About the Health Equity Council
The National Association of Chronic Disease Directors works to improve the health of the public by strengthening state-based leadership and expertise for chronic disease prevention and control in states and at the national level.
This includes a commitment to addressing health disparities and promoting health equity. In addition, NACDD strives to be a catalyst to grow state capacity to address upstream factors with other sectors.
The Health Equity Council connects Members working to promote health equity for knowledge sharing, brainstorming, problem solving, and best-practice dissemination. The HEC works to identify issues that make it difficult to close
the gaps in health status and works toward solutions by partnering with State Health Departments, national organizations, and federal agencies to serve as a collective voice.
The fairness of how benefits and burdens are distributed or divided among several people or groups.
The collective mixture of differences and similarities that includes individual and organizational characteristics, values, beliefs, experiences, backgrounds, and behaviors. It encompasses our personal
and professional histories that frame how we see the world, collaborate with colleagues and stakeholders, and serve communities (CommonHealth ACTION, adapted from Washington State Human Resources).
The process of improving human population by controlled breeding; used by FHA (Federal Housing Association) to control the homogeneity of white families in neighborhoods
1) Of the same measure, quantity, amount, or number as another. 2) Regarding or affecting all objects in the same way (Merriam-Webster, n.d.).
Equal treatment that may or may not result in equitable outcomes (Xavier University, n.d.).
Providing all people with fair opportunities to attain their full potential to the extent possible (CommonHealth ACTION, adapted from Braveman and Gruskin, 2003).
The lens through which you view conditions and circumstances to assess who experiences burdens as the results of a program, policy, or practice (CommonHealth ACTION).
The idea and situation that men and women are not equal. Gender inequality acknowledges the different treatment or perceptions of individuals wholly or partly due to their gender. It arises from
differences in biology, psychology, and cultural norms.
The differences in the rates of disease and health status among groups of people. Most health disparities are the result of poor living and work conditions or discrimination related to socioeconomic status,
age, race or ethnicity, sexual orientation, gender, gender identity, disability status, geographic location or a combination of these factors.
When all people can attain their full health potential and no one is limited in achieving good health because of their social position or any other social determinant of health.
Heath in All Policies (HiAP)
An approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population
health and health equity (World Health Organization).
The result when disparities, or differences are combined with conditions that are unfair, unjust and avoidable.
The attitudes, beliefs and stereotypes we have towards people without our conscious knowledge. They affect our understanding, actions, and decisions unconsciously and can encompass favorable and non-favorable
assessments (Perception Institute, Kirwan Institute).
The term inclusion captures, in one word, an all-embracing societal ideology.
IHI is an independent not-for-profit organization based in Cambridge, Massachusetts. IHI is a leading innovator in health and health care improvement worldwide.
The interaction between gender, race, and other categories of difference in individual lives, social practices, institutional arrangements, and cultural ideologies and the outcomes of these interactions
in terms of power (Davis, 2008).
Systems of privilege and oppression based on social identities, including but not limited to: race (racism), sex (sexism), class (classism), age (ageism), ability (ableism), and sexuality (heterosexism).
All are rooted in doctrines of superiority and inferiority; find systemic expression in individual, institutional, as well as cultural forms; and function through the dynamics of power and privilege. These common
elements are often expressed in the equation PREJUDICE + POWER = OPPRESSION. Systems of privilege and oppression are not discrete and are experienced in interactive and overlapping ways (CommonHealth ACTION,
adapted from Xavier University, n.d.).
The Kerner Commission
Released in March 1968 (identified prominent cause for growing racial inequality as residential segregation)
The systematic targeting or marginalization of one group by a more powerful group for social, economic, and political benefit of the more powerful group (OpenSource Leadership
The process of becoming critically aware of how and why our assumptions have come to constrain the way we perceive, understand, and feel about our world; changing these structures of habitual expectation
to make possible a more inclusive, non-discriminating, and integrating perspective; and finally, making choices or otherwise acting upon these new understandings (Mezirow, 1978).
