Sage Home's RECIPE For Health Equity
by Marca McCallie
“Not everything that is faced can be changed, but nothing can be changed until it is faced.”
-James Baldwin
Working as a mental health practitioner, I’ve noticed that people have different starting points when it comes to addiction and recovery. A mother who has stable housing and a job will require vastly different interventions compared to a mother who is experiencing homelessness and is unemployed. The two mothers are not starting at the same point and thus, require different levels of interventions. To provide equal treatment for both mothers would be ineffective at creating equal treatment outcomes and would inevitably leave the more vulnerable mothers behind. When some types of people consistently get better from treatment, and some types don’t, we must face the reality of health disparities and ask the hard questions, including
Why is this happening?
What is causing this?
How do we change it?
These questions are foundational in understanding health equity.
According to the Robert Wood Johnson Foundation, “Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”
A Visual Representation
Below, I have included graphics to help illustrate this concept from CulturalOrganizing.org. The first graphic shows how we intuitively understand that starting in the same place (equality) is not always fair and/or just (equity).
The second illustration shows us that people have different life barriers that create obstacles requiring more interventions. These pictures show us that it’s not an inherent quality in an individual; the problem is in the various obstacles they face.
The concept of health equity is a necessary goal when addressing the level of interventions needed for mothers with varying backgrounds or social determinants of health. Social determinants of health mean we acknowledge that there are things in our social environments that impact our long-term health outcomes, and that increases our vulnerabilities to stress. According to the Center for Disease Control, some examples of social determinants of health include:
Availability of resources to meet daily needs (e.g., safe housing and local food markets)
Access to educational, economic, and job opportunities
Access to health care services
Quality of education and job training
Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities
Transportation options
Public safety
Social support
Social norms and attitudes (e.g., discrimination, racism, and distrust of government)
Exposure to crime, violence, and social disorder (e.g., presence of trash and lack of cooperation in a community)
Socioeconomic conditions (e.g., concentrated poverty and the stressful situations that accompany it)
Residential segregation
Language/Literacy
Access to mass media and emerging technologies (e.g., cell phones, the Internet, and social media)
Culture
To learn more about social determinants of health and how they impact treatment outcomes, listen to this interview with Dr. Emery Eaves, Sage Home’s partner from the Center for Health Equity at NAU.
A Recipe For Success
Renaisa S. Anthony MD, MPH, is an expert in the field of health equity. She earned her medical degree at the University of Chicago, public health degree at Harvard, medical training at Vanderbilt, and a policy fellowship at the National Institutes of Health (NIH). She has committed her life to improving the health of women, children, families, and communities. In her TED talk from 2012, Dr. Anthony discusses having a RECIPE for health equity. The acronym RECIPE is an excellent way to conceptualize how Sage Home plans to address health equity and provide the best care for mothers facing a variety of different obstacles.
The following is how Sage Home answers Dr. Anthony’s question of
“What is your RECIPE for health equity?”
Research: Sage Home has partnered with the Center for Health Equity at Northern Arizona University to both research equitable practices for pregnant and parenting women and hold our treatment facility accountable to rigorous program monitoring. This is done to ensure that families who receive treatment from Sage Home improve and get the help they need to be successful. Our research team includes a variety of professionals from various fields, including social work, anthropology, medicine, child development, psychology, and public policy. Data is necessary because it can focus our attention towards aspects of treatment that need more attention and can also illuminate what is working and not working so we can adapt our approach and improve our outcomes. We believe that research not only enhances the quality of care provided but can also spread awareness, which promotes better, evidence-based practices for pregnant and parenting women and their families.
Education: Sage Home agrees with Maya Angelou that “when you know better, you do better.” Education is a critical component to achieving health equity. When parents have the knowledge and resources to care for themselves and their children, change happens. Sage Home believes in not only empowering the individual and family unit but empowering our community as a whole. That is why Sage Home is partnering and will continue to partner with key stakeholders in Coconino County committed to improving the quality of life for vulnerable families in our community.
Collaboration: Some of our current community partners include Northern Arizona Healthcare, the Institute for Human Development, the Center for Health Equity, the Child Welfare Training Project, and Housing Solutions of Northern Arizona. Once our doors open, we hope to work in partnership with as many entities as possible in our community, including the schools, courts, doctors’ offices, community housing, and job support services. Click here for a list of resources available in Coconino Country.
Initiative and Implementation: Sage Home is taking the initiative to keep families together during treatment and will implement the program based on research and guidance from sites that have already been practicing this treatment approach. Our leading consultant, Kari Earl, is an expert in the field of family-based treatment and has been a massive support for Sage Home. Check out Kari Earl’s interview with Sage Home HERE.
Public Health and Policy (passion and purpose): Research and practice are important, but public health and policies are necessary for meaningful and lasting change. Sage Home will actively commit to advocating for policy changes that address and remove the barriers our clients face, which interrupt their capacity for real recovery. Research and community collaborations will inform our advocacy efforts that focus on promoting the most equitable and just public health and policies for our clients.
Empathy to Empower (and evaluation): The empathy to empower is foundational. A key component of Heath Equity is rooted in the awareness of power dynamics. Those not in power face different obstacles than those in power. People at the mercy of the system can often feel powerless and resort to behaviors that are ineffective and unlikely to move them towards healthy connections and stability. Empowering practices trust that clients and communities have what it takes to move towards more health and well-being when information and resources are within their reach. Our goal at Sage Home is not to “fix” our clients and families, but instead to empower them through providing a safe and supportive environment where they can receive the education necessary to connect to their communities and families in meaningful and effective ways.
As we aim to help close the gap in rehabilitation services, we focus on helping those who may not have the same resources and options others may be privy to. At Sage Home, it is our mission to help mothers through their treatment so we can keep families together.
We believe that families should be able to safely stay together while on their addiction healing journey.
You can help us keep families together so that no child has to be separated from their family, and no mother separated from their child.
Are you with us?