Center for Health Equity Newsletter - February 2018 - Minnesota Dept. of Health

Center for Health Equity Newsletter
February 2018

Newsletter banner

In this newsletter:
Greetings from the Center for Health Equity
Message from the Director
Message from the Commissioner
Meet our new colleagues, Darwin and Shor!
Internal capacity building to advance equity underway
Advancing Health Equity grants wrap up
Equity in Action: Collaborating with local imams to prevent opioid abuse
Equity Toolbox: HealthEquityGuide.org, a resource for local health departments
Updates and Opportunities

Greetings from the Center for Health Equity

With our February edition of the quarterly newsletter come many new faces! We are delighted to include a special letter from our new Commissioner of Health Jan Malcolm and a short video clip introducing our two newest team members, Darwin Flores Trujillo and Shor Salkas. We also have much to share about our work to advance health equity within the Department of Health, and about new tools for local health departments on how to advance equity within their local organizations. As always, a huge thank you to our partners who help make all of this work happen. And thanks for reading!  

Message from the Director

CHE Director Bruce ThaoDear Health Equity Partners,

On behalf of the Center for Health Equity, we want to start by acknowledging that that Commissioner Ehlinger’s resignation in December was a loss felt by many of us. Under his leadership, MDH did some amazing work to advance health equity across the state, while also internally transforming our agency. Indeed, CHE would not exist without his leadership! We are grateful for the legacy he has left us.

We are also looking forward to working with our new health commissioner Jan Malcolm. Commissioner Malcolm is a tremendous advocate for public health, and we know that she shares Dr. Ehlinger’s passion for advancing health equity and its priority at MDH. Please read her special message to all of you, and join us in welcoming her back to MDH!

While 2017 was a challenging year, in many ways it was also an energizing and productive year for the Center, as you will see from the highlights in the story below on internal capacity building for advancing equity at MDH. Thank you for your partnership, energy and support, which helped make many of our 2017 accomplishments possible.

Here’s a quick preview of things we are looking forward to in 2018.

January marked the first meeting of MDH’s Health Equity Advisory and Leadership (HEAL) Council. The council is comprised of health equity leaders from across the state who represent communities most impacted by health inequities. Members bring valuable expertise from across sectors and the lived experiences of their respective communities. The HEAL Council will be responsible for advising MDH and the Commissioner of Health on health equity practices and policies. Their second meeting is scheduled for March 7, 2018.

In February, we will hold the first meeting of the MDH Internal Health Equity Advisory & Leadership Team Hub (I-HEALTH). I-HEALTH is comprised of a representative from each MDH division. They are tasked with ensuring that health equity is embedded across and within all parts of the department. They will also help break down silos so that health equity strategies, tools and practices are shared agency-wide.

In 2018, the Center for Health Equity will continue to connect, strengthen and amplify the health equity efforts happening across the state in 2018 through a variety of convenings and events. Stay tuned for details on opportunities to engage!

Bruce Thao
Director, Center for Health Equity

Back to top

Message from the Commissioner

Commissioner of Health Jan MalcolmDear Health Equity Champions,

Let me begin by thanking you for your dedication to making Minnesota a healthier place for all people. I also thank my predecessor, Commissioner Ed Ehlinger, who made great contributions in highlighting and working to reduce disparities in health outcomes, pointing out the root causes in structural inequities across communities. He also worked to reframe the conversation about what truly produces health. We are grateful for his leadership. I share these priorities and I am eager to support you in building on this vital work.

As you may have heard, I previously served as Minnesota’s commissioner of health under Governor Jesse Ventura from 1999 to 2003. What you may not realize is that some of the seeds of today’s health equity initiatives were planted during that administration. For example, we convened the Minnesota Health Improvement Partnership (MHIP), which was the predecessor to today’s Healthy Minnesota Partnership. In 2001, MHIP released a groundbreaking report called, “A Call to Action: Advancing Health for All Through Social and Economic Change.” The purpose of that report was to “deepen understanding of the impact that social and economic conditions have on health, and identify recommendations with potential to help create more health-enhancing social and economic environments in Minnesota.” To my knowledge, it was one of the first reports to recommend tackling the root causes of health disparities by addressing the social determinants of health. That same year we were successful in passing legislation that created the Eliminating Health Disparities Initiative.

Seventeen years later, much work remains to be done. Nevertheless, I am proud those seeds were planted, because – through your partnership – they have blossomed into today’s increasingly powerful efforts to advance health equity. I’m delighted to be back at MDH and I am eager to engage with you so that together we can achieve the vision for health equity in Minnesota: where all communities are thriving and all people have what they need to be healthy.

Jan Malcolm
Commissioner of Health

Back to top

Meet our new colleagues, Darwin and Shor!

