SUPPORTING A MOVEMENT
for HEALTH
and HEALTH EQUITY
Lessons from Social Movements
WORKSHOP SUMMARY
Alison Mack, Alina Baciu, and Nirupa Goel, Rapporteurs
Roundtable on Population Health Improvement
Roundtable on the Promotion of Health Equity and the
Elimination of Health Disparities
Board on Population Health and Public Health Practice
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by contracts between the National Academy of Sciences and The California Endowment (20112338), the California HealthCare Foundation (17102), Health Partners, Health Resources and Services Administration (HHSH25034015T), Kaiser East Bay Community Foundation (20131471), The Kresge Foundation (101288), the Mayo Clinic, Missouri Foundation for Health (12-0879-SOF-12), the National Association of County and City Health Officials (2013-010204), Nemours, New York State Health Foundation (12-01708), Novo Nordisk, and the Robert Wood Johnson Foundation (70555). The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
International Standard Book Number-13: 978-0-309-30331-6
International Standard Book Number-10: 0-309-30331-1
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Suggested citation: IOM (Institute of Medicine). 2014. Supporting a movement for health and health equity: Workshop summary. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE ON ACCELERATING
IMPROVEMENT IN THE PUBLIC’S HEALTH1
DAVID KINDIG (Co-Chair), Professor Emeritus, University of Wisconsin School of Medicine and Public Health
MILDRED THOMPSON (Co-Chair), Director, PolicyLink Center for Health Equity and Place
TERRY ALLAN, Health Commissioner, Cuyahoga County Board of Health
MARTHE R. GOLD, Professor, City College of New York
GEORGE ISHAM, Senior Advisor, HealthPartners, Inc.
SANNE MAGNAN, President and CEO, Institute for Clinical Systems Improvement
MARY PITTMAN, President and Chief Executive Officer, Public Health Institute
IOM Staff
KAREN M. ANDERSON, Study Director
ALINA B. BACIU, Study Director
COLIN F. FINK, Senior Program Assistant
AMY GELLER, Senior Program Officer
LYLA HERNANDEZ, Senior Program Officer
ANDREW LEMERISE, Research Associate
CAROL MASON SPICER, Associate Program Officer
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
Consultant
ALISON MACK, Writer
____________
1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1
GEORGE ISHAM (Co-Chair), Senior Advisor, HealthPartners, Inc., and Senior Fellow, HealthPartners Institute for Education and Research
DAVID A. KINDIG (Co-Chair), Professor Emeritus, University of Wisconsin School of Medicine and Public Health
TERRY ALLAN, President, National Association of County and City Health Officials, and Health Commissioner, Cuyahoga County Board of Health
CATHERINE BAASE, Chief Health Officer, The Dow Chemical Company
GILLIAN BARCLAY, Vice President, Aetna Foundation
RAYMOND J. BAXTER, Senior Vice President, Community Benefit, Research and Health Policy, and President, Kaiser Foundation International, Kaiser Foundation Health Plan, Inc.
DEBBIE I. CHANG, Vice President, Policy and Prevention, Nemours
GEORGE R. FLORES, Program Manager, The California Endowment
MARY LOU GOEKE, Executive Director, United Way of Santa Cruz County
MARTHE R. GOLD, Visiting Scholar, New York Academy of Medicine, and Professor, City College of New York
GARTH GRAHAM, President, Aetna Foundation
PEGGY A. HONORÉ, Director, Public Health System, Finance and Quality Program, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services
ROBERT HUGHES, President and Chief Executive Officer, Missouri Foundation for Health
ROBERT M. KAPLAN, Director, Office of Behavioral and Social Sciences Research, National Institutes of Health
JAMES KNICKMAN, President and Chief Executive Officer, New York State Health Foundation
PAULA LANTZ, Professor and Chair, Department of Health Policy, George Washington University School of Public Health and Health Services
MICHELLE LARKIN, Assistant Vice President, Health Group, Robert Wood Johnson Foundation
THOMAS A. LaVEIST, Professor and Director, Hopkins for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health
____________
1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
JEFFREY LEVI, Executive Director, Trust for America’s Health
SARAH R. LINDE, Rear Admiral, U.S. Public Health Service, Chief Public Health Officer, Health Resources and Services Administration
SANNE MAGNAN, President and Chief Executive Officer, Institute for Clinical Systems Improvement
PHYLLIS D. MEADOWS, Associate Dean for Practice, Office of Public Health Practice, School of Public Health, University of Michigan, and Senior Fellow, Health Program, The Kresge Foundation
JUDITH A. MONROE, Director, Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention
JOSÉ MONTERO, President, Association of State and Territorial Health Officials, and Director, New Hampshire Division of Public Health Services
MARY PITTMAN, President and Chief Executive Officer, Public Health Institute
PAMELA RUSSO, Senior Program Officer, Robert Wood Johnson Foundation
LILA J. FINNEY RUTTEN, Associate Scientific Director, Population Health Science Program, Department of Health Sciences Research, Mayo Clinic
BRIAN SAKURADA, Senior Director, Managed Markets and Integrated Health Systems
MARTIN JOSÉ SEPÚLVEDA, Fellow and Vice President, Health Research, International Business Machines Corporation
ANDREW WEBBER, Chief Executive Officer, Maine Health Management Coalition
IOM Staff
ALINA B. BACIU, Study Director
COLIN F. FINK, Senior Program Assistant
AMY GELLER, Senior Program Officer
LYLA HERNANDEZ, Senior Program Officer
ANDREW LEMERISE, Research Associate
CAROL MASON SPICER, Associate Program Officer
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
ROUNDTABLE ON THE PROMOTION OF HEALTH EQUITY AND THE ELIMINATION OF HEALTH DISPARITIES1
ANTONIA VILLARRUEL (Chair), Associate Dean for Research and Global Affairs, University of Michigan School of Nursing
MILDRED THOMPSON (Co-Chair), Director, PolicyLink Center for Health Equity and Place
PATRICIA BAKER, President and CEO, The Connecticut Health Foundation
GILLIAN BARCLAY, Vice President, Aetna Foundation
ANNE C. BEAL, Senior Vice President and Chief Patient Officer, Sanofi-Aventis
REBECCA BRUNE, Vice President, Strategic Planning, Methodist Healthcare Ministries of South Texas, Inc.
