This month, in celebration of the Department of Health and Human Services Office of Minority Health’s National Minority Health Month, advocates, providers, communities and other key stakeholders are working to raise awareness about racial and ethnic health disparities across the country and the role that social determinants play in advancing a health equity agenda for vulnerable populations. Social determinants of health are “the structural determinants and conditions in which people are born, grow, live, work and age.” They include factors like socioeconomic status, education, the physical environment, employment, and social support networks, as well as access to health care.
Getting Local: Partnering for Community Health
In step with this broader understanding of how social determinants influence health equity, Community Catalyst’s Children’s Health Initiative recently launched a new project, Partnering for Community Health. The project works in multiple states focusing on building the capacity of local community efforts while connecting them with state health advocates to improve health equity outcomes through community collaborations. Through these collaborations, the community organizations can inform state advocates on Medicaid and social services policy needs, including Medicaid defense. In March, Community Catalyst staff visited Shelby, North Carolina, one of the project sites, to meet with the local leadership partners Benchmarks and NC Child and other organizations engaged in this work. The experience reminded us of the richness of local work and that advancing health equity is about consumer engagement at every level—starting with the individual up to the system.
Shelby, NC: A Snap Shot
In Shelby, Sun Drop is the local soda – a high octane version of Mountain Dew with a hint of pulpy orange juice – and it personifies Shelby. Shelby is not unlike many small towns in the South – it has a warm familiarity with an extra jolt of something special. In Shelby, folks know each other and, if they don’t, they’ll ask your family name and try to find the connections quickly. The Shelby community feels like family. For instance, one of our hosts, Chris, (the project’s “community quarterback”) could barely sit down for lunch because family and old coworkers were constantly pulling him aside to catch up at the restaurant where we were eating.
In Shelby, the impacts of social determinants of health are ever-present at Graham Elementary School. According to the Robert Wood Johnson Foundation’s Country Health Rankings & Roadmaps, Cleveland County, where Shelby and Graham Elementary reside, ranks 89th out of 100 in the state for health outcomes. As evidenced by the school’s attendance zone, Graham Elementary School includes most of Shelby’s low-income housing communities and these class and racial differences could be impacts of student health outcomes. Social determinants of health research show the greater one’s income, the lower one’s likelihood of disease and premature death. Race, racial prejudice, and race discrimination also impact health outcomes.
These determinants have jump-started this school into being a hub of change as a community school, where it serves an integrated focus on academics, health and social services, and youth and community development and engagement. This charge started with the school’s principal, who can easily identify where the fixes need to happen, and then makes them happen. Even her efforts to turn a pile of dirt into a welcoming grassy entrance have made a world of difference. And she hasn’t stopped there. In fact, she was late meeting up with us during our site visit because she was helping a student’s mother get to a counseling appointment. It’s this natural ability to see opportunity to address the things that impact student health outcomes that makes Graham Elementary a prime location for aligning services and supports to address social determinants of health. For our state partner, NC Child, their engagement with the community informs their Medicaid defense advocacy, understanding that Medicaid services are of primary importance to people in communities like Shelby.
Outside of Graham Elementary, the Shelby community is fueled by positive energy that will make the community school project successful in further advancing health equity outcomes in the next three years. It’s this energy that allows the community to recognize and realize health equity every single day.
Communities as Change Agents
From our short tour of the community work in Shelby, it is a clear reminder that communities have a key role to play in reducing health inequities for vulnerable populations and in paving the way for innovative approaches that connect children and families to the health and social services they need to be healthy. State advocates will be instrumental in deepening their engagement with communities, too – learning from their work and advocating for the tools that they need to be successful. We are excited to support this collaboration each step of the way.