We are thrilled to welcome two new CHE colleagues, Darwin Flores Trujillo and Shor Salkas!

Darwin will serve as a health equity management analyst, providing administrative analysis and support for contracts and grants and financial analysis and support to ensure that program funds are used effectively from a health equity lens. He will also design and implement technical assistance and capacity building activities for grantees and other organizations impacted most by health inequities.

Shor will serve as a health equity planner, coaching staff internally across the department as well as externally with CHE stakeholders. Shor will also coordinate the Internal Health Equity Advisory and Leadership Team Hub (I-HEALTH) Council, the HEAL Council and the MDH Health Equity Community of Practice.

Check out this 4-minute video of our new colleagues to learn more about them!

Back to top

Internal capacity building to advance equity underway

A central part of our commitment to advancing health equity involves equipping our own agency staff to embed equity into everything we do here at MDH. As an agency of about 1,400 employees tasked with a wide range of responsibilities – from around-the-clock monitoring of infectious disease, to testing drinking water, to regulating of health facilities, to promoting healthy living – equity looks different in each program, section and division. While some parts of the agency have been intentional about embedding equity in their work for years, others have more recently started examining their work through an equity lens. Over the past year, Center staff have been working to help coordinate, train and equip MDH employees to move equity work forward across the agency. Here are a few of the ways we are doing this.

Health and racial equity trainings

In 2017, CHE teamed up with the Government Alliance for Racial Equity (GARE) to train over 500 MDH staff, including all MDH managers and supervisors and executive officers. The 4-hour Advancing Racial Equity training provides MDH staff with an understanding of individual and institutional bias and equips them with the skills to begin having conversations on health and racial equity within their divisions. Evaluations have shown that a majority of participants were greatly satisfied with the training and expressed interest in ongoing opportunities for coaching on how to implement action in their own teams around advancing racial equity. Training will continue throughout the coming year, and MDH’s strategic plan includes the goal of having all MDH staff complete the Advancing Racial Equity training by the end of 2018.

Additionally, customized health equity specific trainings were held for the Injury and Violence Prevention Program, the Health Regulation Division, the Health Policy Division and the Health Operations Bureau at MDH. Ongoing efforts continue in these areas to strengthen staff capacity to ensure equity is embedded and integrated into all policies, processes, programming and future planning.

Health equity community of practice

Started in July 2017 and offered bimonthly, the MDH Health Equity Community of Practice meetings are designed to provide space for staff to share and learn from other health equity champions from across MDH. Participants learn from one another regarding health equity opportunities or challenges and work on the tools gathered from the various MDH trainings on health equity. The community of practice is designed to bridge the gap between training and action. A total of three of meetings were held in 2017, with an average of 25 participants. Bimonthly meetings are planned for 2018. The next meeting will be held on Thursday, February 15 and feature three health equity related work groups across MDH.

Equity and Grants Work GroupEquity in grant making

An Equity and Grants Work Group, comprised of staff from across the agency and led by Christine Godwin (OSHII) and Bridget Roby (CHE) is working to advance equity in grant making. The purpose of the work group is to examine MDH's grant making processes and policies through an equity lens; to share grant practices that advance equity across programs; and develop tools, resources and recommendations for improvements to MDH grant practices, processes and policies to advance equity. The group is currently working on three projects:

  • including equity language in requests for proposals (RFPs) and application scoring criteria,
  • developing a bias training for reviewers and facilitators in competitive review processes, and
  • strategic RFP outreach to communities experiencing health inequities.

These project ideas were informed by recent community conversations, feedback from current and previous grantees and from grant staff from across the agency. The work group has been meeting since September. Members of the group include at least one representative from each of the seven grant-making divisions at MDH (not all members pictured here).

Back to top

Advancing Health Equity grants wrap up

Advancing Health Equity grantee logosOur two Advancing Health Equity grants came to a close at the end of 2017, and grantees are currently finishing their final reports. The two grantees – Neighborhood Hub and Voices for Racial Justice – have been working to tackle two critical structural and systemic factors that affect health: housing and the criminal justice system, respectively.

Through this grant, Neighborhood Hub formed a Healthy Homes team that has gone door-to-door assessing home conditions, educating residents on healthy home environments and referring them to resources that can help meet their housing needs. Neighborhood Hub has also hosted several community workshops on topics ranging from pests in the home to knowing your legal rights as a tenant, and the Healthy Homes team is beginning to develop a narrative on housing to help move the issue forward through public policy.

Yet while they have had great success in educating residents and mobilizing stakeholders, they have also discovered that free and low-cost housing resources are hard to come by. “There are no [free or low-cost] resources for alleviating issues of pest, radon and mold,” the team wrote in their most recent report, adding that the cost of hiring a pest control company, a contractor to complete a mold remediation or to install a mitigation system for radon is very expensive.

