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    On the road to Health Equity in Tarrant County through Health Strategy

    All of us deserve a fair chance at a healthy, long and fruitful life.

    Health Equity simply means attainment of the highest levels of health for all. It is easier said than done. What is surprising to many is that the social, environmental and economic conditions around us determine and impact our health more than we can imagine! Due to their significant role in health outcomes, these conditions have been dubbed as social determinants of health.

    Imagine if you live in a neighborhood with no side-walks! If there is traffic on the street, you may be less inclined to walk due to fear of getting hit by a car. Now imagine walking on this busy street with your dog or with your kids. Also, think about where we are going? Is it just for a walk in a sea of homes, or to somewhere with a purpose? Walkability is one example of a social determinant in our environment. There are many areas such as education, employment, healthcare access, community engagement, crime rates, transportation, planned development, housing, and race/ethnic background that can all have an impact on health.

    Tarrant County is a fast growing community of approximately two million individuals living within 902 square miles. Like many large urban communities, Tarrant County varies significantly by culture, race/ethnic background, income, education, green space, housing, crime and many of other social determinants of health. Those social determinants shape the health of our residents differently throughout all of our neighborhoods and zip codes.

    How is Tarrant County addressing health equity?


    Tarrant County Public Health (TCPH) is a nationally accredited health department. As part of the accreditation process, TCPH led the efforts in the community-wide development of the 2014 Tarrant County Community Health Improvement Plan (CHIP). The CHIP illuminates four priority issues (Education, Environment, Healthcare Access and Partnerships) affecting Tarrant County. The collaborative effort of this process has moved diligently toward improving health and wellness along with addressing health disparities in Tarrant County communities.

    For example, an environmental goal is to improve the walkability surrounding elementary school neighborhoods. After gaining support from the community, Texas Christian University’s Harris College of Nursing, Blue Zones Project Fort Worth and TCPH worked with C. C. Moss Elementary School to develop and implement a sustainable walking school bus program called "Walking Wednesdays." C. C. Moss is located in a community in dire need of infrastructure improvements to make it a safer environment for kids to walk and bike to school. With help from the City of Fort Worth, the program addresses such issues as dilapidated sidewalks, inadequate school zone speed limit signage and ineffective crosswalks. By partnering with the Silver Sneakers at the McDonald Southeast YMCA, the children who walk are building relationships with seniors and bridging the generational gap, while they stay physically active on their way to school.

    TCPH strives to promote health in all policies. The department established the Cultural and Linguistic Competency Policy and Procedures to ensure staff develop and maintain health services that are culturally competent, consumer-guided and community-based, and that help to eliminate health inequities. One example is the creation of a Translation Committee to provide appropriate health-literate communication. Another example is the hiring of bilingual staff to meet the growing needs of our diverse Tarrant County community.

    We recognize that training is a key component for the successful implementation of policies. TCPH’s Center for Health Equity (CHE) has trained TCPH staff and the community on the basics of health equity, cultural competence, diversity, social justice and NACCHO’s Roots of Health Inequity. Most recently, the CHE has developed a Limited English Proficiency (LEP) training to assist the Women, Infants and Children (WIC) staff to improve communication with clients.  

    In 2016, TCPH helped the Tarrant County Food Policy Council increase access to healthy foods through three City of Fort Worth ordinance amendments. The results of the ordinance amendments are:

    1. Push Carts could only sell frozen desserts before. Now, vendors with self-propelled carts can sell fresh produce in residential areas.
    2. Mobile Market Vendors could only sell on private property before. They now are allowed to sell on public property, including residential areas.
    3. The Urban Agriculture ordinance was amended to allow urban farms with an approved site plan and permit, aquaponics inside a covered structure and the sales of produce grown in all zoning districts.

    Finally, the department developed a new strategy to infuse health equity throughout the plan. We are building traditional and non-traditional partnerships to address health literacy, healthcare access, disease reduction, infant mortality, breast and cervical cancer, access to affordable nutritious foods and integrated transportation.

    TCPH is working diligently to advance health equity on our journey to becoming the leaders in health strategy in Tarrant County.

    Sincerely,

    Veerinder (Vinny) Taneja

    Tarrant County Public Health Director