A judgment or opinion, usually but not always negative, formed on insufficient grounds before facts are known or in disregard of facts that contradict it. Prejudices are learned and can be unlearned (CommonHealth
ACTION, adapted from American Medical Students Association, n.d.).
When one group has something of value that is denied to others simply because of the groups they belong to, rather than because of anything they have done or failed to do. Dominant group members may be
unaware of their privilege or take it for granted (McIntosh, 2000).
A specified set of activities combined according to precise guidance in order to achieve a specific purpose (National Institute of Justice, n.d.).
A law, regulation, procedure, administrative action, incentive, or voluntary practice of governments and institutions (CDC, n.d.).
A race is a grouping of humans based on shared physical or social qualities into categories generally viewed as distinct by society.
1) A belief that race is the primary determinant of human traits and capacities, and that differences produce an inherent superiority of a particular race (Merriam-Webster). 2) Racism = Race Prejudice + the
misuse of power in systems and institutions (The People’s Institute for Survival and Beyond, n.d.).
The heightened levels of stress and emotion that a person may feel when interacting with people of other races. (Perception Institute).
Separate Fates Thinking
The notion that separate experiences lead to thinking that the consequences for one person are not shared consequences for all (Frameworks Institute).
prejudice or discrimination based on sex or gender, especially against women and girls. Sexism in a society is most commonly applied against women and girls. It functions
to maintain patriarchy, or male domination, through ideological and material practices of individuals, collectives, and institutions that oppress women and girls on the basis of sex or gender. Such oppression
usually takes the forms of economic exploitation and social domination. Sexist behaviors, conditions, and attitudes perpetuate stereotypes of social (gender) roles based on one’s biological sex.
Something conforming to a fixed or general pattern; especially: a standardized mental picture that is held in common by members of a group and that represents an oversimplified opinion, prejudiced
attitude, or uncritical judgment (Merriam-Webster).
When a person worries that their behavior may confirm stereotypes about a group to which they belong. Because of this threat, a person’s attention, our splits between the task at hand and their anxieties,
often causing them to behave in ways that confirm the very stereotypes at the root of their anxieties.
Dislike of or prejudice against people from other countries.
Tools & Resources
- Brennan Ramirez LK, Baker Ea, & Metzler M. (2008). Promoting health equity: A resource to help communities address social determinants of health. Atlanta: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/nccdphp/dach/chhep/pdf/SDOHworkbook.pdf
- Colorado Department of Public Health. (2010) Information Packet and Fact Sheet. CoPrevent [website]. Available at: https://docs.google.com/file/d/0B6U2flh3_SJLaUVaWFFMMWlSM2lpVy1weGlINHZVdw/edit?pli=1
- Phelan JC, Link BG & Tehranifar P. (2010). Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy Implications. Journal of Health and Social Behavior, 51(S):S28-S40.
DOI:10.1177/0022146510383498. Available at: http://hsb.sagepub.com/content/51/1_suppl/S28.full.pdf
- Hummer RA & Chinn JJ. (2011). Race/Ethnicity and U.S. Adult Mortality: Progress, Prospects, and New Analyses. Du Bois Review, 8(1): 5-24. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116787/?tool=pubmed
- Kawachi I, Daniels N & Robinson DE. (2005). Health Disparities by Race and Class: Why Both Matter. Health Affairs, 24(2): 343-352. DOI:10.1377.hlthaff.24.2.343. Available at: http://content.healthaffairs.org/content/24/2/343.full
- Levine RS, Foster JE, Fullilove RE, Fullilove MT, Briggs NC, et al. (2001). Black-White Inequalities in Mortality and Life Expectancy, 1933-1999: Implications for Healthy People 2010. Public Health
Reports, September-October2001, 116:474-483. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497364/
- Satcher D, Fryer Jr. GE, McCann J, Troutman A, Woolf SH, & Rust G. (2005). What if We Were Equal? A Comparison of the Black-White Mortality Gap in 1960 and 2000. Health Affairs, 24(2):459-464.
