Femme 6 - Aiming for Collective Impact

By Mallory Perez – Health Policy & Management Graduate Student

Femme 6 is a student group of Health Policy & Management majors at the UNC Gillings School of Global Public Health. For the Spring 2014 semester, this team of six young women is assisting Every Women Southeast as the coalition grows and expands its network of resources. Mallory Perez from Tampa, FL is a member of Femme 6.

Nowadays, the word “collaboration” gets thrown around a great deal, whether it is a new music record or a team at work focusing on an upcoming project. I recently read an article that made me think critically about why some collaborations work and why others fall flat. “Collective Impact” by Kania and Kramer in the Stanford Social Innovation Review mentions comprehensiveness and risk-taking as part of what makes collective impact successful. The evidence of the effectiveness of cross-sector partnerships is building…slowly. So, what makes engagement in collective impact so difficult? Don’t we all want positive social change?

The five conditions of collective success described in the article are as follows: common agenda, shared measurement systems, mutually reinforcing activities, continuous communication, and backbone support organizations. Establishing all of these elements across various organizations in multiple social sectors can magnify the impact of an initiative and generate large-scale change. Beyond the difficulties of obtaining funding, this type of work requires a change in mindset, one that fully promotes equity. I have learned that collective impact works best when each member has “skin in the game”. No one person pushes to be the sole champion of change. Rather, collective impact is more of a process, and less of who can claim the outcome. The opportunity to learn from the expertise and perspectives of others is invaluable. That opportunity is where we grow, where we bring about change.

Every Woman Southeast is working to apply the collective impact model to women’s health and preconception health. The health sector is rapidly evolving, and it is becoming increasingly clearer that “good health” extends far beyond medical care. Public health, entertainment, advertising, education, and politics are just some of the players that influence our choices, and subsequently our health. At present, Every Woman Southeast seeks to engage partners that will help impact policy decisions and the housing/transportation available to women. Both of these factors contribute to how much autonomy and control women have over their own health. As Every Woman Southeast continues to build more cross-sector relationships, more individuals will discover the ways in which they can participate in collective impact.

The Scoop from AMCHP from a First Time Attendee

By Angela Aina - CDC PHPS Fellow and First Time Attendee of the AMCHP Conference - January 2014

As a first time attendee of the AMCHP conference in Washington, DC, it was great to hear and learn from national leaders in the field of maternal and child health. The keynote speeches from the plenary sessions were very motivating. I most especially loved the speech given by Dr. Maxine Hayes, MD, MPH, with the Washington State Department of Health, when she accepted the Vince Hutchins Leadership Award. As an early career public health professional, learning about initiatives, programs, and strategies that have a focus in health equity is very important to me. Therefore, it was refreshing and affirming to hear the charge of Dr. Hayes, in which she stressed the importance of reducing health disparities by truly addressing the social determinants of health in MCH work. Additionally, it was truly inspiring to have had the opportunity to be among the first the view an episode from a soon-to-be ground-breaking documentary, the Raising of America: Early Childhood and the Future of Our Nation from California Newsreel.


Since I’m new to the EveryWoman Southeast Coalition, it was great to meet some of our regional and national partners. I had the fortunate opportunity to listen to the EWSE Pilot Projects' presentations, which was a valuable learning experience. Hearing about how some of the pilot projects incorporated reproductive life planning and preconception health messages into their health promotion programs and the lessons learned was very insightful. Listening to the accomplishments of the PASO’s radio project in South Carolina and the Reproductive Life Planning project with CHOICES in Memphis, Tennessee, helped to shape my understanding of the impact and reach of the initiatives developed through the EWSE Coalition. It is clear that EWSE is an important initiative for women’s health and health services in the south region of the U.S., especially during these times of reduced funding and increasing health burdens. It was very encouraging to see that the conference provided a space for young MCH and public health professional to link with national and regional leaders. The AMCHP conference is definitely value-added to my professional development, more importantly, in the area of networking and leveraging resources. Of note, it was awesome to see my supervisor, Sarah Verbiest in action as she used the conference as an opportunity to connect with existing partners and gain new partners and resources for the coalition. I am very grateful to have her and Erin McClain as a mentor! Thank you both and the staff at AMCHP for the experience!