NED CALONGE, President and Chief Executive Officer, The Colorado Trust
IRENE DANKWA-MULLAN, Acting Director, Division of Scientific Programs, National Institute on Minority Health and Health Disparities, National Institutes of Health
GERIMALD P. DAUS, Public Health Analyst, Office of Health Equity, Health Resources and Services Administration
JAMILA DAVISON, Pinellas County Health Department
FRANCISCO GARCIA, Director, Pima County Department of Health
ALLAN GOLDBERG, Leader, U.S. Advocacy and Professional Affairs, Merck & Co., Inc.
J. NADINE GRACIA, Director, Officer of Minority Health, U.S. Department of Health and Human Services
JEFFREY A. HENDERSON, President and Chief Executive Officer, Black Hills Center for American Indian Health
EVE J. HIGGINBOTHAM, Vice Dean, Perelman School of Medicine, University of Pennsylvania
CARA V. JAMES, Director, Office of Minority Health, Centers for Medicare & Medicaid Services
OCTAVIO MARTINEZ, JR., Executive Director and Clinical Professor, Hogg Foundation for Mental Health, University of Texas at Austin
NEWELL McELWEE, Executive Director, U.S. Outcomes Research, Merck & Co., Inc.
____________
1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
PHYLLIS D. MEADOWS, Senior Fellow, Health Program, The Kresge Foundation
AMELIE G. RAMIREZ, Director and Professor, Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio
MELISSA A. SIMON, George H. Gardner Professor of Clinical Gynecology, Northwestern University Feinberg School of Medicine
PATTIE TUCKER, Associate Director for Health Equity, Centers for Disease Control and Prevention
ROHIT VARMA, Grace and Emory Beardsley Professor and Chair, University of Southern California
WINSTON F. WONG, Medical Director, Community Benefit, Kaiser Permanente
TERRI D. WRIGHT, Director, Center for School, Health and Education, American Public Health Association
IOM Staff
KAREN M. ANDERSON, Study Director
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
Dawn Alley, Office of the Surgeon General, U.S. Department of Health and Human Services
Jacqueline Martinez Garcel, New York State Health Foundation
Frances Lu, University of California, Davis
Connie Mitchell, California Department of Public Health
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Susan J. Curry, University of Iowa. Appointed by the Institute of Medicine, she was responsible for making certain
that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.
Contents
2 LESSONS FROM SOCIAL MOVEMENTS
Insights from the Sociology of Social Movements
Practical Lessons in Movement Building
3 LESSONS FROM HEALTH-RELATED MOVEMENTS
The Role of Philanthropies in Social Movements
Lessons from the Healthy Cities and Communities Movement
Building Public Will to Achieve Health Equity
Lessons from the Walking Movement
4 INVESTING IN HEALTHY COMMUNITIES: ONE FOUNDATION’S APPROACH
Political Exclusion and Health Inequity
5 LESSONS FROM SOCIAL MOVEMENTS BEYOND HEALTH
Community Economic Development and Education
Tackling Health Inequity by Building Democracy
Building Social Movements from the Bottom Up
A Perspective at the Intersection of Movement and Politics
Roundtable and Audience Responses
C CONSIDERATIONS FOR BUILDING A POPULATION HEALTH MOVEMENT: FIVE KEY DEBATES
ACA | Patient Protection and Affordable Care Act |
ACT UP | AIDS Coalition to Unleash Power |
EPA | U.S. Environmental Protection Agency |
EU | European Union |
IOM | Institute of Medicine |
MEDA | Mission Economic Development Association |
MPN | Mission Promise Neighborhood |
NAACP | National Association for the Advancement of Colored People |
NRC | National Research Council |
OSHA | Occupational Safety and Health Administration |
PICO | People Improving Communities through Organizing |
PSR–LA | Physicians for Social Responsibility–Los Angeles |
RWJF | Robert Wood Johnson Foundation |