clarify the strategic alignment between participant federal partner program missions, goals, and activities, and the goal to end health disparities and promote health equity. The mapping process included an examination of how participant programs applied the “equity lens” within the context of executing their missions. It also included identification of opportunities within participant programs to enhance the existing equity lens, or include one where it did not exist. In this paper, we exemplify this strategy and its outcomes using a case study approach conducted in collaboration with the “Children, Youth, and Families at Risk Sustainable Communities Program” (CYFAR SCP) in the Division for Youth and 4-H, at the National Institute of Food and Agriculture, within the US Department of Agriculture (USDA). Overall, we deduced that the CYFAR SCP program though not driven by an explicitly stated health equity mandate promotes health equity through existing programming. Specifically, we found evidence of the use of an equity lens in how the program targets resources and specific programs to benefit youth that are socially and economically disadvantaged. We also noted alignment between CYFAR SCP’s mission and promoting health equity in the program’s emphasis on improving the social determinants of health for its beneficiaries. Given these initial findings, we conclude that health equity mapping is a potentially insightful first line of inquiry into the tangible connections between a program’s mission, functions and implementation, and the promotion of health equity

Implementation of the National Partnership for Action to End Health Disparities: A Three-Year Retrospective

In April 2011, the U.S. Department of Health and Human Services’ (HHS) Office of Minority Health (OMH) launched the National Partnership for Action to End Health Disparities (NPA) to increase the effectiveness of efforts to eliminate health disparities by coordinating partners, leaders, and stakeholders committed to action. At its core, the NPA is an experiment in collaboration that relies heavily on those on the front line who are actively engaged in minority health work at multiple levels. It gives them the responsibility of identifying and helping to define core actions, new approaches, and new partnerships that ultimately will help to close the health gap in the United States. This paper provides a retrospective examination of the NPA’s creation and development of health equity coalitions at the federal and regional levels and its establishment of strategic national partnerships to move a health equity agenda forward. The article explores how the development of this infrastructure has, in turn, led to the implementation of actions and activities to address health disparities. The article concludes with a reflection on emerging opportunities for improvement and ways forward to continue the initiative’s evaluation and secure its sustainability

An Assessment of Funding and Other Capacity Needs for Health Equity Programming Within State-Level Chronic Disease Programs

Background: Chronic diseases are an important contributor to morbidity and mortality among racial/ethnic minority, low-income, and other under-resourced populations. Given that state health departments (and their chronic disease programs) play a significant role in providing population and preventive health services, their capacity to promote health equity is an important consideration in national efforts to address chronic diseases. The purpose of this study was to examine capacity needs of state chronic disease programs with respect to promoting health equity. Methods: In 2015, the National Association of Chronic Disease Directors (NACDD) conducted a survey of its members that work within a state chronic disease division (CDD) or the larger state health department. The survey was structured to provide information on major funding sources for chronic diseases, the extent to which key funders required a focus on health equity, dedicated staffing for health equity, and training and technical assistance needs of practitioners to support health equity integration in chronic disease programming. All data were analyzed using SPSS 19.0. Findings: A total of 147 chronic disease directors and practitioners responded to the survey from 43 states, the District of Columbia and three of the U.S. Affiliated Territories and Commonwealths. Forty-two percent (N=25) of the 59 directors of state, territorial and tribal chronic disease programs at the time of the study responded. Only 52% of respondents believed their CDD adequately addressed health inequities. Among the 70 respondents who did not know or did not believe their health departments adequately addressed health inequities, barriers identified include insufficient funding (62%), inadequate training (54%), and health inequities not being a priority (22%). Respondents also identified opportunities to strengthen funding requirements to address health disparities Conclusions: Overall, the data highlight some opportunities to enhance the capacity of state CDDs to promote health equity, such as through more direct funding requirements for health equity integration, staff training, increased funding, and specialized technical assistance. Because the response rate was less than 100%, we cannot generalize the findings to every state chronic disease program. However, the responses are relatable to their collective experience

Administrative Roles of Principals on Teachers Job Performance in Private Secondary Schools in Nigeria

This study examined administrative roles of principals on teacher’s job performance in private secondary schools in Nigeria. The study adopted descriptive survey design. Two research questions and two hypotheses guided the study. The population was 3, 027. The study sample 1,816 teachers’ drew from Owerri and Orlu Education Zones using simple random sampling techniques. The study adopted a structured questionnaire as instrument for data collection. The instrument was faced validated by three experts from the Faculty of Education, University of Nigeria, Nsukka. Mean and standard deviation were adopted, while t-test was used to test the hypothesis. The findings of the study revealed principal’s administrative roles in the area of staff personnel administration to enhance teachers’ job performance. It was concluded that government should organize trainings to improve principals’ administrative roles and teachers’ job performance. Based on the findings, it was recommended among others that effort should be made by the principals on their responsibilities of ensuring the success of this listed school administration. The principal also desperately need the cooperation of their teaching staff by encourage one another on their various task so as to facilities various task and also to facilitate learning and curriculum development collectively

Using Inequality Measures to Incorporate Environmental Justice into Regulatory Analyses

Formally evaluating how specific policy measures influence environmental justice is challenging, especially in the context of regulatory analyses in which quantitative comparisons are the norm. However, there is a large literature on developing and applying quantitative measures of health inequality in other settings, and these measures may be applicable to environmental regulatory analyses. In this paper, we provide information to assist policy decision makers in determining the viability of using measures of health inequality in the context of environmental regulatory analyses. We conclude that quantification of the distribution of inequalities in health outcomes across social groups of concern, considering both within-group and between-group comparisons, would be consistent with both the structure of regulatory analysis and the core definition of environmental justice. Appropriate application of inequality indicators requires thorough characterization of the baseline distribution of exposures and risks, leveraging data generally available within regulatory analyses. Multiple inequality indicators may be applicable to regulatory analyses, and the choice among indicators should be based on explicit value judgments regarding the dimensions of environmental justice of greatest interest