Reimagining a System of Care to Promote the Well-Being of Children and Families Proceedings of a Workshop (2021) / Chapter Skim
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4 Reimagining Behavioral and Public Health Systems to Support Children and Families
4 Reimagining Behavioral and Public Health Systems to Support Children and Families
Pages 31-42
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From page 31... ...
Short- and long-term goals for reimagining systems were also identified as stakeholders strive to move the field forward. UNDERSTANDING THE IMPACT OF RACISM ON HEALTH To create systems that are equitable and effective for all children, we need to understand the complex ways that racism impacts health, said Maxine Hayes, former state health officer for the Washington State Depart ment of Health.
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From page 32... ...
The deaths are a reflection of a wide array of preventable chronic diseases and social determinants of health such as poverty, toxic unremitting stress, food insecurity, violence, trauma, police brutality, poor housing, toxic environments, and poor access to opportunities for meeting basic needs. Because racism has been declared the number one determinant of racial/ethnic disparities in health, we should assume the presence of r acism in p ublic health system policies, practices, and norms, and it should be questioned, said Hayes.
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From page 33... ...
The effects of racism on children are toxic and the relationship between environment, ecology, biology, and child health development is incontrovertible, he argued. Physiological Impacts of Childhood Stress The impact of early toxic stress has neuroendocrine and neurobiological impacts that affect brain structure if not addressed, Wright stated.
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From page 34... ...
Specifically, the effects of exposure to early adversity spark neuronal signaling, which through the production of regulatory proteins and enzymatic impact on epigenetic markers can influence the turning-on or turningoff of gene expression. This results in inheritable and intergenerational impacts.
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From page 35... ...
Since the apology, AAP has added specific language in its bylaws and constitution that clearly states that the organization does not discriminate on the basis of race, ethnicity, religion, sexual orientation, gender identification, or country of origin. Wright discussed AAP's history to demonstrate the importance of acknowledging previous negative practices as part of reconciliation and the advancement toward an equitable health agenda.
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From page 36... ...
Finally, Riana Elyse Anderson, a ssistant professor of Health Behavior and Health Education at the University of Michigan's School of Public Health, examined the relationship between basic and applied research and the way that these relationships provide opportunities for collaboration to restructure health systems. Embedding Antiracism and Mental Health into Early Childhood Care To create successful solutions to systemic racism, we must understand the systems that created them, said Horen.
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From page 37... ...
The infant mortality rate for Black infants in 2017 is equal to the infant mortality rate of White infants in 1980, a 37-year delay in achieving the same survival rate. The data on medical home care and infant mortality rates exemplifies the need for an accelerated change of pace, he stated.
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From page 38... ...
As Hayes noted previously, preconception and the mother's overall health must be factored into the approach of addressing infant mortality. This approach must begin in early childhood and emphasizes the need for a comprehensive public health systems approach.
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From page 39... ...
She also called for a mentorship model as an avenue of support and communication for those working toward solutions at different points in their careers. In addition to FIGURE 4-3 The Racial Encounter Coping Appraisal and Socialization Theory (RECAST)
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From page 40... ...
The social determinants outside of clinical care have a significant impact on one's health, and the narrative needs to change to be inclusive of all influential factors, she concluded. Continuing the discussion, a participant pointed to a 2018 study that showed medical homes may not be as effective for Black and Hispanic families (Guerrero, Zhou, and Chang, 2018)
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From page 41... ...
Matt Lyons, director of policy and research at the American Public Human Services Association, reported that his group discussed the need for an outward-facing plan at every level of care from families and children to leadership. This type of outward policy approach would ensure accountability and increase transparency, he said.
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From page 42... ...
Carlos Santos, associate professor in the Luskin School of Public Affairs at the University of California, Los Angeles, also stressed the importance of community health workers and their potential contributions to a diversified health care workforce. Funding Increasing funding of behavioral and public health systems to create new programs and expand existing ones was a common theme among the groups.
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