B3 - Utah’s It Takes a Village Project: Navigating Pacific Islander Data, Community and Culture to Address Birth Outcomes Disparities and Advance Health Equity

The typed transcription of this session can be found HERE

Full Description: In 2010, the Utah Department of Health (UDOH) Office of Health Disparities (OHD) disaggregated maternal and infant health data for Asians and Pacific Islanders. Outcomes were shocking. Since reviewing the outcomes in 2005, the infant mortality rate for Pacific Islanders (PI) had doubled. Other birth outcomes disparities also surfaced across pre-term birth, prenatal care, and birth spacing. The needs of Pacific Islander mothers, babies, and communities were no longer hiding in the healthier outcomes of their Asian comrades.

After almost a decade of investment, OHD can share hard-won knowledge working with communities including hired PI staff, community-based organizations, and community members. Through visuals, all-PI local community videos, interactive activities, community stories, etc. principles and practices can be broadly applied to advancing health equity for maternal/infant health and Title V programs. Principles include:
Data-disaggregation to uncover health disparities. Too often, communities are swallowed up in a larger group similar to when Utah's Pacific Islanders were combined with Utah’s Asian community. Although community numbers may be small, strategies like disaggregating by group, but aggregating over time can be effective.

Innovation and creativity are key to achieving health equity. Traditional public health approaches, including prescriptive programs, are not designed for communities and often lead to alienation instead of support. OHD did not start with a solution in mind, choosing instead to work with the PI community over many years to tailor products to meet their needs and wants.

Intentionally focusing on community strengths promotes health equity. OHD focused on culture as a community strength instead of a barrier. This mindset can lead to efforts and products that resonate with community members and more seamlessly integrate into their lifestyles. It also profoundly recognizes and values lives experience.

What is really innovative about the It Takes A Village (ITAV) project is its thorough anthropological approach. Community members like Jake Fitisemanu taught OHD, “Our culture, our community, our history really has a lot to offer us today. And we can find a lot of strength in terms of promoting health by looking back and really remembering and acknowledging the way that our ancestors lived.”

ITAV’s cultural framework embodies this by mirroring the Pacific way of life and borrowing from traditional Pacific systems for resolving community problems in order to appropriately break the silence surrounding infant mortality and other birth outcomes disparities — effectively reflecting the past to shape the future.

In 2018, ITAV became a Promising Practice. ITAV also informed OHD’s current research study Embrace. ITAV concepts and principles were applied to create curriculum and services culturally responsive to PI women of child-bearing age to address maternal mortality and diabetes disparities.

Abbreviated Description: The Utah Department of Health (UDOH) Office of Health Disparities (OHD) It Takes A Village (ITAV) project takes an anthropological approach. ITAV’s cultural framework embodies this by mirroring the Pacific way of life and borrowing from traditional Pacific systems for resolving community problems in order to appropriately break the silence surrounding infant mortality and other birth outcomes disparities — effectively reflecting the past to shape the future. In 2018, ITAV became a Promising Practice.