Compounding the issue, the team found that community members are often reticent to address housing issues for fear of being uprooted, especially if their landlord may be renting a unit considered uninhabitable or for which the landlord does not have a rental license.

While Neighborhood Hub has focused on addressing housing issues, Voices for Racial Justice (VRJ) has been working to paint a more nuanced picture of health in Minnesota correctional facilities by elevating community voices. To do so, they have partnered with incarcerated men and women, their families and other community members to design, collect and analyze both quantitative and qualitative data related to incarceration and health.

At the time of their last report in fall 2017, the project team had conducted 30 one-on-one conversations with formerly incarcerated individuals and family members, in addition to four listening sessions with community groups.

“We have found [that] visitation, compassion [in health care] and re-entry are very concerning aspects of mass incarceration because of their impact on the health of individuals, families and communities in general,” the team wrote in their most recent report. The team also emphasized that mental health was repeatedly named as one of the most serious aspects of individual and family wellbeing. VRJ’s goal by the end of the project is to identify policies and practices to improve prison health in the state of Minnesota.

In addition to finishing their final reports, both grantees are also preparing to present their findings from the grant project to community stakeholders later this spring. Once dates for the presentations have been finalized, event details will be shared through the Center for Health Equity weekly bulletin. To subscribe, enter your email in the Email Updates box on the right-hand side of the page.

Back to top

Equity in Action

Health equity work is happening across many different areas of MDH – not just inside the Center for Health Equity! This section features different health equity projects, leaders and partners in other areas of MDH and the state of Minnesota.

Local Imams collaborating to prevent opioid abuse

Collaborating with local Imams to prevent opioid abuse in the Somali community

Our colleagues in the Health Improvement Bureau at MDH recently completed a series of trainings with several Twin Cities Imams, Muslim faith leaders, to help combat the opioid epidemic ravaging local communities. The team hopes that this project will be a replicable model of how to partner with faith-based communities in the opioid epidemic response, and in understanding substance use disorder, mental health and trauma more broadly. 

“Engaging faith leadership to take a knowledgeable stand on the issue of opioid use in our community allows a community's selected and trusted leadership to serve their people in this important issue,” said Imam Sharif Mohamed of the Islamic Civic Society of America/Dar Al-Hijrah Mosque, which is based in the Cedar-Riverside neighborhood of Minneapolis. Imam Sharif and Kate Erickson, the MDH opioid overdose prevention director, spearheaded the initiative together as part of the Data-Driven Prevention Initiative funded by the Centers for Disease Control and Prevention.

In 2016, nearly 400 Minnesotans died of an opioid-involved death, and prescription opioids remain the leading cause of opioid-involved death. Since the launch of the Opioid Dashboard last fall, Kate has been giving presentations about the opioid epidemic throughout the state, highlighting the data and information included in the Opioid Dashboard to local public health, licensing boards, tribal health directors, regional prevention coordinators, drug-free communities and others. According to Kate, the state had no specific data to point to the need to engage with the Somali community in particular, but she and her colleagues had heard enough anecdotes about risk in the community that they reached out to several local Imams to see if they were interested in learning more.

“We had heard anecdotally that elders had easy access to opioids back home and were confused and frustrated why doctors in Minnesota were hesitant to refill their medications,” Kate said, adding that they also heard stories of young Somali men being solicited to buy illicit drugs. “When I brought the idea to Imam Sharif Mohamed, there was no hesitation – he wanted to bring the education to the Imams, and subsequently, the Imams bring the education to their congregations or communities.”

Local Imam at opioid abuse training Together, Kate and Imam Sharif worked with their colleagues to develop a three-part training for about 20 Imams and leaders in the local Somali community from September through December of last year. The first training focused on data and information included in the Opioid Dashboard and on practical tools and resources in their community, including the nearest safe drop-boxes for disposing of unused medications and how to find mental and chemical health treatment openings using the Fast-Tracker.

“We were amazed by how much information MDH had about the opioid issue and how much less our community knew of this information,” Imam Sharif said. “There is a huge gap between what MDH knows and what is known in our own community.” This partnership is taking the steps necessary to begin closing this gap.

During the second session, the group took a field trip to Alliance Wellness Center, a chemical health treatment facility that specializes in treatment and recovery for East African communities, to see a treatment facility in person. The third session focused on brainstorming what messages the leaders wanted to take back to their mosques and communities, and what action steps they would take to respond to the growing crisis.

“We brought important and new knowledge to our community leaders, and in turn they were able to share that knowledge with the broader communities that we serve,” said Imam Sharif. “These conversations are continuing past the original program effort.”

