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Science-Driven Approaches to Reducing Inequities Through Public Health Policy

Congressional Remarks
Representative Deborah Ross (D-NC-02)
Serves on the House Judiciary Committee as Vice Chair of the Subcommittee on Constitution, Civil Rights, and Civil Liberties; Serves on the House Rules Committee and the Space, Science, and Technology Committee.

On December 6, 2022, The National Prevention Science Coalition to Improve Lives (NPSC) hosted a congressional briefing on deploying prevention strategies to improve racial equity, particularly in issue areas such as health and education. Research and experience provide guidance about what works to reduce racial disparities and improve health outcomes for all Americans. Despite the existence of strategies shown to reduce inequities and foster equitable practices, translating that knowledge into effective policies has lagged behind the science. 

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National experts on this topic presented approaches to advance equity by implementing evidence-based prevention-informed policies that reduce the conditions that perpetuate inequities and strengthen factors that protect against them, especially in the areas of health and education.  Speakers discussed policies likely to have a population level impact and others that are targeted to specific social conditions within communities. They also discussed how researchers and public sectors can work together to enact such change.

The pandemic exacerbated preexisting inequalities in rates of unemployment, food insecurity, violence, and mortality to name a few.  Now is the time to ensure U.S. health policy is grounded in science-driven approaches to reduce economic, health, and social disparities for all people across the nation.

Many universal policies that aim to prevent negative outcomes for all people tend to benefit only certain segments of the population, leaving minority groups in particular with unequal access to needed services.  The science of prevention offers solutions to this problem. To illustrate, Dr. Shelton discussed how implementation evaluation strategies can provide a framework to identify and resolve the barriers to even-handed enactment of health policies.  Also, implementation science can aid in our understanding of how prevention policies are enforced, further illuminating the root causes of health policy inequities.

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Additional solution-based strategies work to reduce existing inequities by promoting health and well-being for specific populations.  Dr. Iruka discussed how policies focused on preservation, protection, and promotion can ensure that Black children and their families are able to thrive and have equal opportunities to live healthy lives.  Her work not only provides actionable solutions to support Black families, but it is also a model for promoting equity for other negatively affected groups.

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Dr. Johnson-Lawrence demonstrated how successful partnerships between researchers and public officials can learn from policy challenges and failures and move forward to prevent repeated disaster and improve equitable outcomes.  She provided examples of using community-based approaches from the Flint water crisis to promote health improvements through existing health and community systems.

More Information About the Speakers:

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Rachel Shelton,

ScD, MPH

Rachel Shelton, ScD, MPH is an Associate Professor of Sociomedical Sciences at the Mailman School of Public Health at Columbia University. Dr Shelton is a social and behavioral scientist who, in addition to serving as Deputy Chair for Faculty Development and Research Strategy, leads a university-wide Implementation Science Initiative across Columbia. Dr Shelton’s work includes advancing the implementation and sustainability of evidence-based interventions in community and clinical settings to address health inequities. Additionally, she has published extensively on social and contextual factors that influence disparities in cancer and other chronic diseases among Black and Latino populations, including social networks, medical mistrust, racial discrimination and racism.

Iheoma Iruka.PNG

Iheoma U. Iruka, PhD (pronounced EE-OMAH EE-ROO-KAH) is a Research Professor in the Department of Public Policy at the University of North Carolina at Chapel Hill and a Fellow at the Frank Porter Graham Child Development Institute (FPG) as well as the Founding Director of the Equity Research Action Coalition at FPG (the Coalition). Dr Iruka’s will be discussing her work focused on ensuring excellence for young diverse learners, especially Black children and their families, through the intersection of anti-bias, anti-racist, culturally grounded research, program, and policy.

Iheoma U. Iruka, Ph.D.

Vivki Johnson Lawrence.jpg

Vicki Johnson-Lawrence, Ph.D.

Vicki Johnson-Lawrence, PhD is a senior research public health analyst at RTI International. Dr Johnson-Lawrence is a social epidemiologist that uses community-based approaches to address determinants and prevention practices to promote health equity. Her work has expanded from the role of a traditional secondary data-driven epidemiologist to use community-engaged research strategies that inform components of her research, but to also provide a direct context in which the work is applied, modified, and used to promote health improvements through existing health and community systems, with local and community-based organizations, and within the academic context.

Presentations

Dr. Shelton
Dr. Iruka
Dr. Johnson-Lawrence

Watch the Replay!

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Resources:

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Websites

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Brief: Anti-racist policymaking to protect, promote, and preserve Black families and babies

By: Chapel Hill, NC: Equity Research Action Coalition, Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill; Iruka, I. U., *Harper, K., *Lloyd, C.M., Boddicker-Young, P., De Marco, A., & Jarvis, B.

Published: 2021

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Black Child National Agenda: America Must Deliver on its Promise

By: Iruka, I. U., James, C., Reaves, C., & Forte, A.

Published: Sept. 2021

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Primer: Principles of Community Engagement, second edition

By: Centers for Disease Control and Prevention (CDC)

Published: June 2011; *A new version will be released in the Spring of 2023

This primer is a foundational publication that describes how to engage a community effectively, and outlines the capacities an organization needs in order to do so.

It includes eight chapters related to different aspects of effective community engagement:

  1. Chapter 1 provides an overview of community engagement

  2. Chapter 2 outlines nine principles for effective engagement

  3. Chapter 3 provides real life examples

  4. Chapter 4 discusses organizational capacity for community engagement

  5. Chapter 5 discusses engaging communities in research

  6. Chapter 6 discusses social networking

  7. Chapter 7 reviews evaluation practices

  8. Chapter 8 provides a summary

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Guide: Implementation Science at a Glance

By: National Cancer Institute, NIH

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Advancing Health Equity through Implementation Science

Contributors: Prajakta Adsul, Rachel Shelton, April Oh, Stephanie Wheeler, Todd Moore, Ariella Korn,
CPCRN Health Disparities Group, CCIS Health Equity and Context Working Group, ISC3
Health Equity Task Force

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Research Articles

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  • Van Ryzin, M. J., Roseth, C. J., & McClure, H. (2020). The Effects of Cooperative Learning on Peer Relations, Academic Support, and Engagement in Learning Among Students of Color. The Journal of educational research, 113(4), 283–291. https://doi.org/10.1080/00220671.2020.1806016

  • Santos, W.J., Graham, I.D., Lalonde, M. et al. The effectiveness of champions in implementing innovations in health care: a systematic review. Implement Sci Commun 3, 80 (2022). https://doi.org/10.1186/s43058-022-00315-0

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