Health equity is accomplished when everyone has a fair opportunity to be the healthiest version of themselves and there are no barriers, socially or structurally, to achieving this. Health inequities are often found to be more prevalent among minority racial groups and are reflected in differences in length and quality of life; rates of disease, disability, and death; severity of disease; and access to treatment. While overall health trends are improving, some groups continue to experience a disproportionately higher burden of disease and death. Achieving health equity by eliminating those barriers to optimal health is key to having a San Diego that is healthy, safe, and thriving.
Community Response to COVID-19
This past year, the COVID-19 pandemic quickly revealed that certain communities in our county were carrying a larger burden of the disease and COVID-19-related deaths due to health and economic inequities. Community partners immediately stepped-in to increase awareness, education, testing, and vaccination rates and to ensure adequate distribution of resources to communities hardest hit by the pandemic.
San Diego County COVID-19 Equity Task Force
The San Diego County COVID-19 Equity Task Force, established in March 2020 and led by the Multicultural Health Foundation, was created to help implement strategies to address the disproportionately negative impact COVID-19 was having on Southeastern San Diego and other impacted communities of color. Together, they created blackcovidfactssd.org, a collaborative of local Black leaders, doctors, & local community groups, tasked with the job of bringing COVID-19 facts to the Black community – a group with historically higher levels vaccine hesitancy.
Partners Providing Resources
The San Diego Latino Health Coalition was formed to address the disproportionate impact that COVID-19 was having on the Latinx community to provide them with basic needs such as food, rent, and cleaning supplies. The Coalition, led by The Chicano Federation, was able to distribute more than 15,000 COVID-19 safety kits; cleaning supplies to 2,000 childcare providers; rent relief to 3,600 families; 100 devices for distance learning; and holiday meals to more than 500 families.
Somali Family Service of San Diego partnered with the San Diego Workforce Partnership and others to create Shifa360 (shifa is Arabic for ‘healing’) with a mission to empower underserved communities, immigrants, and refugees with health education and life skills. They offered a free Community Health Worker Training Program to prepare the next generation of community health workers to support immigrant and refugee communities.
The County of San Diego coordinated Project SAVE (Scheduling Assistance for Vaccine Equity) as part of the Community Health Worker Communications and Outreach Collaborative designed to support the County’s COVID-19 response. The goal of the project was to directly connect with communities impacted by long-standing health disparities to create and disseminate culturally and linguistically appropriate messages to assist residents with COVID-19 education and vaccination appointments. Seven community-based organizations were contracted to serve four communities of focus: African American, Latino/Latinx, Asian Pacific Islander and Refugee. Five additional organizations were contracted to assist in specific regions of the county.
526,320 People Reached
105 Community Health Workers Hired
26 Languages Spoken
4,566 Appointments Scheduled
San Diego COVID-19 Community Response Fund
National Conflict Resolution Center recognized The San Diego Foundation during their annual Peacemaker Awards for their leadership in creating the San Diego COVID-19 Community Response Fund, which granted $64 million through 387 grants to 250 nonprofit partners who provided services to 2.3 million residents.
Fund awardees include:
“This uncertain, tumultuous year has exposed inequities in our society and further highlighted the polarization in our country. However, I am inspired by the work of all of our honorees to create a world where healthy, collaborative dialogue is possible.” - NCRC President Steven Dinkin.
Culturally Competent Care
The healthcare community is working to create change within their systems. They are sharing resources and best practices, listening and learning from patients and colleagues, and examining implicit bias and policies to improve the health and safety of their community. Anthem Blue Cross reminds us that an important aspect of health equity for marginalized people is the diversity and cultural competency of healthcare professionals. Culturally competent care is defined as the delivery of care within the context of appropriate physician knowledge, understanding, and appreciation of cultural distinctions leading to optimal health outcomes.
Education and training in culturally responsive practices can lead
to a dismantling of health inequities and disparities in healthcare.
