5 th Annual Latino Health Summit : September 19, 2019

1. 5th Annual Latino Health Summit: September 19, 2019 • Culturally-Informed Community Centered Models

2. Octavio N. Martinez, Jr., MD, MPH, MBA Sr. Associate Vice President, Division of Diversity and Community Engagement Executive Director, Hogg Foundation for Mental Health Professor of Psychiatry, Dell Medical School Clinical Professor, Steve Hicks School of Social Work Faculty Affiliate, Rapoport Center for Human Rights and Justice, UT School of Law The University of Texas at Austin

3. Enhancing LatinxHealth: • Vision: Seamless integrated health/mental health/substance use care delivered in a culturally and linguistically person-centered framework at the individual/family/community/practice/system and workforce level. • Key Point: Must be cautious to not oversimplify the values, customs, and beliefs that characterize any group – especially one as heterogeneous as the Latinx communities. • Beware of “othering”: To understand non-dominant groups as inferior, exotic, or deviant. • Practice Cultural “Humility:” Encourage an open mind and recognize that each of us sees the world through our own very distinctive cultural lens.

4. Health Care Factors: • The following factors have significant impact on maximizing quality of life, lifespan, and achieving health equity: • Preventive services • Access to timely screening • Appropriate diagnosis • Culturally-centered disease management • In-patient services • Alternative medicine • Emergency response

5. Health Care Alone is Insufficient! • Health care interventions often come late. • Health care treats one person at a time. • Health care is not the primary determinant of health. • Quadruple Aim: • Improved Care • Reduced Costs • Improved Population Health • Engaged Communities

6. Community Engagement is Critical. • Principles of Community Engagement: • Understand the history. • Recognize and acknowledge the cumulative impact of stressful experiences and environments. • Recognize the role of privilege. • Create an environment for public participation. • Do not blame individuals or groups for their disadvantaged status. • Strengthen the social fabric of neighborhoods. • Include all age groups. • Work across multiple sectors. • Focus on community determinants through a health equity lens. • Measure and track the impact of social policies. • Build on the strengths and assets of communities.

7. Key Components: • Identify strengths and assets. • Prioritize concerns. • Develop an action plan. • Increase resilience. • Improve community conditions. • Instill hope. • Support a recovery philosophy. • Expand opportunities. • Foster sustainability initiatives. • Incorporate community-defined evidence (CDE).

8. Community Engagement Models: • Goal: Support communities to improve health, safety, and achieve health equity through a comprehensive, multi-sector approach. • Engage and partner. • Foster shared understanding and commitment. • Identify the assets and needs. • Envision, plan, and act to achieve desired outcomes. • Measure and evaluate progress. • Core Values: • Respect Integrity Fairness Honesty • Justice Ethical Empathy Transparency

9. Frameworks & Models: • Community-Centered Health Home (CCHH): • Framework for health care institutions to systematically engage in upstream work to improve the community determinants of health. • Recognize and understand the factors outside the health care system that affect patient health outcomes and actively participate in addressing them. • Utilize community health workers or promotoras. • Community Based Participatory Research (CBPR) within a Practice-Based Research Network (PBRN): • Develop equitable partnerships between community representatives, providers, and researchers. • Train community members as researchers and outreach workers. • Create a community advisory board (CAB). • Develop community forums.

11. Collective Impact:

12. Essential Elements: • Dedicated Leadership. • Organizational commitment to investing time, money, and needed resources. • Long-term mindset: Think marathon, not sprint.

13. References: • A Nation Free of Disparities in Health and Health Care. U.S. Department of Health and Human Services 2011. • Applying Principles of Community-Based Participatory Research to Your Program by Health Outreach Partners. • Community-Centered Health Homes in North Carolina: An Exploration of Opportunities by the Prevention Institute. • Culturally Competent Care for Latino Patients by Karen Peterson-Lyer. • Dulin et al: A community based participatory approach to improving health in a Hispanic population. Implementation Science 2011 6:38. • Evidence-Based Psychosocial Interventions for Hispanics: Research and Policy Implications by Luis R. Torres, PhD. • Sanchez et al: Enhancing the Delivery of Health Care: Eliminating Health Disparities through a Culturally & Linguistically Centered Integrated Health Care Approach. U.S. Department of Health and Human Services Office of Minority Health and Hogg Foundation for Mental Health June 2012. • THRIVE Overview and Background by the Prevention Institute.