Winter 2013
NBCSL EVENTS: QUAD CAUCUS MEETING

Joint Caucus Tours the South to Tackle Health Issues in Minority Communities

By Michael D. Reed, NBCSL Policy Analyst serves as a Policy Analyst for NBCSL. Prior to joining NBCSL, Mr. Reed worked for the National Conference of State Legislatures where he managed policy development, lobbying, and federal affairs on education, labor, and trade issues. Mr. Reed’s previous government experience includes serving as an aide in the U.S. Senate for four years and as an aide in the New Jersey Governor’s Office.

17-Quad Caucus 0Members of the Joint Caucus toured the Rankin County Juvenile Detention Center in Mississippi.The Joint Caucus, established in 2012 through a grant from the W.K. Kellogg Foundation, met in August and October to complete its 2013 agenda. Topics largely revolved around healthy communities, and featured discussions with experts on various aspects of health policy, including sexual health, dental care, and obesity. Additionally, the Joint Caucus discussed juvenile justice. Convened by the National Conference of State Legislatures, the Joint Caucus consists of four state legislative caucuses, the NBCSL, the National Asian Pacific American Caucus of State Legislators (NAPACSL), the National Caucus of Native American Legislators (NCNASL), and the National Hispanic Caucus of State Legislators (NHCSL). 

In its fifth meeting in Atlanta, the Joint Caucus focused on dental care and sexual health in communities of color. The meeting kicked off with a session featuring experts from the Centers for Disease Control and Prevention (CDC). This session provided legislators with a better understanding of the research that CDC conducts to track and address risky behavior and preventable diseases among youth. Experts outlined some systemic reasons behind high-risk behaviors, which disproportionately involve youth of color. However, the data revealed dramatically different results within groups, indicating that some states did a much better job of educating and empowering youth to make healthier choices.

The panel opened with Dr. Laura Kann, Chief of the CDC School-Based Surveillance Branch. Dr. Kann presented legislators with an overview of the CDC’s Youth Risk Behavior Surveillance (YRBS) program. The YRBS conducts a national survey of youth behavior in several areas that contribute to death and disability among young people. The YRBS provides a wide range of data and analysis that can be utilized by health officials and policymakers to tailor policy solutions to specific needs of each community, as well as determine the impact of existing programs. 

The second panelist was Dr. Donna Hubbard McCree, Associate Director for Health Equity at the CDC Division on HIV/AIDS Prevention. Dr. McCree’s presentation highlighted modern trends in HIV and AIDS transmission. CDC has recently indicated a significant uptick in new HIV cases across several demographic groups, most particularly people of color. Dr. McCree also noted that race and ethnicity serves as one of many factors used when analyzing trends in HIV transmission and that several other factors must be considered when policymakers discuss solutions in the fight against HIV and AIDS. Other factors include income level, history of abuse, and/or substance abuse.

The final panelist was David Johnson, Sexually Transmitted Disease (STD) Disparities Coordinator for the CDC Division of STD Prevention. Mr. Johnson’s research indicated that communities of color face higher prevalence of STDs, and noted some of the individual, societal, and structural inequalities behind these disparities. A wide range of factors, such as socioeconomic status, educational attainment, and treatment access all play a major role in the transmission and prevalence of STDs among at-risk groups. Mr. Johnson recommended that policymakers consider these comprehensive factors when seeking to reverse these trends. He also stressed the importance of youth education that goes in-depth, allows youth to practice their responses in realistic scenarios, and is scientifically accurate.

The afternoon session switched gears to focus on improving dental health for children of color. Children in low-income and communities of color face significant barriers to quality and affordable dental care. Poor dental health can directly lead to a wide range of dangerous medical issues that can last a lifetime. Fortunately, routine dental screening and care can effectively treat the majority of dental health issues. But without access to such services, these at-risk populations endure serious, but preventable health issues and lower quality of life.

The legislators heard from various experts and practitioners. The panel was moderated by Dr. Albert Yee, Senior Project Advisor at Community Catalyst in Boston, who provided an overview of the broad impact of improper dental health on the nation. Other panelists included Dr. Hazel Harper, Past President of the National Dental Association, Dr. Lisandra Soto, Lead Dentist of the Kansas Healthcare Communicators Society; Valerie Davidson, Senior Director of Intergovernmental and Legal Affairs for the Alaska Native Tribe Health Consortium; Aurora Johnson, Dental Health Aide Therapist for the Alaska Native Tribe Health Consortium; and Dr. Terry Batliner, Associate Clinical Professor at the University of Colorado. 

