Health Disparities

Health disparities refer to inequities that exist among groups based on geographic location, income, education, race, ethnicity, gender, sexual orientation, and/or disability status. People who experience health inequalities are more likely to experience negative health outcomes, such as psychosocial stress and a higher incidence of cardiovascular disease, and are less likely to have access to health and social resources. The COVID-19 pandemic magnified existing health inequities, with Black, Indigenous, and Latino communities disproportionately impacted. State health agencies can work to prevent health disparities by identifying priority populations through a needs assessment; implementing focused initiatives based on needs assessments; working with populations disproportionately affected by ACEs, suicide, and overdose; creating culturally and linguistically competent health promotion materials; and including the perspective of people with lived experience. Using the Suicide, Overdose, and Adverse Childhood Experiences Prevention Capacity Assessment Tool (SPACECAT) can assist your agency with determining the state's level of capacity to address health disparities. Below is a list of beginner, intermediate, and advanced actions your organization can take based on your SPACECAT results.

Beginner Action Ideas

• Determine whether your state has completed a needs assessment to identify priority populations for ACEs, suicide, and overdose prevention.
• Create a list of current state partnerships with populations disproportionately affected by ACEs, suicide, and overdose, as well as the organizations that serve them, including but not limited to protective services and children in foster care; communities experiencing concentrated poverty; communities experiencing concentrated violence; individuals who identify as lesbian, gay, bisexual, transgender, or queer; veterans and military service members; individuals who have a serious physical health condition or disability; individuals with a mental health/behavioral health condition (e.g., substance use disorder); individuals who have previously experienced an overdose; survivors of suicide loss; individuals with prior suicide attempts; individuals experiencing homelessness; rural and frontier populations; racial and ethnic minorities; American Indian/Alaskan Native and tribal populations; and immigrant populations.
• Research examples of culturally and linguistically competent communication and health promotion materials.
• Ascertain how often the perspectives of people with lived experience (e.g., families and/or involved youth, persons in recovery, survivors of suicide) inform programmatic decisions and your agency's overall work.
• Determine whether your state has a clear definition and standardized language around health equity.

Intermediate Action Ideas

• If a needs assessment that identifies priority populations for ACEs, suicide, and overdose prevention exists, look into how the information is currently being used to prioritize initiatives based on the need.
• If a needs assessment that identifies priority populations for ACEs, suicide, and overdose prevention does not exist, research examples of needs assessments used to identify priority populations in other states.
• Reach out to and collaborate with organizations that serve populations disproportionately affected by ACEs, suicide, and overdose, including but not limited to protective services and children in foster care; communities experiencing concentrated poverty; communities experiencing concentrated violence; individuals who identify as lesbian, gay, bisexual, transgender, or queer; veterans and military service members; individuals who have a serious physical health condition or disability; individuals with a mental health/behavioral health condition (e.g., substance use disorder); individuals who have previously experienced an overdose, survivors of suicide loss; individuals with prior suicide attempts; individuals experiencing homelessness; rural and frontier populations; racial and ethnic minorities; American Indian/Alaskan Native and tribal populations; and immigrant populations. Identify ways to support their efforts.
• Review your agency's communication and health promotion materials. Assess whether materials are culturally and linguistically competent and determine gaps.
• Build relationships with community organizations that work with people with lived experience (e.g., families and/or involved youth, persons in recovery, survivors of suicide).
• Research examples of definitions of health equity and determine which definition and language make the most sense to use in your state.

Advanced Action Ideas

• If a needs assessment that identifies priority populations for ACEs, suicide, and overdose prevention exists, determine how current state programs can incorporate this information to better target initiatives to those most in need.
• If a needs assessment that identifies priority populations for ACEs, suicide, and overdose prevention does not exist, use examples found to create a needs assessment that will help your state identify priority populations for ACEs, suicide, and overdose prevention.
• Actively support the efforts of organizations that serve populations disproportionately affected by ACEs, suicide, and overdose, including but not limited to protective services and children in foster care; communities experiencing concentrated poverty; communities experiencing concentrated violence; individuals who identify as lesbian, gay, bisexual, transgender, or queer; veterans and military service members; individuals who have a serious physical health condition or disability; individuals with a mental health/behavioral health condition (e.g., substance use disorder); individuals who have previously experienced an overdose; survivors of suicide loss; individuals with prior suicide attempts; individuals experiencing homelessness; rural and frontier populations; racial and ethnic minorities; American Indian/Alaskan Native and tribal populations; and Immigrant populations through identifying funding sources and data sharing agreements.
• Update your agency's current communication and health promotion materials to make them more culturally and linguistically competent.
• Partner with community organizations that work with people with lived experience (e.g., families and/or involved youth, persons in recovery, survivors of suicide). Create opportunities to connect with people with lived experience and incorporate their perspectives into programmatic decisions and your overall work.
• Update your agency's current communication and health promotion materials to include standardized language and a definition of health equity.

Resources

• Accountable Communities of Health | Washington HCA
• As Awareness Around the Importance of Social Determinants of Health and Health Equity Increases, State Legislation Follows Suit | ASTHO
• Connecting Health and Housing Through Medicaid | NCSL
• Equity in Injury and Violence Prevention | Safe States Alliance
• Integrating Health Equity into Overdose Prevention and Response: An Environmental Scan | NACCHO
• Preventing Suicidal Behavior among Lesbian, Gay, Bisexual and Transgender Youth: Developing LGBT Cultural Competence | SPRC
• Prevention for the Next Generation: Addressing Adverse Childhood Experiences, Suicide, and Overdose | ASTHO
• Promoting Health Equity | CDC
• Rhode Island's Health Equity Zone (HEZ) Initiative | Rhode Island Department of Health
• Using Telebehavioral Health to Increase Access to Care for Rural and Vulnerable Populations Amid COVID-19 | ASTHO

Health Equity Questions to Consider

• Has your agency completed a needs assessment to determine health disparities and priority populations in your jurisdiction?
  
  • Learn about how to conduct a needs assessment. 
  • See CDC’s findings about health disparities in suicide.
• How are health disparities being addressed within targeted initiatives for suicide, overdose, and ACEs prevention? 
  • Review the National Academy for State Health Policy’s report, “Shifting the Health Disparities Paradigm.” 
  • Review the article, “Evaluating Strategies for Reducing Health Disparities By Addressing The Social Determinants Of Health.”
• Does your agency have a department/position(s) dedicated to eliminating health disparities within your work?
  
  • Learn about California's Office of Health Equity. 
• Does your agency invest in partnerships or external organizations that can help eliminate health disparities?
  
  • Review the document, “Reducing Health Disparities at California's Public Health Care Systems.”
• Does your agency integrate people with lived experiences into your prevention work?
  
  • Review the chapter, “Embracing Community and the Wisdom of Lived Experience.”
• Is eliminating health disparities a priority in your agency's suicide, overdose, and ACEs prevention efforts? If so, what are your objectives to ensure health disparities are addressed within suicide, overdose, and ACEs prevention efforts?
  
  • Review the report, “A Roadmap for Promoting Health Equity and Eliminating Disparities.” 
• Are health equity initiatives shared or highlighted in some capacity to raise awareness and continue their success?
  
  • See the health equity initiatives and projects highlighted by the Minnesota Department of Health.