Benchmarks for Schools of Public Health to Achieve to Eliminate Racial and Ethnic Health Disparities

1. Benchmarks for Schools of Public Health to Achieve to Eliminate Racial and Ethnic Health Disparities Presented by Dean James Kyle, MD, MDiv (LLU) Chair, ASPH/Kellogg Taskforce ASPH Associate Deans’ Retreat June 2006

2. Why is this important? • Cancer Screening and ManagementAfrican American women are more than twice as likely to die of cervical cancer than are white women and are more likely to die of breast cancer than are women of any other racial or ethnic group. • DiabetesIn 2000, American Indians and Alaska Natives were 2.6 times more likely to have diagnosed diabetes compared with non-Hispanic Whites, African Americans were 2.0 times more likely, and Hispanics were 1.9 times more likely. • Infant MortalityAfrican American, American Indian, and Puerto Rican infants have higher death rates than white infants. In 2000, the black-to-white ratio in infant mortality was 2.5 (up from 2.4 in 1998). This widening disparity between black and white infants is a trend that has persisted over the last two decades. Source: CDC Office of Minority Health, http://www.cdc.gov/omh/AMH/AMH.htm

3. Background • February 2005 W. K. Kellogg Foundation seminar, “Racial and Ethnic Health Disparities: Schools of Public Health Respond as Engaged Institutions” • Kellogg funded ASPH to work on this effort • The taskforce was convened in Summer 2005

4. Taskforce Charge The ASPH/Kellogg Taskforce is charged with identifying best practices for accredited schools and programs of public health to achieve in order to eliminate racial and ethnic health disparities in the nation’s communities. Part of this includes addressing disparities in the proportion of minority faculty in the schools and programs of public health across the nation. The Taskforce will work closely with the ASPH Diversity Committee, an active standing committee that advises the Deans and Executive Committee on strategies to address issues relating to minority faculty, minority students, the minority health professions workforce, and minority public health, at-large.

5. Taskforce Members

6. Taskforce Activities • Baseline Assessment • Collected data on SPH activities related to the elimination of racial and ethnic health disparities • Data was collected in December and January, and then summarized • Minority Faculty Retreat, January 31-February 1 • Reps from 36 schools and 9 programs attended • Draft benchmarks

7. Charge for Today • Are the benchmarks realistic? feasible? • Do you have any alternate or additional ideas? Are there any missing benchmarks you would suggest? • Do you have any suggestions for measures for these benchmarks, and for the timeframe for achieving them? • If you have any specific “wordsmithing” edits, please send them to Gillian Silver at ASPH, gsilver@asph.org.

8. Draft BenchmarksFor Public Health Schools and Programs • Research • Curriculum • Students • Community Outreach and True Partnerships • Policy and Advocacy • Faculty • Tenure and Promotion

9. SPH: Research • Encourage collaboration that equitably involves multiple principal investigators in the development, implementation, and evaluation of community-based participatory research/health disparities research. • Facilitate research collaboration between faculty at minority-serving institutions (MSIs) and majority institutions (MIs). • Increase the number of peer-reviewed publications co-authored by MSI and MI faculty.

10. SPH: Curriculum • Offer an elective course that focuses on health disparities. • Create or maintain a minimum of one module, section, or case study that teaches students about health disparities in one or more required courses. • Develop practica placements/activities for students that include opportunities to learn about and work to address health disparities issues. • Create or maintain in-house seminars (one series per year) to bring visibility to health disparities issues.

11. SPH: Students • Create, maintain, or enhance pipeline programs that foster the interest of young students in public health careers. • Increase the number of underrepresented minority students enrolled in the SPH, with the goal to reflect the demography of the national population. • Conduct a self-study to review and elicit ways to improve minority student retention. Develop a program based on data from the self-study to increase student retention. • Faculty mentors are encouraged to discuss racial and ethnic health disparities issues with all student mentees, and to involve students in research focused on racial and ethnic health disparities.

12. SPH: Community Outreach & True Partnerships • Formally commit to cultivating a partnership with a community and work with that community to address its health disparities. • Create multi-disciplinary efforts to address community health issues by incorporating other academic disciplines in the effort (e.g., urban studies, political science, education, social work, etc.). • Encourage universities to take a leadership role in mobilizing their institutions and external organizations (agencies in the community, different from CBOs) to work on addressing racial and ethnic health disparities.

13. SPH: Policy & Advocacy • Play an active role in local or state commissions, task forces or Office of Minority Health on health disparities. • Partner with the state department of health and other stakeholders to convene a planning meeting on minority health and health disparities. • Sponsor faculty development workshops on translation of research for purposes of policy development and analysis. • Take a leadership role on the university campus to initiate or further campus-wide support for community engagement and community-engaged scholarship.

