Berrien County Health Department
Contact Person: Nicki Britten, Director of Community Health Planning
Contact Info: firstname.lastname@example.org
The Berrien County Health Department (BCHD) has been working for almost 50 years in Berrien County to prevent disease, prolong life, protect the health of the community, and promote an optimal quality of life for all citizens. This mission is achieved through the continual evaluation of community-wide health needs, particularly where vulnerability exists; through the development of comprehensive population based health policies, both personal and environmental; and through diligent collaboration and cooperation with all healthcare organizations and the community to provide health services.
Berrien County continues to have significant health disparities based on race, economic status, and education. These disparities exist in overall health status, specific chronic diseases, infant mortality, and access to preventative care. Achieving health equity and reducing disparities in the communities we serve is high on the list of Health Department priorities. The Health Department began to focus its efforts on working towards health equity in 2008.
Issues of social inequity and health disparity effect all populations in our county; therefore, our target population is the population of Berrien. However, since disparity adversely affects African Americans in the 49022 zip code (City of Benton Harbor and Benton Township), who have the highest rates of infant mortality and worst health statuses of the populations in Berrien County, this target should receive the greatest benefit from our intervention.
Partners involved in health equity work include: Berrien County Health Department MI, Civil Rights Commission Consortium for Community Development, City of Benton Harbor, Lakeland HealthCare, Whirlpool Corporation, Communities of Health, Southwest Michigan Planning Commission, Healthy Berrien Consortium, Hospice at Home, Board of Health, Conservation Fund, American Cancer Society, & Individual Community Activists.
Activities & Objectives
Health Equity Alliance (HEAL)
The BCHD went through a strategic planning process at the end of 2010 and set a long-term departmental goal to increase equity in health outcomes for all Berrien County residents. Through the Capacity Building Grant (CBG) we set up a county-wide coalition called the Health Equity Alliance, or HEAL, and they have as a goal to build a healthier Berrien County through medical, as well as non-medical strategies aimed to reduce social stratification and inequalities in health. The HEAL taskforce is made up of at least 11 area organizations and more than 25 individuals who advocate for health equity.
The HEAL supports the REACH initiative, which has as its goal to: address disparity in the rates of infant mortality between white and African American populations in Berrien County by providing training to healthcare providers to increase their understanding of social determinates of health with specific emphasis on social factors leading to infant mortality. We hope to reach 30 OB/GYN or Pediatric providers, an additional 50 providers from other health care fields and staff from at least 8 offices or clinics throughout Berrien County.
Other Heath Disparities Reduction Work
Some of the objectives in the disparity reduction work we have been doing include:
- Complete a curriculum package tailored to providers with local information on infant mortality and social determinants of health in African Americans. Measurably increase awareness and understanding providers have of social determinants of health and infant mortality from provider training/lectures.
- Increase knowledge of social determinants of health through Health Equity Alliance meetings and members Improve data collection (Behavioral Risk Factor Survey) to include questions about race and social context. Qualitatively and quantitatively evaluate Berrien County to assess health inequity using survey tools and Photovoice.
- Education for all Berrien County Health Department employees, leaders, and Board of Health members about social determinants of health and how to "undo racism" in their daily work.
- Development of a model curriculum to help others present the Unnatural Causes material in shorter, incremental pieces.
Although the BCHD has been working towards health equity in our county for several years, it is hard to identify any "best practices". There have been several activities that have worked well, some better than others. Most recently, BCHD has had its most successes with the support of several different grants that have allowed the health equity work to take flight. Some of the more successful, sustainable and innovative practices include:
- Capacity building with agency and community partners in Berrien County to strengthen health equity knowledge base, build a common language around health equity, gain necessary skills for communicating health equity concepts, and develop our health equity coalition (made possible by the Capacity Building Grant through MDCH).
- Engaging both BCHD staff and community members in a dialogue about the root cause of health inequalities (made possible by a Social Justice/Health Equity grant through Ingham County). Dialogue about root causes of health inequalities (systemic oppression/racism) has helped staff and community members to see the true reasons why disparities exist, and encourages us to work towards sustainable solutions ? tackling the root causes rather than placing a band-aid over the problem for the short term.
- Community Photovoice project empowered many community members through the participatory based action research. Photovoice was an excellent tool for engaging the community to see how their environments affected their health (i.e. the social determinants of health). This innovative way of doing research and its remarkable results has been a wonderful discussion-engaging tool for presentations and groups across the county.
All of these activities, and many others, have truly allowed BCHD and the communities served to embark on a transformation process to become a healthier and more equitable county. The work, however, is by no means completed; there are still many years of hard work and perseverance towards transformation to come.
Lessons, Challenges, & Recommendations
BCHD continues to struggle with the overwhelming nature of the problem of health disparity. If we believe health disparity is a bigger problem then use of resources then the solution must be also being bigger. When the underlying causes of health disparity are identified as racism, or chronic stress, or lack of jobs then the solution become impossible. How does one end racism with small grants and limited time? This is certainly a challenge. There is so much to do that it is challenging to limit the focus to achievable goals that will also make a difference.
BCHD continues to learn new lessons every day in this work. Some lessons that have been valuable include the following:
- Working towards health equity is a process, not an outcome. It is not something that will happen quickly or necessarily in the way you expect/want it to. Perseverance and vigilance is key to keeping the momentum moving in a forward direction.
- Not everyone will embrace the importance of this work. It is important to find new ways of introducing the concepts to make them vital for everyone to pay attention to. This truly does concern all humankind, but not everyone will recognize that without a little message tweaking.