DOI:10.1377/hlthaff.24.2.459. Available at: http://content.healthaffairs.org/content/24/2/459.full
- Socioeconomic Status
- Allegretto SA. (2011) The State of Working America’s Wealth, 2011: Through volatility and turmoil, the gap widens. Economic Policy Institute: State of Working America. Briefing Paper #292, March
23, 2011. Available at: http://www.epi.org/publication/the_state_of_working_americas_wealth_2011/
- Braveman P, Cubbin C, Egerter S, Williams DR & Pamuk E. (2010). Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us. American Journal of Public Health, 100(S1):S186-S196.
DOI:10.2105/AJPH.2009.166082. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2837459/
- Lantz PM, Golberstein E, House JS & Morenoff J. (2010). Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults. Social Science & Medicine,
70:1558-1566. DOI:10.1016/j.socscimed.2010.02.003. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337768/
- Lantz PM & Pritchard A. (2010). Socioeconomic indicators that matter for population health. Preventing Chronic Disease, 7(4): 1-7. Available at: http://www.cdc.gov/pcd/issues/2010/jul/09_0246.htm
Hillemeier, Marianne, Lynch, John, Harper, Sam, Casper, Michelle. Data Set Directory of Social Determinants of Health at the Local Level. Available at: http://www.cdc.gov/dhdsp/data_set_directory.htm
Health Equity Leadership & Exchange Network (HELEN) provides frequent updates on health equity-related policies, laws and programs through The HELEN Monitor. http://healthequitynetwork.org/library/view/the-helen-monitor-vol.-9/
- Baum FE, Bégin M, Houweling TAJ, Taylor S. (2009). Changes not for the fainthearted: Reorienting health care systems toward health equity through action on the social determinants of health. American Journal
of Public Health, 99(11): 1967-1974. Available at: http://ajph.aphapublications.org/doi/full/10.2105/AJPH.2008.154856
- Burris S. (2011). Law in a Social Determinants Strategy: A Public Health Law Research Perspective. Public Health Reports, 126(S3):22-27. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150125/
- Hillemeier M, Lynch J, Harper S, Casper M. Data Set Directory of Social Determinants of Health at the Local Level. Atlanta: National Center for Chronic Disease Prevention and Health Promotion; 2004. Available
- Syme, SL. (2004). Social determinants of health: the community as empowered partner. Preventing Chronic Disease, 1(1):1-5. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC544525/pdf/PCD1A02.pdf
- World Health Organization. Latest Publications on Commission on Social Determinants of Health. Available at: http://www.who.int/social_determinants/resources/latest_publications/en/index.html
Robert Wood Johnson Foundation. (2010). A new way to talk about the social determinants of health. New York: NY. Robert Wood Johnson Foundation. Available at: http://www.rwjf.org/vulnerablepopulations/product.jsp?id=66428
- United States Department of Health and Human Service. National Action Plan to Improve Health Literacy Available at: http://www.health.gov/communication/hlactionplan/pdf/Health_Literacy_Action_Plan.pdf
Pertillar, Tiffany; Pobutsky, PhD, Ann; Brandt, EdD, MPH, Gail; New, OTR, MPH, Marisa; Delavan, BA, JamieLou; Taylor, MBA, Robyn; Shah, MPA, MA, Amishi; Adunola, DDS, MPH, Folasaya; and Nweke, Onyemaechi (2016) "An Assessment of Funding and Other Capacity
Needs for Health Equity Programming Within State-Level Chronic Disease Programs," Journal of Health Disparities Research and Practice: Vol.
9 : Iss. 6, Article 7. Available at: https://digitalscholarship.unlv.edu/jhdrp/vol9/iss6/7
Recommendations to the NACDD Board to insure an association that is culturally competent
Community Action Guide
The purpose of this document is to assist public health staff with model language to use in official documents. The statements help drive action toward policies that result in real changes in the social determinants
Skills assessment of public health staff - summary (without appendices)
Action ideas to achieve health Equity by linking to the 10 Essential Public Health Services
Document contains a crosswalk or Health Equity Council tools, HP2020 objectives and Community Transformation Grants (CTG) approaches.
