Center for Health Equity Newsletter
In this newsletter:
Greetings from the Center for Health Equity
Message from the Director
Continuing the Community Conversation
Health Equity Leadership and Advisory Council
Meet CHE Evaluator Mia Robillos
Equity in Action: Health Narratives
Updates and Opportunities
Greetings from the Center for Health Equity
As we share our fourth quarterly newsletter from the Center for Health Equity (CHE), we reflect on how much we have grown and evolved over the past year. We have a new director at the helm, bringing renewed energy for equity and health and wellness. We have begun a new grant year, with dozens of grantees eager to build on successes from year one and tackle inequities in their communities. And we continue to refine our role within both the agency and the state to advance health equity for all Minnesotans. We thank you for being a part of our CHE community! Read on to learn more…
Message from the Director
It has been nearly three months since I came on board as director of the Center for Health Equity. I hit the ground running with MDH staff meet-and-greets, the June Community Conversation and meetings with community stakeholders, government agencies, non-profit organizations and health systems. I am also absorbing as much knowledge as I can about the depth and breadth of work here at MDH.
As I approach the end of my first 90 days at the center, I am filled with both deep gratitude and humility. Some of the things I am grateful for:
- The outreach, energy and passion for health equity both within MDH and across communities, organizations and partner agencies.
- The level of support and encouragement from within MDH across all divisions and levels of leadership.
- My incredible team at CHE and the dedication and commitment they bring to this work and to our communities.
- The opportunity to hold a CHE retreat last month to refine our strategic plan, vision and priorities for the center.
Some of the things I am humbled by:
- The amount of work we still need to do to advance health equity for communities most impacted by health inequities.
- The significant amount of work that has already been done internally within MDH around health equity and the amount that still remains to be done. A commitment to health equity is a commitment to a journey and process that is long-term and multipronged. We at MDH have done much work thus far but still have far to go. What the center will focus on in the coming months is doing a better job of communicating our internal progress with the public so that you are not left in the dark about what we’ve been doing to equip staff to do our work differently and shift MDH policies, programs and systems to advance health equity.
In this newsletter are links to summaries from the June Community Conversation in St. Paul. Please know that all of the feedback and rich conversation will be and has already been taken into account to inform how CHE and MDH move forward. We integrated this feedback (along with many years of feedback MDH has collected) into our strategic planning during our retreat in late July.
We have heard you loud and clear. Forthcoming in the next few months will be more information about CHE’s role in the community and our strategic plan, vision and priorities. We are also planning another Community Conversation in Bemidji in the fall. Stay tuned for details. I thank you for your partnership, your dedication to this work and your commitment to ensuring none of our communities are left behind.
Director, Center for Health Equity
Continuing the Community Conversation
Earlier this summer we hosted the second in a series of community conversations on advancing health equity in our Minnesota community. On the evening of June 26, nearly 180 community members and MDH staff gathered at the TIES Event Center in St. Paul for an evening of discussion focused on using collaboration and relationship building to advance health equity. The event was hosted by Minnesota Health Commissioner Dr. Ed Ehlinger and Center for Health Equity Director Bruce Thao.
“The room was packed with passionate advocates and individuals from across our diverse communities and much wisdom was shared,” Bruce said about the event. “This will inform our work and our engagement with community moving forward. I look forward to continuing the conversation.”
For a majority of the meeting, participants took part in World Café-style discussions centered around three key questions:
- What is needed to build a sense of trust and belonging between you and MDH?
- Think about a time you were in a collaborative or partnership where you felt truly valued, heard and respected. What made this possible?
- Imagine MDH as a true partner to you and your community. What would MDH be doing?
The discussions produced many valuable takeaways for the department and will be used to inform our work in partnership with communities moving forward. MDH staff compiled the notes that were taken by table hosts, which can be found on the Community Conversations on Advancing Health Equity webpage.
We would like to extend a sincere thank you to the community volunteers who helped our staff make this event a reality. Their input over several planning meetings was invaluable. We look forward to a continued partnership with them and others in the future.
Plans are currently underway to hold a Community Conversation in Bemidji in the fall. Stay tuned for details.
To stay up to date with CHE events and how you can get involved, subscribe to Center for Health Equity updates, which includes our quarterly newsletters.