American Academy of Pediatrics is working
to improve their understanding of the effects of racism on child and
family well-being and how they can play a role in dismantling racist
systems. They created a repository of anti-racism resources as a starting point for
Kaiser Permanente has evolved their
approach to advancing health equity using data-driven
strategy. They have shown that efforts to provide culturally
responsive, equitable care; addressing social needs; supporting social
justice; and working to dismantle racism have seen positive results in
improving outcomes for all patients. While disparities in many areas
have narrowed, their research shows that gaps still do persist and need to be addressed.
Bastyr University provides courses and
mentorship opportunities that educate about social justice and promote culturally responsive
practices in healthcare and advances health access and equity. Funded
by a 5-year $10 million endowment from the National Institute of
Minority Health and Health Disparities,
San Diego State University HealthLink is a multi-college effort that is
helping SDSU build its infrastructure to support population health and
health disparities research.
"We acknowledge that racism, bias, and inequity are not isolated to the criminal justice system. They exist in all aspects of our society including public safety, healthcare, education, and access to resources and economic opportunity. The San Diego County Medical Society (SDCMS) is committed to working with the community and within the healthcare system to address bias, systemic racism, and inequality and their serious health consequences. The well-being of our community depends on our collective action.”
San Diego County Medical Society Executive Committee
Opening a dialogue between peers can also offer insight on how to solve health inequity. The Academy of Integrative Health & Medicine’s Black, Indigenous and People of Color Task Force held an online forum to have Critical Conversations about Racism in the Integrative Community. Optum has also developed their C-Suite Insights which are conversations with health care executives to drive change in the industry. Their latest panel discussion addresses real world scenarios for making progress towards health equity.
Alliance Healthcare Foundation continues to work with their active Innovation Initiative (i2) grantees who are creating sustainable, transformational health & wellness programs and services through their innovations. One recent example is from Somali Family Service which has been working on new ways to increase vaccine understanding and acceptance.
Equity of Systems
Local governments are also taking an active role in explicitly addressing equity.
San Diego established an Office of Equity and Racial Justice to help
identify systemic bias and make San Diego County an equitable,
inclusive and just place so that all San Diegans feel they belong.
They also created the Framework for our Future, a set of guidance
documents for County operations to advance racial justice, health
equity, economic opportunity, environmental protection, and government
transparency to create a region where all residents can be healthy,
safe, and thriving. The
City of San Diego established the Office of Race and Equity to end racial
disparities within city government by providing education and
technical support to city staff to help them recognize and eliminate
systemic racism and other barriers to fair and just distribution of
resources, access, and opportunity. Similarly, the
City of Encinitas formed an Equity Committee. The committee will discuss a
wide range of social topics and offer advice for creating safe,
healthy, accessible, and inclusive opportunities for everyone who
lives, works, and visits Encinitas.
With black babies being 60% more likely to be pre-mature due to
discrimination, the Black Legacy Now campaign was launched in
partnership with the
San Diego; American Academy of Pediatrics, CA Chapter 3;
March of Dimes; Neighborhood House Association; North County Health Services; Planned Parenthood of the Pacific Southwest;
Project Concern International; Rady Children’s Hospital; and other
community partners, to improve health outcomes for Black babies and
their mothers in the region.
Nearly two-thirds of low-income people with periods in the U.S. report having been unable to afford menstrual products during the previous year. The Free4ME pilot program was developed in partnership with local community leaders including Youth Will, Planned Parenthood, the County of San Diego, and the new Live Well San Diego Youth Sector, to address menstrual equity by providing free, organic menstrual products in 24 County of San Diego facilities.
The COVID-19 pandemic has brought to attention the critical need for equitable access to healthcare and resources. Each person has different circumstances and opportunities that can affect their ability to make healthy choices. Unequal access to good jobs, healthcare, grocery stores, neighborhoods, and schools can create differences that make it harder for a person to be healthy. Through Live Well San Diego, community partners are working together to remove barriers so that everyone has opportunities for success. Together, we can positively change the conditions in which people live, learn, work, play or pray to promote better health and wellbeing so that equity can be possible for everyone.