Addressing Social Determinants of Health through Cross-Sector Collaboration

Juntos: Coloring to Change Latino Family Norms and Expand Knowledge to Prevent Adverse Childhood Experiences

Irán Barrera, PhD., LCSW is a professor of Social Work at the Department of Social Work Education (DSWE) at Fresno State (College of Health and Human Services).  Professor Barrera is examining the impact of a six-week parent child engagement intervention using a coloring book focused on educating families about the impact of ACEs on child development. Strikeout Toxic Stress! is designed to help Latino Spanish-speaking families understand and prevent ACEs by increasing ACEs literacy. The study assesses the impact of the intervention on parents’ knowledge, attitudes, and behavioral intentions related to parenting and knowledge about ACEs. 

Latino children are more likely to experience ACEs, but tailored evidence-based programs to educate Latino Spanish-speaking parents and children about ACEs do not exist.  This project generates evidence about the impact of family interventions to improve parent knowledge, attitudes, and behavioral intentions related to parenting and preventing ACEs. 

Community Partners | Professor Barrera will collaborate with Centro La Familia and the California Initiatve for Health Equity and Action to disseminate the study results and coloring books in the Central San Joaquin Valley and beyond Northern California after the completion of the pilot study. 

Paul Ong

Transportation Disparities, Sustainability and Health

Paul Ong, PhD is a Research Professor and Director of the UCLA Center for Neighborhood Knowledge at the UCLA Luskin School of Public Affairs where he leads multiple projects that translate research findings into actionable neighborhood-related programs and policies. His research on the labor market status of minorities and immigrants, urban inequality, and spatial/transportation mismatch reflects a deep commitment to equity and environmental justice. His current work analyzes the relationship between sustainability and equity, the racial wealth gap, and the role of urban structures on the reproduction of inequality. Professor Ong earned a Master of Urban Planning degree from the University of Washington, and a Ph.D. in Economics from the University of California, Berkeley.

Project Description | Professor Ong is developing a user guide to support health and health policy stakeholders design data-informed programs and policies that address transportation and health disparities. This project is based on research funded by the California Air Resource Board (CARB) to better align equitable and sustainable transportation policies with efforts to improve transportation access.  In addition to being physically isolated, marginalized communities experience other forms of structural inequality—like limited transportation resources, inefficient public transit, low-income and poverty, and discrimination—that create barriers to health and wellbeing. The purpose of Professor Ong’s research is to identify the causes, characteristics, and consequences of transportation disparities and the ways that these disparities impact health in marginalized communities. By partnering with public agencies and non-profit organizations, Professor Ong and his team will translate and disseminate this research so that it is accessible to state and regional agencies, local jurisdictions, community and nonprofit groups, funders, and policymakers. This project focuses on four major forms of transportation disparities (i.e. private vehicle ownership, public transit, active transportation, and environment risks from road networks) and can inform the implementation of key state sustainability legislation, including California’s climate-change initiative (AB 32), the adoption of sustainable community strategies (SB 375) and clean energy strategies (SB 350), and greenhouse- gas (GHG) reduction goals (SB 150).

Community Partners | Professor Ong is collaborating with the Public Health Institute, Asian Health Services, First 5 LA, the California Department of Public Health, and the California Air Resources Board to co-design a user guide and series of CA regional trainings on how to use data to address transportation-related health disparities.

Kristen Madsen

Leveraging Sugar-Sweetened Beverage Taxes to Address Health Inequities

Dr. Kristine Madsen is Associate Professor of Community Health Sciences at UC Berkeley’s School of Public Health and the Faculty Director for the Berkeley Food Institute.  She is a pediatrician and research scientist with expertise in the design and evaluation of interventions related to pediatric obesity, cardiovascular risk, and health disparities. Through her early work as a UCSF faculty pediatrician, seeing patients in the pediatric obesity clinic, she realized that counseling patients and families about healthy eating and exercise would not increase their access to safe, health promoting options—instead, changes needed to be made to children’s environments.  Dr. Madsen works to identify programs and policies that will reduce childhood obesity and its attendant health disparities. Her team is currently conducting research to improve the quality and quantity of physical education in elementary schools, discover innovative approaches to improve child nutrition in schools, and identify impactful policies in schools to reduce obesity and weight-related disparities.  Dr. Madsen earned her M.D. and M.P.H from the University of Indiana, and holds a B.A. in both Mathematics and English from the University of California, Berkeley. She has served as an expert witness to the California Legislature Budget and Finance Committee to discuss her research on sugar-sweetened beverage taxes.