The action guide provides recommendations on how public health staff can help reduce high school drop outs.
Guide calling public health staff to action in recognizing neighborhood segregation as a public health concern and steps to prevention.
10 Promising Practices to reduce social inequities in public health - high level interventions
Public Health Roles for Action to Reduce Health Inequities
Recommendations for NACDD Board Action on the CDC Expert Panel on SDOH report
2019 Council Webinars
For the last 16 years, Mitchell C. (Mitch) Hunter has taken active leadership roles in the Transgender and LGBQ communities.
Serving for 3 1/2 years on the Seattle LGBT Commission, he helped create and implement Seattle's single-use, all-gender restroom law. He served on numerous task forces researching, writing, and editing reports presented
to the Mayor's Office and other City departments. Mitch has worked with corporations, health care facilities, institutions, faith communities, and organizations to further transgender inclusivity and visibility.
Featured in the Seattle Police Department's transgender training video, Mitch helped write the SPD's model policy on working with the transgender community. (
Promoting Health Equity through Health Improvement Plans
Nichelle Shaw, M.P.H., is a public health educator with more than 20 years of public health experience. Currently, she
is a Supervisor at the Cuyahoga County Board of Health overseeing Chronic Disease Prevention programming. She has been an employee with the Cuyahoga County Board of Health since 2000, most notably as the Project
Manager for the Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga), which includes a consortium of more than 100 diverse and committed group of organizations and individuals, who initially came together to complete
the county’s first Community Health Improvement Plan. The HIP-Cuyahoga Consortium continues to work together to build opportunities for everyone in Cuyahoga County to be healthy because everyone should have a fair
chance to reach his or her fullest health potential regardless of where they live, their race, or their income. She lends her direction and support to projects that aim to improve the health of the community by
considering community conditions and other root causes of poor health. She received her master's degree in Public Health from the Rollins School of Public Health of Emory University; and her Bachelor of Arts Degree
in Anthropology and Psychology from Case Western Reserve University.
Health Equity, PHAB, and Health Improvement Plans
Jessica Kronstadt and Robin Wilcox
Jessica Kronstadt, MPP, is the Director of Research and Evaluation at the Public Health Accreditation Board (PHAB). In
that role, she oversees efforts to evaluate the accreditation program and to promote research to build the evidence base around accreditation. Prior to coming to PHAB, she worked at NORC at the University of Chicago,
conducting research on public health services and systems, as well as insurance benefit design, health information technology, and the rural health workforce.
Robin Wilcox, Chief Program Officer of the Public
Health Accreditation Board (PHAB), manages the implementation of the accreditation process for public health departments. Robin also leads the revisions of the standards and measures, modifications to the accreditation
process, and the development of the reaccreditation process and requirements. She joined PHAB in August 2007. Robin's work at PHAB follows a public health career in a variety of settings including governmental public
health, a health care system, academia, local health planning, association work, and private consulting
The ROI of an Inclusive Workforce for Health Equity Impact
Andre Blackman is a pioneering strategist with deep ties into the public health/healthcare, technology and branding
landscapes. He is also the Founder and CEO of Pulse + Signal, a branding and innovation strategy consultancy where he helps healthcare focused organizations stay equipped for the future.
Andre is a sought-after advisor to companies building the future of health and brand builder for the leaders who run them. His contributions have been featured in Forbes, NPR, Reporting on Health, U.S. News
and World Report.
Achieving Better Health Through Disability Inclusion
David Ellsworth, MPH, CHES received his master's in public health degree from The Ohio State University College of
Public Health, where he specialized in Health Behavior and Health Promotion and Environmental Public Health. David is a former LEND Fellow at the OSU Nisonger Center, with a total of five years working for the Ohio
Disability and Health Program. David currently serves as the Health Policy Specialist for the Ohio Disability and Health Program and works closely with all facets of the Ohio Department of Health to ensure that
health promotion efforts are inclusive and accessible to all Ohioans.
The Health Equity Council is a Member-driven council. The Council’s Consultant is Robyn Taylor. Robyn can be reached at rtaylor @ chronicdisease.org.