State Health Report Discussion by Molly Dinardo

mdinardo14 — 2024-04-02 23:11:07 UTC

Cost of health care and access to culturally appropriate providers creates issues for the families we serve

2024-04-03 18:25:06 UTC

Lead Screening

2024-04-03 18:25:16 UTC

Is screening for lead included in all postpartum infant screening? Is it required in any future well-child visits?

Cost of mental health care and access to culturally appropriate providers creates issues for the families we serve

2024-04-03 18:25:24 UTC

access to and training on Narcan administration, referrals into substance use disorder treatment

2024-04-03 18:25:44 UTC

2024-04-03 18:26:11 UTC

It's crucial for healthcare professionals to be culturally sensitive , understand the beliefs and practices of the Somali community when it comes to MCH and provide care that respects their cultural values and preferences. This can help build trust, improve communication, and ultimately lead to better health outcomes for the community.

Issues of heat are problematic for our families when much housing in King County does not include cooling

2024-04-03 18:26:23 UTC

2024-04-03 18:26:38 UTC

Lack of trust and language barrier between the health providers and the families we serve

support for CBOs to provide blood lead level screenings for children receiving services

2024-04-03 18:26:47 UTC

2024-04-03 18:27:19 UTC

How can services be streamlined/accessbile for babies born impacted by prenatal substance use?

Mother's rights

2024-04-03 18:27:51 UTC

I've had several mothers talk about how their newborns were taken from them and were administered methadone without the parent's consent. In cases where the mother was using a drug to control addicton , so it was disclosed, but the child was treated without her knowledge and permission.

2024-04-03 18:28:17 UTC

Access to safe outdoor green spaces for communities of color in particular.

2024-04-03 18:28:19 UTC

Community members receiving services thought they were covered for all types of healthcare, only to find they weren't. system is confusing. Bills received. Finding time to chase down payment for a struggling family is extremely difficult

We're finding that while many institutions want to provide CAC, our families/clients get caught and are bounced between resources and referrals. So not sure if its accountability or more strategic planning for systems of care to work in concert with cbos who often serve as a catchall. (Korean American community)

2024-04-03 18:28:20 UTC

2024-04-03 18:28:35 UTC

Black and American Indian and Alaska Native women have higher rates of pregnancy related death. Pregnancy related mortality rates among Black and AIAN women are over three and two times higher.

intersection between data equity and language justice. Data gathering tools often being available in certain language limits how accurately collected "data" can represent community needs.

2024-04-03 18:28:42 UTC

Inequity in healthcare providers for communities receiving Medicaid (e.g., ABA and dental services

2024-04-03 18:28:47 UTC

Data Equity For Somali Community

2024-04-03 18:29:12 UTC

Community Engagement: Involving the Somali community in the data collection and analysis process to ensure their voices are heard and their priorities are addressed.

Transparency and Accountability: Being transparent about how data is collected, used, and shared, and holding institutions accountable for addressing disparities identified through data analysis.

providing cultural and language match services is very important to immigrant families.

2024-04-03 18:29:30 UTC

We see the low and very low income families we work with struggling more to meet basic needs which leave them less time to take care of health related issues.

2024-04-03 18:29:30 UTC

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Co-designed and co-authored indicators.

2024-04-03 18:29:47 UTC

Non-accessible healthcare for minorities

Persons being stuck in toxic jobs only to receive healthcare

2024-04-03 18:30:09 UTC

Hello, we are VFAAB (Vietnamese Family Autism Advisory Board)

2024-04-03 18:30:36 UTC

We help Vietnamese families with children diagnosed with ASD/DD navigate the healthcare system, connect to social services, and resources in the community (e.g., ABA, Speech/OT, material, housing, and more).

dental providers in rural areas who accept medicaid

2024-04-03 18:30:51 UTC

2024-04-03 18:30:56 UTC

Need to support the training of culturally matched providers in multiple healthcare fields (from doulas to lactation to midwives to primary care and beyond (sorry that this is in the wrong column)

2024-04-03 18:30:59 UTC

Discrimination, unequal acess to health care, gaps in wealth and education play a critical role.

There remain so many barriers to access to early intervention, developmental screening, and if desired, related medical services, and so I think we're still trying to fix those pipelines and develop new pathways/workflows. I encourage continued investment in supporting this.

