Leaders Urge Us To Demand Partnership in Local Community Transformation Awards

by Scout, Ph.D.

Director, Network for LGBT Health Equity

At The Fenway Institute

Asking Officials How We Get Inclusion in Local CTG Awards

Flashback to American Public Health Association (APHA) conference a few months back. This event pulls together 13,000 public healthians from every walk of life. They had a session there where they were announcing the Leading Health Indicators for HP2020. Assistant Secretary for Health Dr. Howard Koh was there, as were several other leaders in the health and racial and ethnic minority communities. Moderating the session was Dr. Benjamin, the well respected President of the APHA.

You know what we do, when they open it for questions, we’re early in the line, asking about disparities and LGBT inclusion particularly.

This time I asked about this $100M of new Community Transformation Grant (CTG) money that’s just been awarded locally. As you know, we’ve been working on this lots and LGBT inclusion in these new awards wasn’t just optional, the way the CDC guidance was written, it was downright difficult for states to justify. To put out $100M of new local funds for tobacco, exercise, nutrition and not even target our communities is a huge loss. Even more worrisome are signs some states aren’t even reaching out to their existing racial and ethnic disparity infrastructure.

How? Demand Partnership

So, that was what my question was about this time, see full transcript below. Importantly, Dr. Benjamin was really clear and almost strident; local advocates need to demand partnering with local CTG grantees. We will too often be left out until we speak up and demand to be included.

So the question is, will we?

In Their Own Words; The Transcript

APHA PRESIDENT BENJAMIN:  Thank you. Next question? 

SCOUT:  Hi. My name is Dr. Scout and I’m from the Network for Lesbian, Gay, Bisexual, Transgender Health Equity. I love that we’re using social media so much as I’m trying to livetweet this event, which definitely bends your brain.

I did my dissertation on social determinants of transgender health. I love that social determinants are in there.

But my question would be you know something? I do a lot of work with community groups. I’ve been working for many years with a set of health disparity networks in Minnesota that are doing health and wellness disparity work around the Southeast Asian populations, Latino populations, African American and African populations, and lesbian/gay/bisexual/transgender population. 

It was dispiriting to see millions of dollars come into Minnesota under Communities Putting Prevention to Work and not see overlap with those existing health disparity networks.

We worked hard that the Community Transformation Grants. Had an RFA that said please do more work with your existing disparity populations and your disparity action plans. And it was even more dispiriting to see that they got almost $5 million in the state of Minnesota and they still haven’t even reached out to the existing disparity networks.

So my question I guess and it’s probably for you, Dr. Koh, what are we thinking around plans not just to ask for disparity inclusion for all populations, but to actually monitor and ensure that it happens as we run these huge sets of new funds out across the country? Thank you.

ASSISTANT SECRETARY KOH:  Well, Scout, it’s good to see you again. You always ask me the good questions. [LAUGHTER] We have a commitment to ending disparities that I think is greater now than ever before.

And when we talk about disparities we discuss them not just with respect to race and ethnicity, but also sexual orientation and gender identity and geography and level of disability and many, many other dimensions.

We do have a dedicated action plan on reducing disparities that was unveiled some six months ago. In fact, the next session I’m speaking at in an hour is on achieving health equity.

That is perhaps the most comprehensive plan to reduce disparity that ever unveiled by the department. And also reflects the growing commitment across the country to truly make the vision of health equity come alive.

So we also have committed to monitoring progress very, very carefully. And our assistant secretary for planning and evaluation, Sherry Glied, is a valuable co-partner and leader. And her whole office is helping monitor outcomes.

This is where using the healthy people data, the leading health indicator data, implementing the national prevention strategy, and using the power of Dr. Glied’s office is going to help us track these outcomes over the future.

Your challenges that you described about the disconnects in various states is reality speaking, so thank you. Please do not give up because I think we are in a new dimension right now with public health, a true paradigm shift with respect to social determinants. And this is our opportunity to make it happen.

APHA PRESIDENT BENJAMIN:  And let me add. I think that’s a perpetual problem and we really, and that’s on us. I’m not sure it’s on them. I think it’s on us and the community to demand that we partner.

We talk about partnerships and collaborations all the time. And then we fail to collaborate and partner. So I think we’ve got to go back to our communities and demand that we do it. Just like in the early days of the HIV/AIDS epidemic.

We’ve got to demand it. We’ve got to require it. We’ve got to talk to our local policy makers. You know, beat up on us local officials. You know, I always hated that when I was a health officer.

But the truth of the matter is unless us and those of us at APHA and others demand that that happen, it’s not going to happen locally. All that kind of control is local at the end of the day.

So let’s certainly try to do that. I know that we’re obviously eager to work in all the communities and make that happen.