Sunday, August 19, 2012

The Nutmeg State: A policy model for health equity

Connecticut is fast becoming a leader when it comes to their policy on health equity for the state’s children and families.  The Connecticut Health Equity Initiative can serve as a model for other states in thinking about how to “enhance the capacity of local health departments in partnership with community partners and leaders to achieve health equity through a focus on the social, political, economic, and environmental conditions that affect health.” 

Indeed, over the last number of years, public health officials, as well as policymakers, have begun to conceptualize health in much broader categories than previously considered.  A recent work edited by Howard Frumkin, Andy Dannenberg, and Richard C. Jackson entitled, Making Healthy Places, speaks to how the physical environment naturally impacts one’s health – everything from the roads we build to the parks we enjoy.  This type of thinking is concerned with social determinants of health, that is, as defined by the CDC, “the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics.”  Health equity, then, is focused on making these determinants more fair for children and families who are situated in vulnerable circumstances, either socially, financially, psychologically, through the places they lives, or a combination thereof.  Connecticut uses an integrated model in attempting to shape healthier citizens, through workforce development, community engagement, and a health equity index that they created based on eight recognized social determinants and other indicators.  Through this index, residents of Connecticut can then go on the Health Equity Alliance website and map their city or county’s health equity.  This is a stirring innovation, because it allows both public health officials and policymakers to visualize health equity.  Hopefully as this tool continues to be refined there will be opportunities to see how various localities’ health equity may change over time.  What I find particularly useful for policymakers is that along with the quantitative data, the Index allows for the collection of qualitative data -- the narrative of those experiencing or witnessing health inequities.  This feature will provide officials with stories to help get the message about health equity out.  

Connecticut is doing great work when it comes to creating tools, strategies, and awareness for sophisticated knowledge and action on health equity.  Other states could and in my opinion, should be following the Nutmeg State’s lead. 

To learn more about state policies to ensure that children are healthy visit               

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