2024-04-03 18:31:11 UTC

2024-04-03 18:31:41 UTC

Lead product testing is really helpful to identify potential lead poisoning dangers in the home. Our communities really want to see more of these opportunities that our organization has been funded by SKCPH in the past (but not currently)

2024-04-03 18:31:43 UTC

Single parent cannot find work because she will lose her social service help. Needs to find work that pays cash without any state/federal reporting. How can one get out of this cycle?

We need to invest in looking deeper into the roots of substance use (which may often be rooted in infancy/early childhood trauma and toxic stress). There are important links between untreated early childhood trauma and later substance use in adulthood. "Prevention" of youth/adult substance use needs to go all the way back to preventation services and early childhood trauma treatment.

2024-04-03 18:32:24 UTC

The state could prioritize Preventative measures regarding implementing psychotherapy for low-income expectant mothers in particular.

2024-04-03 18:32:28 UTC

I feel as though current services as they exist especially for low-income mothers, almost demonize their choice to become mothers while their financial situations are not concrete. Perinatal mothers could benefit from talk therapy to help with the transition of becoming responsible for another life.

Access to health insurance

2024-04-03 18:32:38 UTC

Kudos to Washington State for implementing health insurance for undocumented individuals.

lauraareiza — 2024-04-03 18:33:17 UTC

Latino American families live in neighborhoods that usually do not have a canopy or access to parks, and outdoor activities as well.

A lot of the mothers we serve, their partner lost their life while the mother was pregnant adding the stress of sudden trumatic grief added to the stress of being black women operating in a racist health care institution and the stress that just comes with being pregnant in itself it creates a very dangerous system for our mothers and if mom is not well baby cannot be well either.

2024-04-03 18:33:18 UTC

In the immigrant Latinx community often Moms have to juggle the insurance process, medical care, while navigating the immigrant asylum process, this has been a huge challenge because these parents often have to choose between taking care of their health and keeping up with their legal processes which costly and time consuming

stephanievalerdi — 2024-04-03 18:33:39 UTC

2024-04-03 18:33:46 UTC

Health insurance coverage, quality of care.

Lack of trust in data: What occurs afterward, and how do we observe the genuine impact of the collected data?

2024-04-03 18:33:51 UTC

mdinardo14 — 2024-04-03 18:34:31 UTC

Communities having a hard time accessing public health services in their area - malaria pills, immunizations (Indian communities in Kent). There aren't public health clinics available in these areas... they aren't there they are not accessing them. Availability of public health clinics. When I moved here in the 1990s, knew that there was a Woodinville clinic - can get immunizations, malaria pill etc. no longer able to. Accessibility AND availability of PH clinics.

Making sure the new OMB race/ethnicity recs are implemented in WA, especially the standard for data collection starting at granular level. Also, how identifiers are rolled up into larger categories.

2024-04-03 18:34:33 UTC

Navigators

2024-04-03 18:34:59 UTC

This may apply to multiple columns, but the use of diverse and well-trained community navigators could be a great support to making care more accessible and appealing.

Housing insecurity needs to be connected to health access. I worked with an insulin dependent diabetic who ended up needing to be induced preterm due to maternal health crisis- this was directly related to not having housing to store her insulin. This can’t be seen as separate issues.

2024-04-03 18:35:12 UTC

2024-04-03 18:35:21 UTC

Power, Bias, and discrimination in data collection, analysis, and interpretation.

Quantitative data measures serve funders not the communities.

2024-04-03 18:36:12 UTC

These measures don't capture individual needs, even if they are culturally more respectful questions. Entering communities and demanding they quantify their day to day experiences when trauma studies show that the conceptualization of time is different for those under chronic stress, is almost cruel. Someone may be having an "ok day" at the time of an interview but it doesn't highlight their chronic pain

Black, Indigenous, people of color (BIPOC) parents face barriers to accessing resources and healthcare

2024-04-03 18:37:12 UTC

Several BIPOC parents have talked about traumatic experiences with NICU, and medical trauma around how they are treated - stories of anti-Blackness, racism, fatphobia, queerphobia/transphobia, and doctors who make BIPOC parents feel / experience "revolving door healthcare" with doctors requiring or strongly advocating for unnecessary and invasive medical interventions for birthing parents just to speed up the process. Additionally, finding doctors who respect and honor the support of doula and birth workers in the process is difficult!