Project Description | Dr. Madsen is working with researchers and community leaders to disseminate evidence about the impacts of sugar sweetened beverage (SSB) taxes on SSB consumption, and funding for equitable obesity prevention and community health promotion programs. SSB consumption is a major contributor to obesity, and over 50% of U.S. adults and 61% of of children consume SSBs every day.  SSB consumption is particularly high among low-income families and communities of color who are disproportionately targeted by SSB marketing and bear a disproportionate burden of diet-related disease. While four California cities—Albany, Berkeley, Oakland, and San Francisco—have passed soda taxes, new legislation (AB 1838) prevents all other CA cities from passing local soda taxes. Dr. Madsen’s research team conducted the first study on the longer-term impacts of Berkeley’s soda tax on SSB consumption, and this and other research strongly suggests that SSB taxes have the potential to reduce SSB consumption in low- income neighborhoods, and generate revenue for obesity prevention and community health programs.  By combining data on SSB purchasing and consumption, local government SSB tax revenue spending, and community perceptions, the goal of this project is to disseminate evidence that can be used to combat laws that prohibit new soda taxes and disempower communities from securing local resources to address health inequities. Critical to this project is the urgent need for public information about how soda-tax revenues are generated and spent, so that policy recommendations are made to increase the efficacy, equity impacts, and transparency of SSB taxes. Dr. Madsen and her team are developing a series of videos, fact sheets, infographics, and regional briefings to disseminate information about SSB taxes, and to support community participation in community health promotion.

Community Partners | Dr. Madsen is collaborating with the Praxis Project(link is external)—a leader in public health and community organizing efforts to advance health equity and justice for all communities—to reach key grassroots stakeholders who will make effective use of the findings from this project.

Amanda Brewster

Medi-Cal Health Homes: Early efforts to coordinate physical health, behavorial health, and community services for Medi-Cal benef

Amanda L. Brewster, PhD and Emmeline Chuang, PhD will lead this project. Dr. Brewster is an Assistant Professor of Health Policy and Management at the UC Berkeley School of Health. Her research examines how management and inter-organizational relationships influence the performance of health care organizations. Dr. Brewster’s recent work focuses on coordination of health care and social services to address both medical and social determinants of health.Dr. Emmeline Chuang is an Associate Professor in the Department of Health Policy & Management within UCLA's Fielding School of Public Health, where she directs the PhD program and teaches courses on organizational theory and behavior and mixed methods research. Dr. Chuang’s research focuses on how the organization and management of health and human services affects service access and quality of care, particularly for underserved populations. Her research has been funded by the National Institute on Drug Abuse, the Centers for Disease Control and Prevention, the Hitachi Foundation, and the William T. Grant Foundation.

Project Description | In order to enhance the ability of policymakers to learn from and build upon the Health Homes Program, Professors Amanda Brewster (UC Berkeley) and Emmeline Chuang (UCLA) will co-lead a project to characterize the Medi-Cal Health Home implementation process across California. The Health Homes Program, together with related initiatives such as the Whole Person Care pilot, represent an extraordinary push to integrate systems of medical, social and behavioral care for Medi-Cal beneficiaries. Professors Brewster and Chuang plan to understand the implementation of the program by interviewing key personnel of Medi-Cal Managed Care Plans, community-based care management entities, and other service providers supporting Health Homes enrollees in specific counties. Their Cal-IHEA Evidence to Action project will address topics such as:

  • Factors that influence Medi-Cal Managed Care Plans participation in the Health Homes Program

  • Approaches to coordination among plans, care management entities, and other service providers

  • How the Health Homes Program may relate to other initiatives

Professor Brewster and Professor Chuang will share their results and discuss implications with policymakers through a policy briefing in spring 2020 in partnership with Cal-IHEA.