Community Conversation on Advancing Health Equity: Group Discussion Highlights and Trends
Findings from the November 14 Public Health Equity Event
On November 14, 2016, the Minnesota Department of Health held a community conversation to discuss progress toward health equity. The goals of this event were to (1) provide an update on MDH’s efforts to advance health equity, (2) to provide a forum for community-based organizations and others to share stories of their efforts to advance health equity and (3) to continue a dialogue about the challenges facing our collective efforts, in order to engage in collaborative problem-solving.
For part of this event, about 30 tables of attendees had small-group discussions around nine different topic areas relating to health equity. These small-group discussions generated over 100 pages of notes and addressed a wide range of health equity advances, challenges and suggestions.
MDH staff read over every comment and noticed that a few overarching ideas appeared numerous times across all nine topic areas and discussions. We acknowledge that not every comment is represented here, and that attempting to summarize over 100 pages of notes will not represent the full range of ideas expressed within each group. MDH staff are continuing to dive deeper into each page, though we thought it would be valuable to share some of the most common ideas that were expressed across the various topic areas and discussions.
The following is a summary of a few common themes that came out of these discussions.
MDH needs to foster true collaboration between community members, community partners and administration.
- Community members should be involved in decision making from the very beginning.
- Community members should be paid for their time and contributions.
- Community members should help identify and address issues of concern.
Needs and wants of the funder, MDH and members of the community are often misaligned.
- Who gets to establish what areas are most in need of funding?
- Smaller organizations can’t access funding.
- Community partners are often left out of initial planning discussions.
Interagency collaboration is not happening, and it should be.
- There is a disconnection/lack of communication between different state agencies, local health departments and community members. Health equity issues affect all of these players, and there is an opportunity to increase collaboration and information-sharing.
An emphasis on “evidence-based” work, information and strategy is problematic for health equity efforts.
- Many organizations have a hard time quantifying the work that they do in this way.
- This emphasis is often “put against” valuable community wisdom, and leaves little room for true community input, collaboration and other forms of knowledge.
“One size does not fit all!”
- This applies to grant applications/funding practices, providing health services, messaging, data sharing/data gathering, and all other areas of health. The system is still structured in a way that does not allow for intricate tailoring of differences and needs, and this is problematic.
Community partners lack direct contact points at MDH.
- Members of the community face barriers in getting answers, making contact with staff at MDH and feeling like they have an entry point for getting their voices heard.
- Community partners need a way to access political engagement, data analysis, structural systems, etc.
MDH needs to find a way to incorporate community partners into formal staff settings.
- The MDH staff is not representative of the communities it is trying to serve.
- MDH needs to hire more people who represent the diversity of all Minnesotans.
- Hiring practices may need to be modified – this may need to be a policy/organizational/structural change.
MDH needs to build in two-way, structural measures of accountability and communicate the results.
- Internal measures: what are we actually doing? What do we need to do?
- External measures: ask the community – are we doing a good job?