St. Louis County is the 45th largest county in the United States, and the most populous county in Missouri. St. Louis County has a population of just over 1 million residents and represents 16.2% of Missouri's total population. St. Louis County's racial demographics are made up of White: 69%; Black/African American: 24%; Asian: 4.2%; Hispanic or Latino: 2.8%. The poverty rate in St. Louis County is 9.8%.
The St. Louis County Department of Public Health (DPH) is a key resource for residents, as it provides the following services: medical, dental, health education, immunizations, lead screening and treatment, nutrition counseling, prescription savings program, sexually transmitted infections services, social services, substance use disorder treatment, Women, Infants & Children Nutrition Program, women's health, and X-Ray services.
DPH provides services to a racially, culturally and socioeconomically diverse population. Due to its diverse nature, St. Louis County has many social determinants that impact health inequities. St. Louis County's poverty is concentrated geographically and disproportionately affects African-Americans. Historically, poverty in St. Louis County has been concentrated in the inner-ring communities of North County. St. Louis County has identified a 12 year gap in life expectancy between census tracts in North County. In addition, the Missouri Department of Health and Human Services reported that there are 7.2 asthma emergency department visits per 1,000 population. Also, 17.57% of Black residents are uninsured compared to 7.18% of White residents (American Community Survey, 2010-2012).
DPH is committed to being a public health leader in the community, and has recognized the need to take steps to address health disparities and inequities. In an effort to serve County residents with a racially and culturally approach, DPH formed a Health Equity Committee (HEC) and developed a health equity training plan. One of the HEC initiatives was to develop a department-wide health equity training plan that educates employees about social and demographic factors that affect health including, but not limited to racial equity, LGBTQIA (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex and Asexual), cultural competency and health literacy. This plan seeks to serve as a training guide on creating a culture of health equity. The training plan is made up of 5 modules, and a separate Managers Module was created and implemented at the launch of the HEC Training Plan. The Manager's Module is provided to managers and supervisors as an educational tool on the training plan, what to expect, and how to support staff who participate in the HEC Training Plan.
The two goals for Health Equity training are: 1.) increase new hire and existing staff awareness and understanding of health equity and, 2.) incorporate health equity awareness into job functions to better serve County residents. The objectives for goal 1 are: 1.) employees will complete health equity training and gain awareness of the health equity definition; 2.) creation of a health equity training curriculum; and 3.) provide ongoing communication to share health equity training materials with DPH staff. The objectives of goal 2 are: 1.) develop and implement a manager specific training to guide managers to incorporate health equity awareness and language into their programs; and 2. develop all health equity training to ensure Problem Solving” component.
All training plan objectives have been met, although the committee is still in the progress of launching modules 4 and 5. After the launch of modules 4 and 5, staff will have had the opportunity to complete all health equity modules.
The factors that have led to the success of the HEC training plan initiative has been ongoing support from DPH leadership, and encouragement of staff to attend the training sessions. The Manager's Module was a key step in the implementation of the HEC training plan. This module offers an understanding to the goal of the training plan and why it is necessary. Managers and supervisors are empowered to support staff in attending the training opportunities and provide follow up support.
The HEC and training plan is a cross-collaboration of DPH staff and divisions. HEC members provide support for implementation of the modules and to ensure that goals and objectives are being achieved. Regular communication via email has informs staff of upcoming modules and to complete trainings.
In 2017, the HEC Training Plan was recognized as one of NACCHO's Promising Practices.
http://www.stlouisco.com/Health-and-Wellness/About-Your-Department-of-Public-Health