Category: Employment and Labor Market

Accountable Care Communities Offer An Opportunity to Address Healthcare Disparities at the Systems Level

In a previous blog post, which you can find here, ncIMPACT shared information around NCCARE 360, an interdisciplinary referral tool being implemented in the state of North Carolina’s medical care systems. As we continue to research impacts of the health of a community, we find it increasingly important to look at the way data around how changes become integrated with existing cultural norms and daily lives of community members in North Carolina. NCCARE 360 is part of an effort to implement a model of Accountable Care Communities (ACCs).

ACCs

ACCs aim to address health at the community level through addressing the social drivers of health and looks at health on a systems level to better coordinate healthcare with a wide variety of stakeholders within a community. This coordination includes involving non-traditional partners in health initiatives, such as faith communities and academic researchers. ACCs have an underlying value of authentic community engagement. In the context of the ACC model, it is not enough to go into communities and give out information. Stakeholders must work alongside communities to create a power dynamic that gives community members agency and self-determination. Under the ACC model, the goal is to elevate the voices of community members who are most impacted by health disparities. For example, specific race groups are more likely to experience disparities within population health–those voices need to be amplified within this model.

 

 

Health Inequities by Race

In fact, the data suggests that many health initiatives have historically neglected or taken advantage of specific race populations, such as the Native American and African American communities (see Black-White Disparities in Health Care Report, released by the American Medical Association[1]). Racial disparities in health begin even at the stage of conception. African American babies are more than twice as likely to die during childbirth than white or Hispanic babies in North Carolina. While white babies die at a rate of 5.4% in North Carolina (comparable to the Hispanic rate of 5.5%), Black babies die at a rate of 12.4% (see figure below from NCDHHS).

 

 

Maternal mortality rates are alarming in general, but when analyzed by race, it is evident that Black mothers have a totally different experience during pregnancy and childbirth than their racial counterparts. In 2013, in the state of North Carolina, the maternal mortality rates for Black and white women was almost the same, with the white racial category making a large jump up in rates and the Black racial category briefly falling. However, since then, the numbers have since diverged once more. Today, a Black woman in North Carolina is 3x as likely to die from giving birth than a white woman. From 1999-2013, Black women accounted for 49% of the deaths due to childbirth in the state of North Carolina, while African Americans make up 22% of the state’s population (https://schs.dph.ncdhhs.gov/data/maternal/).

While working with the Kate B. Reynolds Charitable Trust on their targeted health strategies, our interviews with experts repeatedly brought up the importance of cultural competency at the systems level to address disparity. For example, one anonymous interviewee we spoke with mentions struggles with healthcare perceptions for older African American men:

“He grew up in a time where he knew studies were being done on Black people. Telling him he needs to go to the doctor brings up distrust for him. Entering into those large facilities, he’s not inclined to do that. He needs a provider that looks like him and be able to come to a place that feels safe.”

 

These disparities are alarming and to begin addressing these health inequalities, research and reports indicate that strategically culturally appropriate care, community capacity building, and homegrown community leader involvement will all need to be present as a start to making the state’s health system more culturally appropriate. These non-traditional partnerships implemented in Accountable Care Communities will require a breaking down of walls for everyone involved–silos will need to be removed for an integrated community care system.

For more guidance on implementing the ACC model, please see the following guide, provided by Kate B. Reynolds Charitable Trust and Duke Endowment, visit http://nciom.org/nc-health-data/guide-to-accountable-care-communities/

 

 

[1] https://www.ama-assn.org/about/ama-history/history-african-americans-and-organized-medicine

 

 

 

Women in Construction

When more residents thrive, communities thrive.

Talent is essential for growth and competitiveness. When the potential of women is not fully harnessed, companies and communities lose out on skills, ideas, and perspectives that are critical for addressing challenges and maximizing new opportunities.

This reality is proving especially true in the construction sector for the greater Triangle industry, and communities are responding in innovative ways.

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Education and Skills for Tomorrow: Is Your Workforce “Future Ready”?

Earlier this month my colleague, Dave Brown, published a blog hinting that we, at ncIMPACT, are working on a Future Ready Communities Dashboard. Our current series of blog posts focuses on “What it means to be a Future Ready Community.”

Future Ready Communities will be successful because of their vibrancy, their interconnectedness, and their fluid structures for causing positive human collisions. They will be built on and for great ideas. These communities will lead based on their brain trust, and they will in turn become a magnet, attracting other good minds. The relational effect is clear: Good minds make a community great, and great communities attract good minds.

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Opioid Epidemic Ignores Boundaries in North Carolina

At its recent NC Rural Assembly titled “Claiming Our Future,” the NC Rural Center offered an important discussion on the opioid epidemic in North Carolina. Introduced by Dr. Anu Rao-Patel from Blue Cross Blue Shield of NC, the session began with sobering statistics — including the fact that drug overdoses are now the leading cause of accidental death in NC (ahead of vehicular crashes). According to Centers for Disease Control and Prevention estimates, the cost of unintentional opioid related overdose deaths in NC totaled $1.3 billion in 2015.

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Our Future Workforce: The Rise of the Individual

This is the fourth and final in a blog series on drivers of change for Our Future Workforce. The other three posts focus on demographics, automation, and business model changes. Our next series will use case studies to offer insights into local and regional efforts in North Carolina seeking to respond to these drivers. Please offer suggestions for case studies here

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Our Future Workforce: The Rise of New Business Models

This is the third in a blog series on the drivers of rapid and profound changes in who will work and where, when, and how work will be done in the coming years. The first in the series focuses on demographic drivers and the second on automation.

Dramatic industry model changes are forcing companies to reactively reposition their business models or face failure. Take the following example: Black Friday is dead. This was the early, and erroneous, call by bored local news beat reporters as they stood in empty parking spaces outside stores or pointed to people leaving malls with no purchases in hand the day after Thanksgiving. For some retailers, the news coverage may foretell a death sentence, but not for all. Retailers that continue to thrive will do so because they are agile enough to respond to the reality that the reporters missed the point. Black Friday is not dead. Black Friday has moved!

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Our Future Workforce: Driven by Technological Disruptions

This is the second in a blog series on drivers of rapid and profound changes in who will work and where, when, and how work will be done in the coming years. The first post on Our Future Workforce can be found here.

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Our Future Workforce: Demographic Drivers

The nature of work is changing rapidly and dramatically. How we prepare for the who, when, where, and how work is done will challenge our state’s leaders and the institutions that support our workforce. To fully understand what lies before us, we must first examine the scale of the drivers of change. Our research at ncIMPACT suggests there are four primary drivers: demographics, disruptive technologies, new business models, and the rise of the individual. This blog post focuses on the first of these, and highlights some important demographic changes in North Carolina.

North Carolina is growing. But according to demographic analysis by our friends at Carolina Demography, much of this growth follows a trend of clustering in the state’s existing population centers, and will continue to do so over the next two decades. As people increasingly reside in those areas, strong job growth tends to concentrate there, too.

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What You Told Us in the ncIMPACT Planning Survey

We launched ncIMPACT in 2017 to help public officials in North Carolina navigate critical policy challenges across a wide range of topics, including health, education, economic development, criminal justice, public finance, and the environment. As we planned this new initiative, we wanted to hear from practitioners and other citizens about the most vexing policy issues in their community and in the state as a whole, and what we could do to help. As such, in January 2017 we drafted an online survey and distributed it with the assistance of various peer associations and a targeted Twitter campaign. Over the course of two months, we received 154 responses to our survey. Please read on for an analysis of our results.

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Welcome to the ncIMPACT blog, where we feature posts on the following topics:

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