This blog was written by Kate Burch, Director of the California LGBT HHS Network.
Last week the Office of Health Equity (OHE) released Portrait of Promise: The California Statewide Plan to Promote Health and Mental Health Equity, a demographic report and strategic plan addressing how socioeconomic factors impact the health of California’s diverse communities. One of the offices within the California Department of Public Health (CDPH), the OHE was established in 2012 to align state resources to “achieve the highest level of health and mental health for all people, with special attention focused on those who have experienced socioeconomic disadvantage and historical injustice.” This report is the result of thousands of hours of research and analysis, input from community leaders and subject-matter experts, and many rounds of community outreach and debate.
While considering both the upstream and downstream causes of health outcomes and health disparities, OHE identifies the upstream factors as the appropriate focus for policy interventions to address health inequities. About half of a society’s health outcomes are a result of the upstream determinants of health, including air quality, housing quality, transportation access, employment, income, neighborhood safety, violence and crime prevention, education, access to healthy food, linguistically appropriate services, protection against institutionalized racism, and other environmental and socioeconomic factors. The advantage of focusing policy interventions on the upstream determinants of health is so that changes can have a population-level impact.
Portrait of Promise contains demographic analyses on the root causes of health disparities in California, addressing factors such as wealth and poverty, race and ethnicity, access to healthy food, geographic trends, education level, housing issues, access to transportation, pollution, insurance rates and access to health care, neighborhood safety, hate crimes, and discrimination. The report also notes the limitations in current data, including the notable lack of available data on sexual orientation and gender identity, small sample sizes which leads in turn to unstable data when disaggregated for certain ethnicities, and small sample sizes for mental health data.
In addition to the attractive charts and graphs showing demographic analyses, Portrait of Promise includes strategies to begin addressing health and mental health inequities. The three main strategies are assessment, communication, and addressing infrastructure.
OHE has identified key interventions for organizations that are health partners (including fields such as education, housing, transportation, land use planning, etc.), agencies in the health field, and community organizations. The appendix has a detailed list of goals broken out by strategy and target audience, as well as a list of activities and resources that CDPH can utilize to implement the plan. As a follow up to this report, OHE will prepare focused issue briefs that explore research on the nature of a given problem and identify possible solutions.
CDPH currently has a Health in All Policies task force that works with a wide range of state agencies and local governments to help ensure that health considerations are embedded in traditionally non-health-related decision-making processes. The California Reducing Disparities Project, another project within CDPH, seeks to address mental health disparities faced by historically disadvantaged populations in California. OHE has begun well – with consistent outreach for stakeholder input and their close coordination with CDPH’s other projects addressing health disparities. We look forward to seeing how Portrait of Promise adds to the conversation and informs all of our work for health equity.VIEW THE FILE Quality