Health Equity




OHEC Health Equity Position Statement - Link >>


Fair Society, Healthy Lives: 6 Policy Recommendations


A.  Give every child the best start in life

B.  Enable all children, young people and adults to maximize their capabilities and have control over their lives

C.  Create fair employment and good work for all

D.  Ensure healthy standard of living for all

E.  Create and develop healthy and sustainable places and communities

F.  Strengthen the role and impact of ill health prevention


     Presented by Sir Michael Marmot

     UCL Institute of Health Equity

     APHA Conference, November 2013

     Boston, MA


"Healthy Places" Principles


In order to promote health equity and guide land use, transportation, housing, parks and recreation, redevelopment, and infrastructure decision-making, the Oklahoma Health Equity Campaign declares the following Healthy Principles:




1. Preserve and promote communities that are diverse and socially just


     •    Healthy and sustainable communities are fundamentally places that have and retain a diversity of residents with regards to age, gender, family

          structure, ethnicity, and income.  Such communities should be free of significant physical, social, or economic, barriers to membership, provide

          residential opportunities that foster diversity, and maintain a public realm that stimulates interaction and inclusion.


     •    Development and investment should be prioritized to create neighborhood conditions that reduce avoidable chronic injury and disease in communities

          with the greatest need – especially low-income populations and communities of color.


2. Create complete neighborhoods, cities, and regions


     •    Communities should have safe access to: high quality: parks, recreational facilities, and natural spaces; quality schools; housing; fresh food; health

          care; public transportation; and, infrastructure for active multi-modal transportation including walking and bicycling.  “Access” to these resources should

          be defined as proximity, appropriateness, and affordability.


3. Ensure safe environments


     •    Communities should be free of hazards from environmental contaminants in air, soil, and water and of excessive noise.


     •    Streets and public spaces should be safe for pedestrians and all other users including pedestrians, bicyclists, disabled persons, and seniors.


     •    Communities should be free of crime and violence.


4. Promote opportunity


     •    Ensure that high quality jobs and workforce training are available to local residents including low-income residents, people of color, women, the

          disabled, seniors, and immigrants


     •    Ensure access to high quality and affordable K through 12 education, and post-secondary education.





5. Institutionalize health participation in planning and development activities


     •    Public health needs and objectives should be incorporated into all planning and development decision-making, and representatives from the field of

          public health should be engaged in all major planning and development decisions.


     •    Cities and regions should establish performance measures/indicators for healthy places that will be tracked before, during, and after plan/project

          implementation, and should establish partnerships that identify agency responsibility for data collection and monitoring.


6. Practice more efficient, effective, and inclusive governance


     •    Planning, infrastructure investment and development should incorporate broad input and participation from diverse representatives and community

          stakeholders, especially those who have the potential to be impacted negatively by decisions.


     •    Communities should pursue a comprehensive strategy for health that reflects locally-relevant health issues through multidisciplinary partnerships

           between agencies responsible for parks and recreation, planning, housing, economic development, schools, and public health.


7. Establish accountability


     •    Public decision making should be transparent and democratic.


     •    Agencies whose decisions and actions impact health, including Parks and Recreation, Planning, Housing, and Economic Development, and Public

          Health, should be knowledgeable of and held accountable for the health impacts of their decisions.






The Partnership for Sustainable Communities established six livability principles that will act as a foundation for interagency coordination:


1.  Provide more transportation choices


     •    Develop safe, reliable and economical transportation choices to decrease household transportation costs, reduce our nation’s dependence on foreign

          oil, improve air quality, reduce greenhouse gas emissions and promote public health.


2.  Promote equitable, affordable housing


     •    Expand location- and energy-efficient housing choices for people of all ages, incomes, races and ethnicities to increase mobility and lower the

          combined cost of housing and transportation.


3.  Enhance economic competitiveness


     •    Improve economic competitiveness through reliable and timely access to employment centers, educational opportunities, services and other basic

          needs by workers as well as expanded business access to markets.


4.  Support existing communities


     •    Target federal funding toward existing communities – through such strategies as transit-oriented, mixed-use development and land recycling – to

          increase community revitalization, improve the efficiency of public works investments, and safeguard rural landscapes.


5.  Coordinate policies and leverage investment


     •    Align federal policies and funding to remove barriers to collaboration, leverage funding and increase the accountability and effectiveness of all levels of

          government to plan for future growth, including making smart energy choices such as locally generated renewable energy.


6.  Value communities and neighborhoods


     •    Enhance the unique characteristics of all communities by investing in healthy, safe and walkable neighborhoods – rural, urban or suburban.



Linking Action on Health Inequities with the 10 Essential Public Health Services


1.  Monitor health status to identify and solve community health problems.

     •    Improve and better coordinate state data systems to track disparities

     •    Make these data more easily accessible, especially to the community

     •    Grow infrastructure and support for community-driven health assessment


2.  Diagnose and investigate health problems and health hazards in the community.

     •    Build capacity of state and local health departments to conduct public health surveillance and epidemiology research with populations experiencing

          health disparities

     •    Develop an integrated environmental public health tracking program

     •    Expand use of health impact assessments to understand how policies outside of the health department influence health inequities.


3.  Inform, educate, and empower people about health issues.

     •    Expand health education and empowerment efforts by building community partnerships to design, implement, and evaluate communications

          strategies, by training and fielding peer health educators

     •    Develop and evaluate culturally tailored public health communications messages that are disseminated through new and traditional media.


4.  Mobilize community partnerships and action to identify and solve health problems.

     •    Mobilize communities experiencing inequities in health outcomes by strengthen community partnerships and developing integrated approaches to

          community health


5.  Develop policies and plans that support individual and community health efforts.

     •    Develop and support individual and community-level inequities elimination efforts by:

          - Develop state-wide action plan

          - Promote community health planning as a tool to balance allocation of health care resources with community needs

     •    Establish a minority health report card

          - Establish a statewide inter-agency and interdepartmental coordinating council to coordinate the work of state agencies to address health inequities

     •    Address upstream determinants of health such as housing, access to healthy foods, transportation, recreation options.


6.  Enforce laws and regulations that protect health and ensure safety.

     •    Review and evaluate how policies and practices affect the health of communities experiencing inequities in health outcomes.

     •    Where necessary, strengthen enforcement of state laws and regulations that protect the health and well being of vulnerable populations.


7.  Link people to needed personal health services and assure the provision of health care when otherwise unavailable.

     •    Measure and expand access to quality personal health care services

     •    Assure access to a coordinated system or quality care and culturally and linguistically appropriate services by:

          - Encourage health systems to adopt medical home models

          - Expand language access

          - Expand access to primary care, especially in underserved communities

          - Include requirements to address health inequities in all state health services contracts


8.  Assure competent public and personal health care workforce.

     •    Improve the capacity of health and public health professionals to respond to the needs of communities experiencing inequities in health outcomes by:

          - Requiring cultural competency training of current and future health professionals

          - Expand efforts to increase diversity in state health professions workforce

          - Encourage training and employment of community health workers.


9.  Evaluate effectiveness, accessibility, and quality of personal and population-based health services.

     •    Evaluate effectiveness of individual and population-based health services in eliminating health inequities and publicly report this information.


10.Research for new insights and innovative solutions to health problems

     •    Provide the support and resources needed to ensure that the OMH is able to successfully carry out its legislative charge and coordinate the state

          health departments’ health inequities efforts.


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