Culturally appropriate care needs to be addressed at the workforce development realm as well, where BIPOC individuals and communities have equitable access to education, training, and ongoing support to become healthcare professionals.

2024-04-03 18:38:18 UTC

Many major healthcare systems promote work environment culture that perpetuate white supremacy culture that are hostile and threatning to BIPOC workers, so for health justice and cultually responsive care to be promoted, major healthcare systems must be held accountable (e.g. looking at the employee demographics that reflects the communities served, employee turnover of BIPOC employees, etc.).

2024-04-03 18:38:39 UTC

Distrust in the System

2024-04-03 18:38:40 UTC

In the Somali community we serve, we see a movement away from immunization and the health system overall due to distrust/fear. The health system does nothing to address their concerns. Their experiences often pushes them further away from the system

due a lack of cultural appropriate care.

2024-04-03 18:38:55 UTC

Race and trust in the healthcare system.

Not sure if fits here but Youth and Family Resource Centers (YFRC) for example are mainly geographically based and play a crucial role in addressing social determinants of health. Even when ethnic community-specific groups are involved, integration bewteen cbos and YFRCs to provide access to these benefits remains a challenge.

2024-04-03 18:38:59 UTC

Clinics that honor birthworkers/doulas

2024-04-03 18:40:36 UTC

Finding doctors / hospitals / clinics that support parents who are interested in home births, by & for BIPOC birth centers, and allowing birthworkers/doulas to be present for appointments and the birth requires arduous advocacy from the parent and/or doula. Several parents described having to change doctors a few times, or when giving birth at a hospital, being treated poorly in such a vulnerable moment.

Equitable compensation for multicultural employees

2024-04-03 18:41:17 UTC

At the state level, we must compensate multilingual/multicultural employees who shoulder the burden that are invisible to white leaders. There needs to be some accountability for healthcare organizations in WA state to ensure multilingual employees are assigned smaller caseloads and higher compensation.

ongoing coverage by Medicaid for ABA, even after it has been shown to be harmful to autistic individuals and AMA has withdrawn support for the therapy.

2024-04-03 18:41:24 UTC

Challenges w/ interpreters in sensitive situations (miscarriage/abortions). I've heard from several parents who have had procedures done without fully understanding what was to be done, having traumatic results.

stephanievalerdi — 2024-04-03 18:44:27 UTC

Mistrust/curiosity with how county uses data

2024-04-03 18:49:32 UTC

For undocumented parents and parents from communities historically facing oppression and coercive trauma in medical industry and by state powers: lack of understanding for why the county is asking identifying information, what is done with the reported data, and how that information is used to support the needs of parents in underserved communities (if at all, rather than just assessing what communities do for themselves or how they are seeking support from nonprofits).

environmental clean up/protection

2024-04-03 19:02:44 UTC

The ways racism/classism intersect with environmental justice and climate change organizing, and including people from these communities in decision making. Often times, interstate highways, large development projects, airports, location for landfills/factories/etc more often go through and pollutes neighborhoods that are historically communities of color. And when new apartment complexes, light rail stations, and "infrastructure improvements" come to these neighborhoods, they often don't include or listen to BIPOC communities and their leadership in decision making. And then BIPOC communities and families get pushed out or priced out. When prioritizing environmental justice, Board of Health needs to consult with Black, Indigenous, People of Color community; and ideally go beyond consulting and hire BIPOC who hold relationships/leaderships with organizers and neighbors into positions with decision making power.

mdinardo14 — 2024-04-03 19:05:19 UTC

I would second the CHW roles created for and paid for by the state and recognized as a crucial need for serving the community

mdinardo14 — 2024-04-03 19:08:07 UTC

mdinardo14 — 2024-04-03 19:08:57 UTC

Many families we work with are on Medicaid. Many services we need are not covered under Medicaid. Stability… might need some addition of services/ADA, etc… but the pay scale is not equivalent. Getting to the haves and have nots… then you have private medical insurance, services, etc…. If you have the have nots… are we compensating everyone equitable for them to run a business, providing services….