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WASHINGTON, DC (October 17, 2017)—When the U.S. Department of Health and Human Services (HHS) Office on Women’s Health (OWH) funded community coalitions across the country to address gender-based health disparities, the communities identified and addressed a wide range of concerns, from inadequate walking and biking facilities in Billings, Montana to impacts of trauma in Baltimore. Several of the OWH Coalition for a Healthier Community (CHC) grantees advanced policies to improve the conditions they identified as disproportionately harming the health of women and girls, and their policy successes are described in a supplement to the journal Women’s Health Issues, published today.
Women’s Health Issues is the peer-reviewed journal of the Jacobs Institute of Women’s Health, which is part of the Department of Health Policy and Management at the Milken Institute School of Public Health at the George Washington University.
Articles in the new supplement describe the following:
Advancing trauma-informed care in Baltimore: When the B’More Fit for Healthy Babies coalition in Baltimore explored barriers to Baltimore women’s physical activity, they didn’t just find that violence, drug dealers, and sexual offenders made it hard for women to exercise outdoors; they also found trauma to be a substantial problem for health overall. Violence following the death of Freddie Gray while in police custody created additional urgency. In partnership with the Baltimore City Health Department, B’More Fit advanced trauma-informed policies and trainings for staff across Baltimore City agencies in order to reduce trauma-related barriers to health.
Assuring “complete streets” in Billings: In Billings, Montana, Healthy By Design coalition partners identified unsafe streets and inadequate sidewalks and bike trails as problems disproportionately affecting low-income individuals, especially women and children. By sharing their study findings on how the built environment can limit opportunities for physical activity, especially for women and girls, they helped convince the Billings City Council to adopt – and, later, strengthen – a Complete Streets policy that requires consideration of pedestrians, cyclists, and users of mobility devices (as well as drivers) in the layout and planning of local streets.
Helping to reduce women’s stress levels in New Haven and beyond: In New Haven, Connecticut, a needs assessment by the New Haven Mental Health Outreach for Mothers (MOMS) Partnership showed that difficulties securing enough diapers is a major stressor for mothers living in poverty. MOMS and National Diaper Bank Network published an article on diaper need and mothers’ mental health in Pediatrics, garnering the attention of legislators interested in addressing the problem. California and Connecticut lawmakers proposed policies to exempt diapers from local sales tax, while San Francisco and the Obama Administration launched new programs to provide free diapers to low-income families.
Improvements by faith organizations and educators in Philadelphia: Organizations belonging to the Philadelphia Ujima Coalition for a Healthier Community updated their internal policies. Participating faith organizations now serve healthier foods at events, and leadership training incorporates education on relationship and sexual violence. A high school and a medical school have implemented gender-informed curriculum changes to improve students’ understanding of the role of gender in health.
Strengthening the role of community health workers in Utah: The Coalition for a Healthier Community for Utah Women and Girls (CHC-UWAG) recognized community health workers (CHWs) as a key component of an intervention to improve nutrition and exercise among women from five different racial/ethnic groups. In addition to testing their intervention, CHC-UWAG supported policy changes designed to make it easier for Utah health systems, agencies, and community organizations to incorporate CHWs into future health-improvement efforts. These include adding a CHW section to the Utah Public Health Association and working with other state-level groups to develop mechanisms for CHW training and reimbursement.
Studying policy change across the CHC initiative: The complete OWH Coalition for a Healthier Community program provided assistance to 10 grantees, including coalitions in Delaware, Hawaii, Illinois, Michigan, and Washington as well as those described above. A review of all grantees’ policy changes by the MayaTech Corporation identified 77 policies intended to facilitate change at the coalition, school, organizational, local, or state level. These include Delaware’s trauma-informed jail diversion program for women with substance use disorders who engage in sex work and Hawaii’s legislation to help survivors escape abusive partners or sex trafficking.
Stephanie Alexander and Stephen Hayes, OWH, provide an overview of the Coalition for a Healthier Community program and its grantees’ policy achievements in the commentary introducing this new supplement.