How can we best advance health and hasten health improvements for people who disproportionately suffer poor health outcomes? How can a lens of health equity influence decisions we make?
To explore these questions, better understand how to address health disparities and boost health equity throughout the Badger State, the Wisconsin Partnership Program at the University of Wisconsin School of Medicine and Public Health hosted the Advancing Health Equity conference in fall 2016.
Featuring talks by nationally recognized thought leaders and active panel discussions among myriad stakeholders, the day-long event drew nearly 500 participants who attended in person at UW-Madison or watched via livestream at UW-Extension locations throughout the state. All were eager to learn how their voices and actions can make a difference in patient care and public health.
Addressing health equity
UW School of Medicine and Public Health Dean Robert Golden, MD, described the conference as a first step in the Wisconsin Partnership Program’s journey to expand health equity as an integral part of its vision and framework for future investments.
“This is the time to spark an inclusive effort to address the crucial imperative of health equity head on,” Golden told the crowd of faculty and staff, public health and health care professionals, nonprofit organizers and community members.
David Williams, PhD, MPH, outlined the social determinants of health—including race, socio-economic status and environment—as well as the need to address large socio-economic gaps and policies that impact health. He is the Florence Sprague Norman and Laura Smart Norman Professor of Public Health, Harvard School of Public Health, and professor of African and African American studies and of sociology, Harvard University.
“All policy that affects health is health policy,” he told the crowd. Williams also discussed the importance of improving neighborhoods and strengthening the communities’ capacity to improve health.
“Your ZIP code,” he said, “may be a stronger predictor of your health than your genetic code.” Williams encouraged the audience to break down silos and collaborate across all sectors to improve health for everyone. “We need political weight and a commitment to new strategies. No single sector can do it alone."
Other featured speakers included Susan Skochelak, MD, MPH, group vice president for medical education at the American Medical Association, on health equity and the role of medical education; Edward Ehlinger, MD, MPH, Minnesota commissioner of health, on partnerships and health equity; and Sergio Aguilar-Gaxiola, MD, PhD, director, University of California-Davis Center for Reducing Health Disparities, on health equity and the role of research.
A community engagement theme echoed throughout all presentations, panel discussions and audience comments. For instance, Ehlinger urged participants to use community organizing as a public health tool and encouraged communities to build the capacity to address social determinants of health.
Aguilar-Gaxiola agreed and noted, “Communities and collaboration are critical if we are going to advance health equity.”
A research panel encouraged participants to examine asset-based community development, adding that it’s important to learn what others are bringing to the table. Members of this panel were Gina Green- Harris, MBA, director, Milwaukee Outreach and Program Services, Wisconsin Alzheimer’s Institute, and director, Regional Program Office, Lifecourse Initiative for Healthy Families; Dorothy Farrar-Edwards, PhD, director, Collaborative Center for Health Equity, UW-Madison Institute for Clinical and Translational Research; and David Pate Jr., PhD, associate professor of social work, UW-Milwaukee School of Social Welfare.
Harnessing medical education
Cynthia Haq, MD, director of the School of Medicine and Public Health's Training in Urban Medicine and Public Health Program, was excited to discuss how medical education and health care practice could move the needle on health equity. Skochelak and panelists Haq, Tracy M. Downs, MD, FACS, and John Meurer, MD, discussed how medical students can be agents of change in advancing health equity.
“A culturally competent health care system can help improve health outcomes and quality of care, and can contribute to the elimination of health disparities,” said Skochelak.
Downs, the School of Medicine and Public Health associate dean for multicultural affairs and an associate professor in the Department of Urology, noted, “When training our residents, cultural competency must be more than just a box that gets checked.”
He continued, “How do we become experts? We reach out and collaborate to bring in many talented people so we can develop a supportive network for our students and other trainees.”
The thrust of Downs’ role as an associate dean is to work with students and underrepresented faculty members at the School of Medicine and Public Health; Downs plays an integral role in shaping the school's initiatives focusing on diversity and inclusion. He uses his own experience as an African-American male surgeon to help prepare students for times when they may encounter a lack of cultural sensitivity in clinical settings. He also works with them on future residency and fellowship selection, making sure they are “on top of their interview game” and choose to apply to programs where they will succeed.
Another faculty member dedicated to teaching about diversity in health care, Haq added, “We are ready to tackle health inequities. Our students are passionate about working with others, both within and outside the health system, to identify and address social factors that influence health.
"When we support and direct our students’ energy and passion, they can become community-engaged physician leaders who are well-prepared to contribute to promoting health for all.”
Planning the next steps
“Our conference was intentional in its design,” said Eileen Smith, director, Wisconsin Partnership Program. “We created the conference with an emphasis on the Wisconsin Partnership Program’s three focus areas: education, partnerships and research.”
Further, at the working lunch, table facilitators captured individual health equityrelated perspectives and other feedback for the Wisconsin Partnership Program.
“Our staff is pouring over the input and will use that information as part of our strategic actions going forward,” said Smith.
In his closing remarks, Golden reminded participants that the conference was just the beginning, the foundation from which the Wisconsin Partnership Program will build its health equity initiatives.
To the many participants from different sectors, different interests, different communities—rural and urban, Golden challenged, “Today, I’m making a request of myself and all of you—let this be our launching pad going forward.”
“Take your individual passions and follow them,” he advised. “Build partnerships to help achieve your goals. And most importantly, have resilience for the struggles ahead.” Golden concluded, “We know there will be challenges, but we are committed to the long-game and to the ambitious, audacious goals we will set.”