The Health Equity Advisory and Leadership Council
Thanks to the help of 10 volunteer community advisors, we are now accepting applications for a new MDH health equity advisory body, which will be called the Health Equity Advisory and Leadership (HEAL) Council.
The HEAL Council will advise MDH and provide a forum for honest and constructive feedback on the strategic direction of the Center for Health Equity and the department as a whole. The council’s goals will include examining MDH strategies and priorities, while ensuring that MDH interacts successfully with communities most impacted by health inequities.
The HEAL Council will be comprised up of 15-25 members who are recommended by a review committee (made up of both MDH staff and external partners) and appointed by the commissioner. In making these appointments, the commissioner will work to ensure the council has representation from each of Minnesota’s legislative councils of color/Indian Affairs and Minnesotans with disabilities.
For more information about the HEAL Council and to apply, please visit the Announcements page.
Behind the Scenes: Meet CHE Evaluator Mia Robillos
If it has to do with health equity related data, you can bet that Mia Robillos has a hand in it. As the Center for Health Equity’s only evaluation expert, Mia never has a dull moment at work. From the Eliminating Health Disparities Initiative (EHDI) and Advancing Health Equity grants to the African American Infant Mortality project, Mia is working to measure, analyze and improve what we do and how we do it.
And she loves it.
“I think this is an exciting time for CHE because of the direction that we’re taking,” Mia said. “We’re changing the way we do our work – in our practices, in the policies we implement and in the data that we use. And also in the partnerships that we form.”
Today, Mia is most excited about her work evaluating the EHDI grants – grants that the legislature created in 2001 with the goal of improving the health status of Minnesota's populations of color and American Indians.
“We’re trying something different for the first time in the history of EHDI,” Mia explained. Mia and the grant management team have recently collaborated with Rainbow Research, Inc. and the Prevention Research Center at the University of Minnesota to develop a shared measurement system among grantees. The goal is to be able to report in aggregate what the grantees are accomplishing in each of the eight priority health areas.
In the past, each grantee created their own measurement and evaluation benchmarks independent of one another. This method had its benefits in terms of grantee autonomy and independence; but it also made it difficult to gauge the impact grantees were making collectively in Minnesota. This made it hard for CHE to tell the public and the legislature about the important impact that public dollars are making in reducing health disparities.
So the team is working to find a compromise. “We’re doing both – we are building a shared measurement system with a few common outcomes in each health area, but we’re still allowing grantees to report their overall accomplishments however they want to report them.”
The team has been working hard to make the development of the system a participatory process, working closely with grantees and MDH staff in each of the health areas to find outcomes that are both feasible and useful for everyone.
“With the shared measurement system, grantees will be better able to relate their work to other grantees in the program. They’re on this journey together,” Mia said. She added that grantees will also be able to more easily relate their work to other initiatives around the country, as many of the shared outcomes align with national indicators like Healthy People 2020.
Mia and her colleagues will be working to roll out the shared measurement system over the next few months. Meanwhile, she is also working on a multitude of other projects that are keeping her busy – EHDI legislative reports, focus groups for CHE's infant mortality project and technical assistance to local public health departments. Needless to say, Mia is an invaluable member of the CHE team!
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.
Health Narratives: Building Power to Create the Conditions for Health for All
Have you seen that ClearWay Minnesota “money train” ad on TV? You know, the one with the scary looking guy that dusts the ashes of a dead smoker off a train seat, and then tries to lure some kids on board?1
“That ad is chilling,” said Ronel Robinson, the president of the Minnesota Association of Black Social Workers.2 “When I saw it, I thought, ‘That’s a good example of changing the narrative .’”
In April, Ronel and her association members invited two trainers from the Minnesota Department of Health – Helen Jackson Lockett-El and Jeannette Raymond – to their monthly meeting to give a presentation on changing the narrative about health.
A public narrative is a story that, when told in many different ways, can shift public consciousness and change what kind of actions or futures are possible. A dominant narrative is one that overrides other narratives in a society and has the most power to shape what is possible.
Examples of the current dominant narrative about health in our society include:
- Health = health care or health insurance.
- Health is an individual responsibility.
- Health inequities are the result of individual choices, not systemic problems.
