place , advancing progress: health equity in · housing policy is health policy housing policy...

PLACE ,

POLICY and

PROGRESS:

Place Matters

Delaware

ADVANCING

HEALTH

EQUITY IN

DELAWARE

Some images and content © 2015.

INTRODUCTIONS

Karen Horton, AICP, Principal Planner, DE State Housing Authority; [email protected]

Mawuna Gardesey MBA, Chief, Family Health Research and Epidemiology; [email protected]

Mark Marosits, MHA, Co-founder, Worldways Social Marketing; [email protected]


MILESTONES

1. HEALTH EQUITY and the SOCIAL

DETERMINANTS OF HEALTH

2. WHY PLACE MATTERS TO HEALTH

3. HOUSING and HEALTH

4. DE POLICY and HEALTH NEXT STEPS


1. Health

Equity and the

Social

Determinants

of Health


SHARE PAIR #1

Which do you think is MOST IMPORTANT when it

comes to achieving health equity in Delaware,

and reducing disparities in the health of women

and infants— and WHY?

Improving access to care and/or coverage?

Changing personal behavior?

Changing norms and culture?

Changing the built environment?

Changing the social environment?


WHAT IS Health Equity?

According to the CDC:

Health equity is achieved when every person has

the opportunity to attain his or her full health

potential, and no one is disadvantaged from

achieving this potential because of social position

or other socially determined circumstances.


WHAT ARE

the Social

Determinants

of Health?


This means that

two people

living just a few

miles apart can

have radically

different health

prospects. http://healthequityde.com


http://healthequityde.com/

http://healhthequityde.com/

2. The Bottom

Line: PLACE

MATTERS when

it comes to

HEALTH


The Power

of Place

For many people, where they live is

not just a matter of choice. Moving

may cost too much, be too far

from family, or mean too much of

a leap from the familiar.

Generations of poverty,

discrimination, lack of affordable

options and other social factors

often hold people in place.

And when transportation is limited,

many only have access to what is

within walking distance.

They can’t ‘opt out’ of the social

determinants of health that they

live with. No matter what the

consequences.


The Thriving

Communities

Approach Achieving health equity and

eliminating disparities is an

overarching goal for Healthy

People 2020 and a top priority

here in Delaware.

We recognize that many types of

policies affect health at the

community level.

We are working to create new

ways that policy makers,

community residents, & providers

can work together to address the

social determinants of health.


http://www.healthypeople.gov/2020/default.aspx

http://www.healthypeople.gov/2020/default.aspx

The Policy & Health Scorecard

It has been said:

“ALL POLICY IS HEALTH

POLICY”


Why?

Economic Stability

Education

Living Environment

Social Context

Access to Care

It’s because

HEALTH is

increasingly

driven by social

determinants,

not personal

choices, or

expansion of

clinical care…


Why?

Economic Stability

Education

Living Environment

Social Context

Access to Care

… and because

SOCIAL

DETERMINANTS

are often

created…or

abated… by

POLICY


Let’s Make the Connection

Health Determinant: ECONOMIC

STABILITY. Affected by policies

addressing:

Poverty

Employment

Food Stability

Housing Stability


Health Determinant: EDUCATION.

Affected by policies addressing:

High School Graduation

Early Childhood Learning

Language and Literacy

Enrollment in Higher Education



Health Determinant: NEIGHBORHOOD

AND BUILT ENVIRONMENT. Affected by

policies addressing:

Quality of Housing

Crime and Violence

Access to Healthy Foods

Environmental Quality



Health Determinant: SOCIAL AND

COMMUNITY CONTEXT. Affected by

policies addressing:

Perception of Discrimination and Equity

Incarceration/Institutionalization

Social Cohesion/Family Stability

Civic Participation



Health Determinant: HEALTH AND HEALTH

CARE. Affected by policies addressing:

Access to Health Care

Access to Primary Care

Health Literacy



SHARE PAIR #2: Scorecard

Please look at your scorecard handout. It

invites you RATE the IMPORTANCE of

policies in each of the categories to

improving the health of women, infants

and families in Delaware. For now,

CHOOSE the ONE that you think is most

important, and share those with your pair

partner.


3. HOUSING

AND HEALTH:

A Case in

Point


DSHA at a Glance

Rental

Key Activities:

Housing

Development

Rental Subsidies

Asset Management

Homeownership

Key Activities:

• First-Time Homebuyer Mortgages

• Second Mortgage Assistance

• Foreclosure Mitigation

• Home Rehabilitation


Housing Policy is Health Policy

Housing policy affects these social determinants of

health, DIRECTLY and INDIRECTLY:

Housing stability and quality of housing, of course

Environmental quality, access to transportation which is access to many other things, fresh food

access and more

And, these factors converge to influence broader

social determinants of health, like poverty and

family stability.


DSHA PROGRAMS

Low Income Housing Tax Credit –

Qualified Allocation Plan (QAP)

Public Housing

Downtown Development Districts

Place Matters Delaware


LOW INCOME HOUSING TAX CREDIT PROGRAM

Created by Tax Reform Act of 1986

Public/Private partnership

Nation’s largest funding source for creating

affordable housing

DSHA is designated as Delaware’s “housing

credit agency”

Qualified Allocation Plan outlines selection

criteria for allocating credits



Location Siting Preferences

Threshold requirement – must be

located in areas targeted by the

State for growth and economic

development

Incentives to create new rental

housing in ‘Areas of Opportunity'



Access to Public Transportation

Collaboration with DART

Impact of collaboration:

7 affordable rental communities serving 532 families to be served by transit!



Access To Services

Grocery markets

Schools

Library

Licensed child care

Usable park space

Walk-in medical facility or hospital

Pharmacy

Community center



Community Compatibility

Building design consistent with architecture of

surrounding area

Connectivity to adjacent neighborhoods or

trail systems

Development Amenities

Community gardens

On site community center

Exercise or walking trails




Example


Examples


Example


PUBLIC HOUSING

508 units at 10 sites in Kent and Sussex Counties

Playgrounds and basketball courts at all sites

Mifflin Meadows – full size basketball court,

new playground and a bike path throughout

the site

Enhance and upgrade as funds permit



PUBLIC HOUSING

Terrific onsite 4-H program at almost all

sites

UD Cooperative Extension partnership

120 kids participate

Healthy snacks

Arts, crafts, Wii-fit program



DOWNTOWN DEVELOPMENT DISTRICTS

Created to leverage state resources in a limited number of designated areas in Delaware’s cities and towns to:

spur private investment;

improve commercial vitality; and,

build a stable community of long-term residents.

Accomplished by designating Downtown Development Districts (DDDs) and offering state and local incentives to investors who invest within the Districts.



DOWNTOWN DEVELOPMENT DISTRICTS

January 2015, Governor announced first three Districts Wilmington

Dover

Seaford

The District Plan for each District will serve as focal point for coordinated action by state, local, and private entities



4. POLICY

AND HEALTH:

Next Steps

LET’S LOOK

AHEAD


Where Do We Go From Here?

Engage colleagues like Karen in CROSS-SECTOR PLANNING for collective impact

Find new ways to ENGAGE COMMUNITY RESIDENTS as advocates in identifying challenges and solutions

COLLATE AND SHARE our work online, using http://healthequityde.com platform, developed by our own DHMIC Health Equity and Systems Committee, with input from DPH and others

What else, what DO YOU think?

)


http://healthequityde.com/

THANK YOU!

Visit the Delaware Health Equity Action

Center Online at healthequityDE.com


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