Closing General Session: ‘The pursuit of health is the pursuit of justice’

What do you get when the nation’s three largest public health associations come together to discuss health equity? Inspired, motivated and compelled to action.

At today’s Closing General Session in Denver, APHA welcomed to the stage the two other acronyms synonymous with public health in America: the Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO). Moderated by new APHA President Thomas Quade, health commissioner for Marion County, Ohio, the panel discussion kicked off with a definition of health equity from Camara Jones, who represented APHA on the panel and had just ended her term as APHA president.

Jones, a senior fellow at the Satcher Health Leadership Institute at Morehouse School of Medicine, started by saying her definition of health equity is a bit different from the Healthy People 2020 definition, which is the “attainment of the highest level of health for all people.” Instead, Jones defined health equity as the “assurance of the conditions of optimal health for all people.” The main reason for the difference, she told hundreds of closing session attendees, is to emphasize that health equity is not an outcome, but a process — and one that requires vigilance to sustain.

However, to succeed at achieving health equity, we need a “theory of change,” said panel speaker Edward Ehlinger, immediate past president of ASTHO and Minnesota state health commissioner. Luckily, there’s already one available.

In developing its Healthy Minnesota 2020 framework, public health workers in the state created what’s now known as the Triple Aim for Health Equity. The triple aim (a term many of you are probably familiar with thanks to its first incarnation as a theory of health system improvement) calls for expanding our understanding of what creates health; taking a health-in-all-policies approach with health equity as the goal; and strengthening communities’ capacity to create their own healthy future.

While public health certainly knows how to provide critical services, Ehlinger said the field is less skilled at affecting living conditions and building power within communities.

“If we all work together, we can create the change that improves health,” he said, adding that having a state agency talk openly about health equity issues such as institutional racism helps create a space for communities to organize and discuss difficult topics.

Claude Jacob, NACCHO president and chief public health officer for Cambridge, Massachusetts, told attendees that his health agency has been spending a lot of time “looking in the mirror and understanding our blind spots.” Noting how important it is for public health workers to set the tone for health equity conversations, Jacob said it’s critical to invest in building equity-related competencies within the public health workforce. That way, he told attendees, practitioners are equipped to move the equity agenda forward.

Jacob also noted the importance of bringing health equity conversations into the community and into nontraditional venues.

“This is heavy work,” he said. “And it does require we become more neighborly.”

Ehlinger added that a first step toward achieving health equity is changing the narrative about what creates health in the first place, noting that public health has the data and experience to back up the argument that it takes much more than medical care to create the healthiest nation. And it’s when that narrative changes, he said, that we’ll attract new partners toward health equity.

“We have to have a strategy for building power in communities,” he said. “(It) starts with changing the narrative, questioning the world we live in.”

As the panel discussion ended, APHA Executive Director Georges Benjamin stepped up to officially close this year’s Annual Meeting in Denver. But first he had an exciting announcement: APHA has declared 2017 as the Year of Climate Change and Health. That means over the next year, APHA will strategically build on its work to raise awareness of the health impacts of climate change as well as mobilize members and partners to take action to reduce the health consequences of a changing climate.

And of course, the capstone of the year will be the 2017 APHA Annual Meeting and Expo, which will have a theme of “Creating the Healthiest Nation: Climate Changes Health.”

As we say goodbye to another inspiring Annual Meeting, let’s part ways with this moving quote from U.S. Surgeon General Vivek Murthy, who sent his closing session remarks by video: “The pursuit of health,” he said, “is the pursuit of justice.”

See you next year in Atlanta!

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This year's Closing General Session speakers, from left to right: Claude Jacob of NACCHO; Edward Ehlinger of ASTHO; Camara Jones, immediate past president of APHA; and Thomas Quade, new APHA president. Photo by Jim Ezell/courtesy EZ Event Photography