1. HEALTH EQUITY RESEARCH INTERVIEWS: 1st ROUND TOP-LEVEL RESULTS & NEXT STEPS
August 22, 2016

2. OVERVIEW 6 interviews – 11 interviewees (5 dyads, 1 solo)
Scott Burris & Laudy Aron
Anita Chandra & Tamara Dubowitz
Brian Smedley & Naima Wong Croal
Paula Braveman & Elaine Arkin
Shiriki Kumanyika
Rachel Davis & Sheila Savannah
Interviews lasted at least 60 minutes
Dyads challenging  recommend solo interviews for next round

3. ACADEMY HEALTH 3-GENERATION MODEL
Most interviewees acknowledged that these different “generations” of health equity research exist, BUT:
Linear, sequential model is overly simplified
Stages/generations are often overlapping, not occurring one at a time
Many referenced the 2011 Annual Rev. Public Health article by Stephen Thomas around fourth generation research

4. 3-GENERATION MODEL, continued
“I think those are useful distinctions to make, what I don’t like is the sense that these are the sequences, and you sort of pass from one and then when you grow up you do the other. I don’t think you want to imply that at all because you’re always going to need all of those. You’re going to need research in all of those. They are overlapping, rather than sequential as portrayed here.”
“[The model] ignores the fact that there has been intervention research going on for decades. What I find most useful is to think about intervention research happening at different levels of analysis. Much of the early work has been done at the individual level. Slowly that research began to evolve and to more carefully consider social context. More recently, people are beginning to intervene at the level of institutions and structures and systems. This has been important because work is needed at all levels; we need comprehensive approaches to solve health disparities and advance health equity.”

5. OTHER TOP-LEVEL THEMES
SOLUTIONS
Field is ready to consider solutions
Lots of existing research that is ready to be acted upon
AREAS
Hard to identify specific areas in health equity to be addressed – all seen as important
Need for work across multiple areas and multiple disciplines that are interrelated and not distinct
RESEARCH DESIGN
Traditional NIH RCT design does not lend itself well to health equity work – need more natural experiments
Need to develop distinct standards for health equity research (rather than “anything goes” approach)
“Many people seeking MPHs are coming from other disciplines, and they’re starting to see the overlap of public health in their work, whether they’re from planning, or education, or healthcare. I think that really leveraging that strength and looking at more interdisciplinary studies so that we are more holistically using the science of public health as part of academic programs across multiple different disciplines would be really important.”

6. TOP-LEVEL THEMES, continued
INTN’L LESSONS
A sense that other countries (UK, Australia, Canada, etc.) are much more advanced in their health equity research
Lesson learned – need more longitudinal studies in US that could incorporate health equity outcomes of interest
AREAS
Unanimous agreement that health equity research should be include of all marginalized/oppressed populations (gender identity, rural populations, disabled community, etc.)
However, a fear that too much dilution could lead to important resources being directed away from populations most in need – COCs and low-income
DEFINING HEALTH EQUITY
Interviews did not directly address the definition of health equity
A sense that we need to define what exactly is entailed by health equity research, and expand what is constituted as health – education, residential segregation, etc. could all have health and equity implications
If we’re talking about health equity, what are we talking about when we talk about health outcomes? We’re talking about economic outcomes, all kinds of health outcomes. If we’re going to talk about health equity, we really need to broaden what we’re talking about when we talk about health equity research. To me, justice research is health research, transportation research is health research. Everything is health research.”

7. HEALTH EQUITY FUNDERS Current Funders Potential Funders
Robert Wood Johnson Foundation
NIH: NIMHD, NCI, NIEHS, NHLBI
Kellogg, Annie E. Casey, Kresge (less so), Ford Foundation (NY), Gates, Hewlett, Packard, California Endowment
California Health Foundation
Convergence Partnerships
SAMHSA
Movember Foundation
Grantmakers in Health
US Chamber of Commerce Foundation
Gates, Annie E. Casey, Ford, Kresge, Macarthur
Healthcare foundations/Convergence Partnerships
City governments
US Department of Education, HUD
Community foundations, esp. in South
Association groups, like Natl. League of Cities, US Conference of Mayors, etc.
Universities and hospitals as anchors

8. NEW INTERVIEW QUESTIONS
Added based on feedback from interviewees on guide
Added at different points throughout interview period, so not asked of all interviewees
Potential to be included in/modified for next round interviews
Are there lessons in health equity outside of the United States that have informed your work?
What needs to change or evolve in health research training, health practice, etc., to better include health equity?
There may be a need to transition health equity into other disciples outside of public health. How do you think this might be accomplished, and what disciplines should be included?
Is there one leading indicator that you think would be a good signal of improving health equity?

9. Questions?
Discussion
Next Steps