San Francisco Health Equity Initiatives Update
The Health Commission Meeting of the San Francisco Department of Public Health (DPH) on June 6, 2023, discussed key goals to address health disparities, support community relationships, ensure workforce diversity, establish sustainable equity infrastructure, prioritize equity culture, and maintain accountability. Initiatives include funding the Office of Health Equity, department-wide training, equity goals for DPH sections, and improving the experience of Black/African American staff. Data on life expectancy disparities by race and district were analyzed, emphasizing the importance of addressing black health priorities through community partnerships and interventions like behavioral health and joyful living programs.
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Health Commission Meeting DPH Equity Update DPH Equity Update June 6, 2023 Ayanna Bennett, MD, MSPH, FAAP Chief Health Equity Officer
1. Reduce key health disparities 2. Support authentic community relationships Our Equity Goals 3. A diverse, inclusive, skilled workforce 4. A sustainable equity infrastructure 5. A culture that prioritizes equity 6. Ensure ongoing accountability for progress
Fund the Office of Health Equity (OHE) Work with the Office of Racial Equity Department-wide equity training Equity goals for each DPH section Report at the ZSFG and LHH Joint Conference 2020 Health Equity HC Resolution In-depth review of policies and practices Equity in RFP and vendor selection Health equity criteria for all DPH contractors Disaggregate all DPH data Improve experience of Black/African American staff
HEALTH DISPARITIES: Longevity Life Expectancy by Race 100 85.8 yrs. 90 75.6 yrs. 80 70 60 D6 50 D1 40 30 79.1 yrs. 20 10 D10 0 Black/ African America n 76.5 68.3 Native America n Latino(a ) Pacific Islander All Asian White Women Men 86.1 80.3 89.6 83.9 87.9 82.5 84.2 79.6 76.8 75.5 Life Expectancy by District 78 SF CHNA 2019, Native American California Vital Statistics 2021 4 Office of Health Equity San Francisco Department of PublicHealth
HEALTH DISPARITIES: Black Health Priority Setting Planning Group Review of Community Input Project initiated as a partnership btw DPH and UCSF Health with $125,000 CDC Grant Mega-Black Budget Unity Council Additional members: 2 community leaders, 4 residents, Kaiser and HSA representatives Health Subcommittee of the African American Reparations Advisory Committee (AARAC) Small Development Group met over 1 year National research review of major contributors to Black longevity and effective interventions Individual Community Leaders Health Commission Resolutions Ethnographic study with SF Black Elders (2023) and DPH Clinic patients (2019) 5 Office of Health Equity San Francisco Department of PublicHealth
HEALTH DISPARITIES: Black Joy & Longevity Physical Health & Wellness Behavioral Health and Joyful Living Accountability Neighborhood Clinics Community Collaboration Equal Access Reduce Disparities Overdose Prevention Opioid Treatment Mental Health Services Stress Reduction Racial Equity Lens Evaluate & Review Audit & Track Share Data Healthy Communities and Environments Health Workforce More Black Health Professionals Black Hiring Initiatives DPH Staff DEI Training Violence Prevention Economic Resources and Housing Food Security Environmental Pollution Clean-Up 6 Office of Health Equity San Francisco Department of PublicHealth
COMMUNITY RELATIONSHIPS: Neighborhood Tours Community Health Workers will take staff on tours of key neighborhoods. First, Bayview in late June All 9 Priority Neighborhoods over the following months Initial staff will be Primary Care clinic staff and senior leadership 7 Office of Health Equity San Francisco Department of PublicHealth
WORKFORCE: 2021-23 REAP Activities 100% % Overall complete 90% 2022 2023 (to date) 80% 70% 60% 50% 40% 30% 20% 10% 0% 3. Discipline and Separation 5. Professional Development 1.Hiring and Recruitment 4. Equitable Leadership 6. Organizational Culture 2. Retention and Promotion 7. Board and Commission 8 Office of Health Equity San Francisco Department of PublicHealth
INFRASTRUCTURE: OHE Expansion
INFRASTRUCTURE: Area Organizational-Assessments 15.0 201920202021 2022 Annual self-report of level of activity around equity, including: - Training - Staffing and budget - Community engagement - Planning and metrics 13.0 11.0 9.0 7.0 Most areas show steady increases in activities, few loses around pandemic or staffing shortages 5.0 3.0 1.0 ZSFG LHH PHD PC JHS MCAH BHS 10 Office of Health Equity San Francisco Department of PublicHealth
CULTURE Staff Engagement Survey 90% 2019 2023 80% 70% 60% 50% 40% 30% 20% 10% 0% Asian Black Latinx White Asian Black Latinx White Asian Black Latinx White Asian Black Latinx White I am actively involved in advancing racial equity in my work. I feel comfortable talking about race and racism in the workplace. Managers in my department treat staff from all racial/ethnic groups with respect My division is taking active steps to improve racial equity. 10 Office of Health Equity San Francisco Department of PublicHealth