Yet while this narrative dominates, we know that it is grievously incomplete and in many ways harmful to advancing health equity. The narrative training, which MDH originally developed (with the assistance of the Grassroots Policy Project) for MDH staff, helps participants identify ways in which the dominant narrative about health is at work in society. Being able to identify the dominant narrative allows us the opportunity to choose to work out of an alternative, emerging narrative: one that recognizes the root causes of health inequities. This approach is grounded in the first part of the Triple Aim of Health Equity – expanding our understanding of what creates health.
Ronel explained that after taking the training, she began to recognize the dominant narrative at work in the world around her. And when she saw the ClearWay “money train” ad, she appreciated how it flipped the script around youth tobacco use. Instead of focusing on getting kids to change their behaviors, the ad challenges Big Tobacco’s strategy of finding and targeting “replacement smokers” (i.e. kids). In other words, it recognizes the larger context in which individual choices are made to create health. For Ronel, the initial training was just the beginning. “I continued to process what I learned after the meeting,” she said.
Jeannette, a developer of the training, said this is common. Once the training opens people’s eyes to the dominant narrative, they begin to notice it everywhere in their daily lives. “Then,” she said, “they want to know what to do next.”
The next step for the Minnesota Association of Black Social Workers was to make time at their next meeting for group reflection and conversation. In their discussion, Ronel and her colleagues noted many opportunities where reframing the narrative could lead to policy changes that would positively affect the black community, such as limiting menthol tobacco sales, changing zoning for liquor stores and even reframing discussions of sexual health and sexually transmitted infections.
For Jeannette and Helen, a next step may be to develop a follow-up training that helps frame narratives as a pathway to power. In the meantime, they are juggling requests from both inside and outside MDH for the introductory training, which the Black Social Workers helped confirm can successfully be adapted for audiences outside of MDH.
“We wanted to see how [the training] could be used to help strengthen the capacity of the community to create their own health,” Jeannette said. Strengthening the capacity of communities to create their own healthy future – a second tenant of the Triple Aim of Health Equity – requires acknowledging that communities themselves need to be involved in creating policies and systems that improve conditions.
Jeannette and Helen are just two of a group of MDH staff who have been trained to train others in changing the narrative about what creates health. The agency is hoping to expand training opportunities in the future.
As for the Minnesota Association of Black Social Workers, Ronel said they’re hooked. “We had such a lively and dynamic discussion in the mini-training,” Ronel said. “We’re eager to see what comes next.”
1“Money train” is a recent ClearWay Minnesota TV ad. It is a part of their “Stop the Start” campaign to prevent youth tobacco use.
2The Minnesota Association of Black Social Workers was established over 25 years ago. It is a local chapter of the National Association of Black Social Workers, which is comprised of people of African ancestry and is committed to enhancing the quality of life and empowering people of African ancestry through advocacy, human services delivery, and research. Members of the Minnesota chapter come from diverse professional backgrounds, including public health, clinical health, mental health and social work. Several times a year they offer professional development opportunities and lectures open to everyone in the community, regardless of race or professional background. To learn more please visit their Facebook page.
Thank you to our student interns!
As the summer draws to a close, we're saying goodbye (for now) to two fabulous student interns at the Center for Health Equity. Theng Yeng Xiong (left) is headed back to the College of St. Benedict, where she will complete her senior year as a nutrition major. Nailah Abdullah (right) recently graduated from South High School in Minneapolis and is headed to Drake University for her freshman year. We wish them both the best and look forward to seeing the great things they accomplish in the future!
Updates and Opportunities
Apply for the Health Equity Advisory Leadership (HEAL) Council
The Center for Health Equity is now accepting applications for the MDH Health Equity Advisory Leadership (HEAL) Council. The HEAL Council will advise the Department of Health and provide a forum for honest and constructive feedback on the strategic direction of the Center for Health Equity and the department as a whole in advancing health equity. For more information and to apply, visit the Center for Health Equity Announcements page.
Listen to a KRSM interview with Director Bruce Thao
Earlier this summer, Bruce sat down with Deatrick LaPointe of KRSM Southside Media Project to discuss his background and vision for the Center for Health Equity at the Minnesota Department of Health. An archive of the interview is available on the KRSM website.