Connecting Webinars to Action Steps in Louisiana

Blog Post by Caroline Brazeel from Louisiana

Every Woman Southeast is having an incredibly positive impact on my personal and professional life through its meaningful webinars and support from my colleagues in other states. It’s the fact that we are a regional organization of local people that makes us uniquely poised to impact change. Here’s one example of how EWSE pops into my life at random and opportune moments:

I spent some of the last moments of 2013 talking about Jamila Batts and Dr. Kimberlle Wyche-Etheridge’s October EWSE webinar. After a great NYE dinner, one of the guests, an architect, began describing his most recent work project – a redesign of some of New Orleans’ public schools. In an effort to design a building that met the needs of the students, parents, teachers and school board, he had immersed himself in the lives of the people that flowed into and out of the school. He found old pictures of the building’s façade from the early twentieth century and attended community meetings where neighbors voiced concerns and parents expressed their hopes for the new building. He took that information and thoughtfully proposed options to the school board for adapting the existing structure to meet the current and future needs of those who use it.

His process of reaching into archives for an explanation of how the school became what it is today evoked Dr. Wyche-Etheridge’s work on the Nashville CityMatCH Racial Healing project. When I told him about how they worked in Nashville to map the history of one neighborhood’s development, he couldn’t wait to get home and look it up on the EWSE site. To him, the Nashville project was a combination of his interest in urban planning, architecture, and social justice. To me, his work was a window into how the physical infrastructure for school health and wellness is shaped. At work, I don’t spend any time talking to architects, but our conversation made me realize I needed to reexamine my definition of non-traditional partners.

I’m not sure I would have seen the connection between architecture, education and public health as clearly had I not heard Dr. Wyche-Etheridge and Ms. Batts speak about their work in Tennessee. What I know for sure is we have to ask the right questions of the right people to know how to go about doing our work differently. In 2014, I’m hoping to work on the expansion of my definition of non-traditional partners, and I know my EWSE colleagues will help guide me in that pursuit.

Caroline works at the Louisiana Department of Health and Hospitals in the Office of Public Health. She is a member of the EWSE Leadership Team.

Jessica Hardy is Leading the Way in Alabama

Happy New Year Everyone!

Jessica Hardy is a very active and engaged member of the EWSE leadership team. She is a registered nurse, with an advanced degree in public health from the University of Alabama, Birmingham (UAB). She has served more than nineteen years with the Alabama Department of Public Health in various capacities, including the Alabama Women’s Health Liaison for the U. S. Department of Health and Human Services and for the Centers for Disease Control and Prevention. Jessica was appointed to serve as the first Director for the Alabama Office of Women’s Health (OWH) in 2002 (a position she continues to hold), and was appointed as Acting Director of Alabama’s office of Minority Health from 2009 to 2012. In addition to her work and volunteering with EWSE, Jessica is currently a doctoral candidate in the Doctor of Nursing Practice (DNP) program at Troy University, in Alabama. We asked Jessica about the health problem she cares the most about as well as about the favorite part of her work and her favorite book. Here are her responses!

Infant mortality is a concern not only for Alabama but for the nation as a whole. In Alabama the infant mortality rate is higher than the national average and is compounded with a very daunting disparate rate between the white and black infant mortality rate. It has been said that the infant mortality rate reflects the health of a community; in Alabama this is one of our top women's health issues today. What I love most about my current responsibilities is the outreach into the community. My work allows me to advocate for health in general, and preventive health programs in particular. Communities are very receptive to shared health information. I enjoy serving as liaison between public health and the communities across our state. One of my favorite books is by Christine Northrop, Women's Bodies Women's Wisdom. I have found that women in the community can often relate to the information Dr. Northrop shares in her books, and it opens the door for me to introduce additional resources to the women in communities across Alabama.

