Dr. Jessica Barnack-Tavlaris Department of Psychology at TCNJ PhD in Experimental Social/Health Psychology from University of Wisconsin – Milwaukee MPH from San Diego State University Experiences working with community based organizations (in San Diego) that serve Latino/a, Samoan, and Somali populations Advanced CEL course (Health Psychology) – partnered with Urban Mental Health Alliance Worked at Planned Parenthood (in Western NY) Reproductive and Sexual Health Research Lab Dr. Jessica Barnack-Tavlaris

Factors that influence health (individual and community level) Health Disparities How are you contributing to the health of our community? Topics for today

What are some of the things you DO to stay healthy? What are some of the barriers that get in the way of you doing these things regularly? Or at all? What privileges do you have that help you stay healthy? Reflecting on your own

Which haven’t we mentioned yet? Conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. What are some of the factors you have observed that are affecting the health of the Trenton community? Both barriers and strengths/resources http://www.kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/

What are Health Disparities? “Preventable differences in the burden of disease, injury and violence, or opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other populations, groups, and communities.” ~ Centers for Disease Control and Prevention (CDC) What are Health Disparities? http://www.cdc.gov/nccdphp/dach/chhep/disparities.htm

Racial/Ethnic Health Disparities in Coronary Heart Disease (CHD) http://www.cdc.gov/minorityhealth/CHDIR/2011/FactSheets/CHDStroke.pdf

Racial/Ethnic Health Disparities in Stroke http://www.cdc.gov/minorityhealth/CHDIR/2011/FactSheets/CHDStroke.pdf

Racial/Ethnic Health Disparities in Diabetes Diagnosed and Undiagnosed Cases among Aged 20 Years or Older Non-Hispanic Whites: 15.7 million or 10.2% of all non- Hispanic Whites Non-Hispanic Blacks: 4.9 million or 18.7% of all non- Hispanic Blacks Diagnosed Cases Only Hispanic/Latino Americans: 11.8% of all Hispanic/Latino Americans Risk for Diabetes 77% Higher for Blacks than Whites 66% Higher for Hispanic/Latino Americans than Whites Racial/Ethnic Health Disparities in Diabetes American Diabetes Association, 2012 http://clinical.diabetesjournals.org/content/30/3/130.full#ref-8

Conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks http://www.kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/

“a system of structuring opportunity and assigning value based on phenotypic properties (i.e., skin color and hair texture associated with “race” in the US) that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and ultimately undermines the full potential of the whole society through the waste of human resources” ~ Jones, 2003 In what ways do you think racism and discrimination affect health? Racism Jones CP. Confronting institutionalized racism. Phylon. 2003;50(1-2):7---22

Lived Experience of Race and Its Health Consequences (Smedley, 2012) Lower quality of care even when controlling for access factors Physicians’ biases, stereotypes, attitudes, and expectations Cultural and linguistic barriers to care Inequitable distribution of access to political power, resources, and social status Discrimination in housing, employment and mortgage lending affects where people can live Chronic stressor Experiencing discrimination is associated with smoking, higher blood pressure (CVD), shorter telomere length (accelerated aging), higher rates of cancer, chronic pain Internalized racism associated with psychological distress, alcohol use, poor cardiovascular health Lived Experience of Race and Its Health Consequences (Smedley, 2012)

Small Group Discussion How are the organizations you are working with connected to community health outcomes? Discuss how your specific positions at your placements are tied to the social determinants of health? In other words, how can YOU play a role in addressing health disparities? Get creative! I want to see you think of ways that are maybe not so obvious. Put examples on the board. Who’s responsibility is it to address health disparities? What types of interventions and/or policies need to be put in place? Small Group Discussion

Dr. Martin Luther King Jr. (1966) “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Dr. Martin Luther King Jr. (1966)