1. Righting the Wrong of Social Injustice in Health *** Why it matters? Why act now? Health Equity and Young Children Conference May 29, 2013 Maxine Hayes, MD, MPH Washington State Department of Health 1

2. 10 Things to Remember about Health 1.Health is more than health care. 2.Health is tied to the distribution of resources. 3.Racism imposes an added health burden. 4.The choices we make are shaped by the choices we have. 5.High demand + low control = chronic stress. 6.Chronic stress can be deadly. 7.Inequality – economic and political – is bad for our health. 8.Social policy is health policy. 9.Health inequalities are not natural. 10.We all pay the price for poor health.

3. “Of all the forms of inequality, injustice in health is the most shocking and the most inhumane.” Martin Luther King Jr. – March 25, 1966 2 nd National Convention of the Medical Committee for Human Rights “Nowhere are the divisions of race and ethnicity more sharply drawn than in the health of our people…no matter what the reason, racial and ethnic disparities in health are unacceptable in a country that values equality and equal opportunity for all.” Bill Clinton – February 21, 1998 3

4. Health Disparities vs. Inequities Disparity only defines differences between groups. Inequity describes the “causes” of disparities in the context of environmental conditions that are required to generate parity and equality. 4

5. Inequities result in disparities in health status that are “unfair, unjust, avoidable and unnecessary.” 5

6. Healthy People 2010 addressed the need to eliminate disparities, but these disparities are rooted in societal inequities manifested through institutional racism, income gaps, entrenched poverty and social injustice! A new vision for Healthy People 2020 is needed. 6

7. Why inequities matter? 7

8. Health Olympics 8

9. Not everyone has equal opportunity for health 9

10. Inequalities in Opportunity Start Early 10

11. “Getting it right in the beginning is getting it right!” Maxine Hayes, MD, MPH 11

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13. Health Education Economic Development Human Services SCIENCE OF EARLY CHILDHOOD An Integrated Science of Early Childhood Development Could Drive More Productive Investments Across Sectors

14. Timing is Everything! 14

15. Abundance of Opportunity for Policy, Programs and Services Health Reform (ACA) Home Visiting (MIECHV) Early child and brain development science Early child care and education funds Race to the Top Grants (RTT) Community Transformation Grants Early Childhood Comprehensive Systems Grants Child Care and Development Funds Head Start State funded Pre-K Early Childhood Advisory Councils BUILD Initiatives Project Launch QRIS Reach Out and Read

16. How can we use a racial equity lens to help inform our approach in supporting the development of an early learning system at the local and state level? 16 Washington State’s Essential Question

17. Washington State’s approach to RETOC and early learning 17

18. “Impossible is just a big word thrown around by small men who find it easier to live in the world they’ve been given than to explore the power they have to change it.” Muhammad Ali 18

19. “We must all have the audacity to believe we can transform the current system” Maxine Hayes, MD, MPH 19