Addressing Structural Racism, Bias, and Health Communication as Foundational Drivers of Obesity Proceedings of a Workshop Series (2022) / Chapter Skim
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13 A Multisector Conversation on Systems-Levels Changes for Obesity Solutions
13 A Multisector Conversation on Systems-Levels Changes for Obesity Solutions
Pages 109-120
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From page 109... ...
Clinical and Community Data Initiative uses existing infor mation technology in new ways to link individual data across clinical and community sectors to create local data that can help researchers better evaluate multiple interventions and un derstand differential effects by root causes. (Blanck)
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The fourth session of the third workshop included reflections from members of the Roundtable on Obesity Solutions on the roundtable's past, current, and future work and additional member perspectives on the workshop, which were followed by a final speaker who provided closing remarks for the first day of the workshop: Nicolaas Pronk, president of HealthPartners Institute, chief science officer at HealthPartners, Inc., and affiliate professor of health policy and management at the University of Minnesota School of Public Health. OPENING REFLECTIONS William Dietz, consultant to the Roundtable on Obesity Solutions and chair of the Sumner M
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Dietz submitted that, because the roundtable provides a venue for public, ongoing dialogue among leaders and voices from diverse sectors and industries, its current focus on structural racism, bias, mental models, and health communication is sound, but it faces the challenge of inspiring the members to take action. Dietz highlighted a new NAM venture, a funding investment called the Grand Challenge on Climate Change, Human Health, and Equity, a multiyear global initiative to improve and protect human health, well-being, and equity by working to transform systems that both contribute to and are impacted by climate change.
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Shiriki Kumanyika, emeritus professor of epidemiology at the University of Pennsylvania Perelman School of Medicine, research professor in the Department of Community Health & Prevention at the Dornsife School of Public Health at Drexel University, and Food and Nutrition Board liaison to the roundtable, followed Dietz in reflecting on the roundtable's work. According to Kumanyika, the roundtable represents a significant paradigm shift in how the National Academies addresses obesity.
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Pronk elaborated on this concept of shared values by describing an example of three key sectors -- public health, health care, and business and industry -- organizing around a framework of shared values including equity, harm prevention, ethical principles, science, and practical wisdom as they pursue policy or programmatic initiatives. As an example of a multisector systems change initiative, he mentioned providing health insurance coverage for obesity prevention and treatment options, such as bariatric surgery, in a way that yields benefits for all stakeholders (health plans, employers, and government)
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uses existing information technology in new ways to link individuals' data across clinical and community sectors to create local data that can help researchers better evaluate multiple interventions and understand differential effects by root causes. CODI's data assets and inputs include data from individual-level electronic health records (EHRs)
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, maintained that better progress toward obesity solutions will come from factoring in the lived experience of people with obesity and thinking about systems that will work for and not against them. He reported that the OAC has begun applying lessons learned from the roundtable's systems mapping efforts, which integrate structural racism, biased mental models and norms, and health communication.
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She highlighted the potential of innovation to make healthy foods more convenient and better tasting, to drive reformulation that improves the nutrient profile of foods, and to make healthy foods more accessible and affordable. She ended her remarks by stressing the food industry's potential to help improve nutrition security.
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Another example of funded research is the Harlem Strong Mental Health Coalition, a multisector, community-engaged collaborative for system transformation.3 According to Yanovski, health insurers will work with a network of community-based organizations, medical providers, and behavioral health providers, with a long-term goal of developing a sustainable model for task-sharing mental health care that will be embedded in a coordinated comprehensive network of services, including primary care, behavioral and mental health care, social services, and other community resources. Lastly, Yanovski informed participants that a suite of funding initiatives for transformative research to address health disparities and advance health equity is planned for fiscal year 2023.
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She replied that the pandemic illuminated the critical need to address the social side of health, giving the example of the difficulty of isolating for people who work in low-wage jobs with no paid sick leave or who live in crowded housing. She confirmed that the pandemic has reaffirmed the Foundation's focus on addressing root causes of health and social inequities, such as long-standing discriminatory policies and systems, with the goal of helping to create a country that allows everyone a fair, just opportunity to live the healthiest life possible.
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From page 119... ...
began to emerge in early 2020. Even though this work occurred prior to the COVID-19 pandemic and the rise in activities to promote social justice and combat systemic racism following George Floyd's death, Hovmand continued, the authors of the map recognized that addressing structural racism and promoting health equity would be important components.
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From page 120... ...
In contrast, they proposed that if a lens of structural racism, health equity, and racial equity is at the forefront, the meaning of systems change will be different. This point brought Hovmand to the notion of collective action, which they suggested goes beyond simply convening multiple sectors to activating double- and tripleduty solutions that address multiple complex problems at multiple scales.
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