From the Field: Health Care Law's Positive Impact on Women

Making Change Happen in Florida

  Leah Barber-Heinz is the CEO of Florida CHAIN

Lost in all of the political wrangling over the Affordable Care Act is the fact that Florida’s women, an astounding 1.4 million of whom are uninsured, will see a huge positive impact thanks to these reforms.

The new law creates significant cost savings by eliminating annual and lifetime limits on how much insurance companies cover if women get sick, as well as prohibiting insurers from dropping women from coverage when they fall ill. Moreover, plans in the new health exchanges place a cap on how much insurance companies can force women to pay in co-pays and deductibles. Starting in 2014 women who cannot afford quality health insurance will be provided tax credits, and the Act will completely close the donut hole for prescription drugs by 2020.

The law also provides more and better health care options and ensures coverage of basic health services including maternity benefits. Maternity benefits are often not provided in health plans offered through the individual insurance market.

Also of particular relevance to women is the fact that the new law already prohibits insurance companies from denying children coverage based on preexisting conditions. Moving forward, it will prohibit insurance companies from denying any woman coverage because of a pre-existing condition, excluding coverage of that condition, or charging more because of health status or gender. Right now, a healthy 22-year-old woman can be charged premiums 150 percent higher than a 22-year-old man.

The Affordable Care Act also aims to crack down on excessive insurance overhead by limiting how much insurance companies spend on nonmedical costs such as executive salaries and marketing. And insurance carriers must justify their premium increases in order to remain eligible for the health exchanges.  

The positive impact these reforms will have on Florida’s women and their families cannot be overstated. A recent report by Families USA found that more than 70 percent of consumers in the individual market will be eligible for financial assistance through the Marketplaces, because they either qualify for tax credits that will make their coverage more affordable or for Medicaid.

As a result of these and other important reforms included in the Affordable Care Act, fewer Florida women will delay needed care or be forced to give up basic necessities in order to get the health care they need.

Voices from the Field: Callie Womble, Intern Extraordinaire

Hello Blog World! My name is Callie Womble and I'm a Masters of Public Health student in the Health Behavior Department at the University of North Carolina Gillings School of Global Public Health. My graduate program focuses on the social and behavioral sciences as a means of understanding and improving the health of populations. One of my academic passions is minority women’s health. I enjoy brainstorming innovative ways to improve wellness and reduce disparity. I first got involved with women’s health in undergrad when I co-founded the UNC Chapel Hill chapter of the Office of Minority Health’s Preconception Peer Educator program and interned at NARAL Pro-Choice North Carolina. These experiences were invaluable to me because they introduced me to the Maternal and Child Health (MCH) field, and ignited my passion.

 

As a graduate student, I wanted to build on that foundation and gain more research experience. In May of this year I began my practicum at the UNC Center for Maternal and Infant Health. My main responsibility has been to disseminate the Women’s Voices Survey, and analyze its results. Working on the Women’s Voices survey was a great because it directly addresses health disparities (an issue near and dear to my heart) and has given me a chance to sharpen my data collection, management and analysis skills.

At the end of August we closed the Women’s Voices survey with 1,950 responses from women of all nine EWSE states and our sample truly represented a life course perspective engaging women of all ages. (How awesome is that?!)  Analyzing the data has been incredibly fulfilling – the survey validates the stories of women in our region. The daily lived experiences of Southeastern women matter, and this survey both affirmed the women as individuals and provided a space for them to share how they see the world.  For me, the most thought-provoking aspect of the data analysis was coding the qualitative responses to questions asking women what they need in order to improve their health. Some of the quotes that really got my attention included:

·         I need an accountability partner.  I have the tendency to procrastinate and put other's needs before my own.  I need a gently forceful person to make sure I'm doing what I'm supposed to do.

·         More education and support on how to balance the many competing demands that women face today with work, family, friends, etc.

·          to have doctors treat me as a human and not just as a poor-Medicaid recipient.

·         A practitioner that listens.