Dr. Harper called for increased attention to cultural competency for dental professionals at all levels and highlighted evidence that cultural competency improves quality of care. Dr. Soto elaborated on the economic impact of oral disease and noted that young people who suffer from oral diseases and tooth decay have harder times finding jobs, which can impact future job prospects and earnings. Ms. Davidson presented on the use of mid-level dental providers to expand affordable dental care and treatment to underserved communities. In her presentation, Ms. Davidson noted that mid-level dental providers are highly trained, skilled, and regulated dental professionals that can work in tandem with dentists to provide many critical dental procedures. Ms. Johnson outlined her outlined her work in underserved communities, such as providing cleanings, screenings, and oral hygiene instructions to children and adults. Dr. Batliner closed out the panel, discussing the ways that underserved communities deal with dental emergencies in the face of limited access to dental providers.

At the Joint Caucus’s sixth meeting, held October in Jackson, Mississippi, lawmakers continued to explore health issues by diving into childhood obesity and wellness. Natalie S. Burke, President and CEO of CommonHealth ACTION, facilitated the panel discussion on PLACE MATTERS, a national initiative to eliminate health disparities, working at the local level and across states to identify and address social, economic, and environmental attributes of neighborhoods, schools, workplaces, and other places that shape health.

The panel offered communications and outreach strategies and outlined the following policy recommendations for youth: (1) keeping students in school and out of prison; (2) providing opportunities for those who have been incarcerated; (3) addressing mental health needs of youth and families; and (4) developing student-centric policies and ensuring spending follows children to various educational settings. Dr. Autumn Saxton-Ross, Program Director of the Health Policy Institute at the Joint Center for Political and Economic Studies, gave an overview of PLACE MATTERS including its status, locations, and accomplishments. Lela Keys, Project Director for Mid-Mississippi Delta Place Matters, and DeBorah Williams, Executive Director of Legacy Village, both of whom work as team leads at grassroots organizations, shared their work in community, challenges, and lessons learned.

The legislators also heard from Sandra Shelson, Executive Director of Partnership for a Healthy Mississippi, and National Conference of State Legislatures (NCSL) experts, Amy Winterfeld, Health Program Director, and Doug Shinkle, Environment, Energy, and Transportation Program Director, who provided information on legislative trends and examples of policies being used to improve health and wellness for children and communities. These solutions ranged from the ways states can improve nutrition in schools to developing safe routes to encourage walkable communities. Legislators broke into small groups that focused on solutions that addressed both structural/environmental changes as well as behavioral changes for healthier outcomes.

During this meeting, legislators also discussed juvenile justice. The Juvenile Justice session opened with Douglas Blackmon, famed journalist and author. Mr. Blackmon, a White male, discussed his upbringing in rural Mississippi among its first class of schoolchildren to integrate public schools. While at the Wall Street Journal, Mr. Blackmon stumbled upon massive evidence that throughout the South following Reconstruction, several states developed criminal justice systems to legally re-enslave hundreds of thousands of African-American men and lease them as convict-workers up until World War II. As such, he argued that the American criminal justice system was designed to fail African Americans and other minorities, so understanding its fundamental flaws is essential in any reform efforts.

Legislators also heard from Jody Owens, II, Managing Attorney with the Southern Poverty Law Center, who provided legislators with an overview of issues surrounding juvenile detention, including unsanitary conditions, poor education, lack of appropriate medical care, and even abuse.  The juvenile justice portion of the meeting ended with a site visit to Rankin County Juvenile Detention Center (cited in the state as a model juvenile detention facility). There, the legislators had an opportunity to tour the facility, meet facility administrators and youth, and more about how the facility operates.

The Joint Caucus provides a unique opportunity for a diverse array of legislators from across the country to learn both with and from one another. By tackling these important, often difficult issues, the Joint Caucus fosters a sense of community and togetherness that helps to break down barriers that often tether sound policy decisions. The Joint Caucus looks forward to continuing its critical work in 2014.

NBCSL Policy Analyst serves as a Policy Analyst for NBCSL. Prior to joining NBCSL, Mr. Reed worked for the National Conference of State Legislatures where he managed policy development, lobbying, and federal affairs on education, labor, and trade issues. Mr. Reed’s previous government experience includes serving as an aide in the U.S. Senate for four years and as an aide in the New Jersey Governor’s Office.

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