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BARHII BRIEFS AND RESOURCES

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To support the capacity-building of local health departments, BARHII’s Built Environment Committee (BEC) has completed the development of a series of five short guides which include information on why climate change is a public health and equity issue, the environmental and health co-benefits of climate change action, how to get involved in climate change action planning, and tangible steps to address climate change.

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An inclusive local economy promotes everyone’s health by allowing households to meet basic needs and plan for a healthy future. Many working and middle-class residents have been left behind—facing low wages, spiraling debt, disinvested neighborhoods, and shrinking social supports. These preventable conditions are associated with preventable diseases, injury, and ultimately lower life expectancy. This brief explores the impacts of Economic Opportunity on Individual and Community Health as well as concrete strategies to bolster health through economic policies.

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From 2009-2011, the BARHII Community Committee conducted qualitative assessments in seven local health jurisdictions to explore local priorities in health inequities and social conditions as well as highlight best practices and lessons learned related to (1) public health department and community agency collaborations and (2) how health inequity concerns are being addressed by both health departments and community agencies in the Bay Area. This series of reports summarizes the findings of 39 focus groups describing perspectives of both health department and community agency staff for the region as well as five individual counties.

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Natural disasters intensified by climate change do not discriminate, but our responses to them can. The neighborhood we are from, the languages we speak, our class, race, disability, age, existing health conditions, and immigration status all shape how we are impacted by disasters, and the resources our families and communities have to recover. Keeping equity at the forefront of the recovery process and ensuring the participation of communities who have been marginalized will ensure more effective recovery for all. This document presents key findings and recommendations to assist public health departments and other local government staff improve equity in recovery, with a focus on low-income and immigrant communities.

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The Health Inequities in the Bay Area report is an attempt to show how a large set of factors influences health in the nine-county Bay Area, and also to suggest the kinds of policy initiatives and activities that will be crucial for both reducing the disparities and improving overall health.

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Growing evidence demonstrates a strong relationship between our health and the environments in which we live. The way our neighborhoods, streets, and homes are designed affects whether children can play outside and walk to school, whether families can access basic goods and services, and even whether neighbors can socialize and look out for one another.This Healthy Planning Guide is intended to help public health and planning departments collaborate on strategies to promote healthier communities. Each page links health risks to aspects of the built environment, outlining ways to ensure that neighborhoods are designed to support health equity and community well-being.

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When housing costs require increasingly high percentages of a family’s budget, families are forced to make choices that create unhealthy tradeoffs. Families forego medical care or prescriptions, live in substandard or overcrowded housing, or move farther and farther away from the Bay Area’s job centers. In February of 2016, BARHII dove deep into the housing issues that are re-shaping the Bay Area. We created BARHII’s first brief on Housing Affordability, Displacement, and Health with the goal of shaping a housing future that promotes health equity.

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During a BARHII meeting of Maternal and Child Health Directors in 2017, troubling stories were shared about high housing costs causing extreme and sometimes dangerous overcrowding, increased family homelessness, and reductions in money available for food and medical care. These conditions have implications for the development of the Bay Area’s youngest residents and the future economic health of the region. While this issue brief focuses on housing stability and family health in the San Francisco Bay Area, the information is salient in many communities across the country where housing costs—and housing insecurity—are rising.

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BARHII has developed a resource to assist staff at all of our member local health departments, and in particular those that participated in BARHII's iREACH (impacting Regional Educational Achievement to Change Health) Initiative, in continuing to address educational attainment in the communities we serve. California's new public education funding formula can help improve health equity by investing much needed resources in the communities that need them the most.

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The Organizational Self-Assessment (Self-Assessment) for Addressing Health Inequities Toolkit (Toolkit) provides public health leaders with tools and guidelines that help identify the skills, organizational practices and infrastructure needed to address health equity and provide insights into steps LHDs can take to ensure their organization can have an impact on this growing problem.

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The COVID-19 pandemic has hit low-income tenants in the Bay Area hard, exacerbating the region’s severe housing affordability crisis. Approximately 140,000 households are behind on rent, owing nearly half a billion dollars. i This has serious ramifications for health and well-being, especially for BIPOC households that have faced decades of inequitable housing and economic policies. Black, Latinx, and Pacific Islander communities in California currently face a 20% higher COVID-19 death rate than the statewide average, driven in part by unstable and crowded housing conditions. ii These same communities are more likely to be faced with choosing between paying for essential medical care, food, and rent.

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The Minimum Wage and Health: A Bay Area Analysis Report demonstrates that a Bay Area-wide minimum wage increase would benefit the health and well-being of nearly 1 million low-wage earners. A large body of research literature on wage, income, and health demonstrates that public policy interventions that aim to increase the incomes of low income populations will increase income equality and economic security as well as lower mortality rates, improve overall health status in the population, decrease health inequity, and lower overall healthcare costs.

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In 2009, BARHII and Planning for Healthy Places convened a roundtable of redevelopment and public health departments in the San Francisco Bay Area to discuss how health-promoting strategies can be incorporated into the process of rebuilding low-income or “blighted” neighborhoods. This report explores the potential for collaboration between these agencies and shows how both can overcome their own institutional challenges to create a strong partnership to improve community health.

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Partners for Public Health provides a broad overview of the many public agencies that make policy decisions affecting aspects of the built environment, and outlines the structure and decision-making process for each agency (at the local, regional, state, and federal level), pointing public health professionals toward opportunities for engagement.

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The purpose of this step-by-step technical guide is to assist local public health departments and their community partners in the collection, analysis, and usage of priority living conditions data indicators for local community health assessments, program/policy development, and health equity advocacy. Included in this guide are an introduction section with a Bay Area regional social gradient analysis using concentrated poverty, educational attainment, cause of death and life expectancy data; 15 “how to analyze” social determinants of health (SDOH) indicator chapters; a table of 72 priority SDOH indicators and their data sources; and technical data appendices.

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The State Health Department Organizational Self-Assessment for Achieving Health Equity: (State Self-Assessment) provides public health leaders with tools and guidance to help identify the skills, organizational practices, and infrastructure necessary to achieve health equity. The Self-Assessment can be a key component in strengthening the health department’s capacity to partner with communities, agencies and organizations to achieve health equity. The process requires commitment at all levels within the health department.

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In summer 2020, BARHII, the coalition of the Bay Area’s local public health departments focused on
health equity, joined with OCCUR, an Oakland‐based equity non‐profit, to catalyze the creation of a
Black housing strategy for the Bay Area. BARHII and OCCUR began a series of conversations with Black
housing developers, Black housing advocates, and CBOs that provide housing and other services to
underserved Black communities. These conversations resulted in the formation of the Bay Area Black
Housing Advisory Taskforce, known as “Black HAT.”

RISE TOGETHER RESOURCES

2019 Policy for Shared Prosperity Presentations 

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