Both Kate and Imam Sharif remain committed to the work and hope their partnership will serve as a model for addressing the opioid crisis and other health issues with faith-based communities in Minnesota.

“I cannot emphasize enough how important it is that we replicate this effort regarding opioids and truly every major public health issue,” said Imam Sharif. “When public health efforts ignore faith leaders, they signal to the community that they hold disregard for the community's beliefs and so these efforts begin with a measure of distrust. These trainings must be the model going forward, and if we can replicate these partnerships, we will have a huge capacity to make changes.”

Other key partners in the initiative include Alliance Wellness Center Director Yussuf Shafie, Islamic Civic Society of America Executive Director Wali Dirie and Minnesota Poison Control Educator Lauren Prnjat. The trainings were recorded, and a resource video will be posted to the Opioid Dashboard later this spring. To receive an email update when the video is posted, subscribe to Center for Health Equity updates.

Back to top

Equity Toolbox

Advancing health equity is complex work that requires partnerships across organizations, agencies, and sectors. This section features tools and resources that can be used to advance health equity.

Assistant Commissioner Ayers featured on HealthEquityGuide.org, a resource for local health departments

MDH Assistant Commissioner Jeanne Ayers recently promoted the health equity work of MDH and our community partners on an exciting new website promoting equity in local health departments.
HealthEquityGuide.org is a resource with inspiring examples of how health departments have concretely advanced health equity – both internally within their departments and externally with communities and other government agencies.
Their website includes:

  • A set of strategic practices to advance health equity in local health departments.
  • Key actions health departments can take to advance their current practice toward health equity.
  • 25+ case studies from local health departments that describe how they advanced the strategic. practice, factors that enabled the work, impacts of the change and advice for others.
  • 150+ resources from allied organizations and others to advance the strategic practices.

The site also features a case study written by Assistant Commissioner Ayers called “Minnesota Changes the Narrative around Health Equity.” The case study provides a detailed history of Minnesota’s health equity efforts, enumerating our successes and sharing tips to help other health departments get started. Minnesota’s case study is just one of 25 others featured on the site from health departments around the country.

Assistant Commissioner Ayers is also featured in the fourth episode of a four-part webinar series, Advancing Health Equity in Local Health Departments. Each webinar focuses on a set of strategic practices that health departments can use to pursue transformation of their work internally, with communities and alongside other governmental agencies. The final webinar will take place on Thursday, February 15 from 10-11 am PST. The webinars are also archived and available to view on the Human Impact Partners website.

Human Impact Partners developed the HealthEquityGuide.org in consultation with national health equity leaders and with support from The California Endowment.

Back to top

Updates and Opportunities

Director Bruce Thao's Keynote Address for MMA Health Equity Forum

CHE Director Bruce Thao gave the keynote address at the Minnesota Medical Association (MMA) Health Equity Forum in January. In this address, rather than focus on the statistics, Bruce shares his personal health equity story and urges the audience to reflect upon their own stories. He leaves us with these questions to reflect upon:

  • What opportunities have enabled you to create and define what optimum health is for you? How are you providing opportunities for others to create and define their health?
  • What experiences have told you that you belong (or do not)? In what ways are you telling others that they belong (or do not)?
  • Have the places and spaces you have lived allowed you to thrive? How are you creating the spaces where others feel that they belong and have the opportunity to thrive?

View the video on the Minnesota Medical Association's Facebook page.

2018 Opportunity Conference Advancing LGBTQ Health

Opportunity Conference logoThe 2018 Opportunity Conference is a regional conference that will take place on March 26-27 dedicated to advancing health equity and promising practices related to LGBTQ communities and all intersecting communities. The conference will offer a range of workshops from data dissemination, to working with transgender patients in different clinical settings, to tobacco control (and much more!). CHE will take part in the conference as a sponsor and presenter. For more information and registration, visit the Opportunity Conference website.

A Public Health Journal features staff from CHE grantee Neighborhood Hub

Kale Severson and Kimberly CapriniKale Severson and Kimberly Caprini from Neighborhood Hub, one of our Advancing Health Equity grantees, were featured on A Public Health Journal last month. Through their grant, they are working to address housing as a public health issue in North Minneapolis. The weekly show features public health professionals, thought leaders, policymakers and community activists. Program episodes are also available on the A Public Health Journal YouTube channel.

Follow Bruce on Twitter!

Twitter logoStay up to date on the latest in health equity through Bruce’s official Twitter account @BThao_MNHealth and through the Minnesota Department of Health account @MNHealth.

Back to top
View November 2017 newsletter

Updated Wednesday, 14-Feb-2018 09:58:46 CST