14. SPH: Faculty • Increase the number of underrepresented minority faculty in public health schools and programs, with the goal to reflect the demography of the national population. • Appoint practitioners who work with underrepresented minority communities to the faculty. • Form support groups for minority faculty in similar disciplines within the university community, especially for open discussion of issues too sensitive for individual mentors. • Provide junior faculty with the opportunity to have reviewers read their papers and grant applications, to assist in their career development. • Designate resources within school and program budgets to pay for underrepresented minority faculty to attend national meetings. • Develop training/workshops for faculty that focus on imparting teaching skills and on managing funded research, and encourage new faculty to participate in these trainings. • Encourage junior faculty to take advantage of institutional research support mechanisms currently provided.

15. SPH: Faculty -- Tenure and Promotion • Charge department chairs to review with new faculty the criteria for tenure and promotion, as well as encourage periodic reviews to assess progress and the need for additional help. • Assign a senior faculty mentor to new faculty members to assist them in developing a strategic plan for tenure and promotion, and meet periodically with them to monitor progress. • Provide protected time for new faculty, in order to help them move successfully towards tenure and promotion. • Educate the members of promotion and tenure committees about community engagement and community-engaged scholarship, and prepare them to understand and apply the guidelines in the review of community-engaged faculty.

16. SPH: Tenure and Promotion (cont’d) 12. Proposed changes to tenure and promotion committee policies: • Increase the number of years allowed for junior faculty to come up for promotion or tenure to allow for development of partnerships with community, implementation of the interventions, translation of those interventions, and evaluation of research process and outcomes. • Change the school’s culture so that an NIH R01 is not valued over other grant awards of similar magnitude. • Recognize/value faculty policy development and analysis efforts. • Involve community partners in a meaningfully way in the promotion and tenure processes for community-engaged faculty members.

17. Draft Benchmarks for ASPH • Faculty • Research • Curriculum • Policy and Advocacy

18. ASPH: Faculty • Provide opportunities for minority faculty to network at national meetings. • Collaborate with the NIH Office of Minority Health and other funding agencies to create post-doctoral training opportunities for underrepresented minorities. • Develop publication/book on career advancement issues specific to minority faculty. • Post health disparities curricula on a web-based archive. • Develop a “data bank” or list of experts on minority health researchers for the purposes of research collaboration and mentoring.

19. ASPH: Faculty (cont’d) • Advocate for agencies to fund minority faculty career development efforts. • Offer faculty workshops on excellence in teaching pre-APHA annual meeting (on topics including use of alternative methods to support teaching (e.g., webcasts, webinars), problem-based learning techniques, and practice-based teaching, research, and scholarship in practice). • Convene a subcommittee to explore teaching requirements for junior faculty, protecting faculty time (encourage co-teaching with senior faculty). • Commission a journal issue for the publication of taskforce/minority faculty-authored manuscripts. • Convene a committee of representatives from schools and programs to develop sample language for insertion into individual schools’ tenure and promotion guidelines.

20. ASPH: Research • Seek funding from foundations to develop and implement a process for the provision of start-up funds for junior faculty in community-based participatory research/health disparities research. • Seek funding to enhance collaborative research between Minority-Serving Institutions and majority institutions. • Include discussion of health disparities and community-based participatory research in Deans’ and Associate Deans’ retreats. • Develop operational definition of health disparities research, andproduce a health disparities document that includes a formal definition and defines the issues and significance to public health.

21. ASPH: Curriculum • Solicit grant funds to award an annual prize for a health disparities class or module/materials development. Modules could include non-traditional ways of sharing information, e.g., oral history sharing for American Indians. • Add “health disparities” as a classification/topic on the ASPH Public Health Case Studies Resource Center, and encourage faculty to submit case studies that highlight racial and ethnic health disparities issues. • Offer workshops for faculty on developing curricula specific to community-based health disparities.

22. ASPH: Policy & Advocacy • Prioritize health disparities research in advocacy efforts. • Strengthen relationships with the Congressional Black Caucus, the Latino Caucus, the Asian/Pacific Islander Caucus, and the Native American Caucus. • Form a “Friends of the National Center for Minority Health and Health Disparities” coalition, in order to support full funding and sustaining the center. • Co-sponsor the Health Education Advocacy Summit, sponsored annually by multiple health education and public health organizations (http://www.healtheducationadvocate.org/Summit/about.html). • Begin advocacy training, focused on health disparities issues, for interested administrators, faculty, staff, students and community partners. • Develop a web-based advocacy resource center focused on health disparities.

23. Prioritization Affix dot stickers next to the benchmarks that you think are the most important to work on as a top priority.

24. THANK YOU! Thank you for your hard work and input. If you have any comments, please contact Gillian Silver at ASPH, gsilver@asph.org.