·         A better job so I didn't have to work so hard.  More time. I feel like a lot of my health issues stem from my lack of time to do things like prepare meals and exercise. I work a lot, so that doesn't leave much time for me.

·         Access for the African American population, especially those in rural areas.  Transportation is an issue.  Fear is another issue.  Cost factors in.  Prescription costs prevent consistent medication being used.

These quotes remind me that women in our region often have many responsibilities. They are moms, daughters, friends, sisters, employees, students, church members, sorority members, girlfriends, wives and the proverbial list of “hats women wear” goes on and on. Subsequently, prioritizing others’ needs above their own is a current norm for most women. It also reminds me that the social determinants of health (e.g. where you live, work, play and pray) are REAL and they truly impact how women experience life and wellness. In order to create lasting change we as public health professionals need to strategize ways to make self-care for women the default choice, as well as ways to positively influence the social determinants of women’s health. Indeed, this is a tall order but it’s necessary to change the status quo.

As my practicum comes to close, I have started to reflect on all I have learned these past six months. While the technical skills are indeed significant to me, what resonates most to me about my practicum is the well-rounded nature of my experience. From meetings with stakeholders, to capacity development webinars, to daily in-office conversations with my supervisor and the fellow staff, this experience has been a total emersion in all things MCH. I’ve learned countless new jargon, discovered new thought leaders and followed intense political legislation alongside my fellow staff. 

The most meaningful part of my practicum has been interacting with professionals from different disciplines. It has been both informative and rewarding to hear about women’s health issues from their perspective and then share my thoughts from the HB point of view. These interactions have highlighted how all disciplines have significant expertise necessary for accomplishing our shared goal: improve the health of populations. By working together we are able to put the different pieces of the puzzle together, have a collective impact and achieve our shared goal. Although my practicum is ending, I am excited to continue this versatile experience of personal and professional development as a part of the EWSE leadership team.  As a North Carolina partner I am looking forward to continuing our work towards health equity in our region.

Connecting in Mississippi

Last week I had the opportunity to travel to Gulfport, Mississippi to partner with EWSE Leadership Team member Juanita Graham and her colleagues on promoting the life course approach to reducing infant mortality.The focus of my trip was a presentation to the District 9 FIMR Teams (fetal, infant mortality review) coordinated by Mary Craig and Cheryl Doyle, both experienced and dedicated leaders on this project. Teams have now reviewed over 50 cases and 7 area hospitals have introduced some new policies and classes, particularly around SUIDS risk reduction. The group is now eager to expand their thinking about new approaches to preventing infant death. The meeting was very well attended, including several staff from the state health department in Jackson. The group had a lively discussion about life course and shared ideas about how it could be applied in Mississippi. 

Part of the trip included the chance to network with Juanita's colleagues on behalf of the coalition. My visit happened to coincide with the MS Nurses Association Conference which was themed “Hunting for Evidence-Based Practice” (thus the camo gear). I had the great opportunity to go with them on an evening boat ride in the Gulf. The sunset over the Gulf was amazing and those MS nurses know how to have fun! I also had the chance to recruit some new members to the state team and learn about the MS Coast Interfaith Task Force which is doing some fantastic work on community resilience, access to health care, life planning for 8th graders and more.

While the landscape is lovely and the people are really warm, Mississippi faces many challenges, including poverty, obesity, few resources for programs and high rates of maternal mortality. Fortunately, the state also has a cadre of nurses and public health leaders who are determined to make change happen. Seeing how the community has rebuilt from two recent disasters (Katrina and the oil spill), it was clear that the people of Mississippi are resilient. Hearing that in 2012 Mississippi has achieved its lowest rates of infant mortality ever (while other Southern states have seen increased rates or stagnation) absolutely affirms that these leaders are making a difference. We look forward to connecting with new colleagues and continuing to build the  Mississippi Connection!

Savannah Cooksey, Connie Bish, Juanita Graham, Cheryl Doyle, Sarah Verbiest and Mary Craig (start top left to right)