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Health Equity
Impact Report

2022-2023

Health Equity
Impact Report

2022-2023

Welcome

We are excited to share with you Heluna Health’s annual impact report, featuring stories on how we are advancing health equity and preparedness in the communities that we and our partners serve. Whether you are a longtime friend or are just learning about us, we hope that this report will inspire you to continue or join the effort to mitigate health disparities in California and beyond.

In pursuing Heluna Health’s mission to advance population health, our team is directly involved in supporting and/or implementing more than 500 initiatives a year. These encompass a wide range of health-related challenges, including disparities in maternal and infant health, childhood obesity, gang intervention, homelessness, and much more. Common among the interventions undertaken is an evidence base, data analysis, and research.

I hope you will be inspired by the stories in this impact report. The problems we face in population health are daunting, but they are not intractable. There is much more that we need to do to better address the social determinants of health that contribute to health inequities in communities across California and beyond. Together we can and will make great progress in improving the lives of those living within our communities; I look forward to working with you to further our success.

Blayne Cutler, MD, PhD

President and
Chief Executive Officer

Blayne Cutler, MD, PhD

President and
Chief Executive Officer

We are excited to share with you Heluna Health’s annual impact report, featuring stories on how we are advancing health equity and preparedness in the communities that we and our partners serve. Whether you are a longtime friend or are just learning about us, we hope that this report will inspire you to continue or join the effort to mitigate health disparities in California and beyond.

In pursuing Heluna Health’s mission to advance population health, our team is directly involved in supporting and/or implementing more than 500 initiatives a year. These encompass a wide range of health-related challenges, including disparities in maternal and infant health, childhood obesity, gang intervention, homelessness, and much more. Common among the interventions undertaken is an evidence base, data analysis, and research.

I hope you will be inspired by the stories in this impact report. The problems we face in population health are daunting, but they are not intractable. There is much more that we need to do to better address the social determinants of health that contribute to health inequities in communities across California and beyond. Together we can and will make great progress in improving the lives of those living within our communities; I look forward to working with you to further our success.

OUR MISSION

Heluna Health enhances the health, wellness,
and resilience of every community we serve

OUR Vision

Healthy, strong
communities for all

OUR Values

HELUNA HEALTH OVERVIEW

Heluna Health provides innovative services and evidence-based programs that improve the overall health and well-being of our communities.

At Heluna Health, population health is personal. Through our partnerships and direct service population health programs, Heluna Health is leading the effort to eliminate health disparities for people living in vulnerable circumstances and creating change in systems and policies to improve health outcomes in every community we serve. For more than 50 years, Heluna Health has worked together with nonprofit and community-based organizations, public health agencies, healthcare systems, providers, and policymakers to strengthen health interventions and create equitable access to preventive services, primary care, nutrition, housing, early literacy resources, and more.

OUR Values

HELUNA HEALTH OVERVIEW

Heluna Health provides innovative services and evidence-based programs that improve the overall health and well-being of our communities.

At Heluna Health, population health is personal. Through our partnerships and direct service population health programs, Heluna Health is leading the effort to eliminate health disparities for people living in vulnerable circumstances and creating change in systems and policies to improve health outcomes in every community we serve. For more than 50 years, Heluna Health has worked together with nonprofit and community-based organizations, public health agencies, healthcare systems, providers, and policymakers to strengthen health interventions and create equitable access to preventive services, primary care, nutrition, housing, early literacy resources, and more.

Heluna Health works with and supports a wide range of population health partners, providing administrative support so they can increase their capacity and raise their visibility so they can better achieve their goals.

Working directly in local communities, we implement evidence-based, innovative population health programs.

Through training, internships, and professional development, Heluna Health is leveraging decades of population health expertise to inspire, advance, and activate mission-driven professionals to improve health outcomes in the communities where they serve.

Our expert staff conducts research and data analysis, developing partnerships that generate valuable insights such as data briefs and national survey reports.

Our organization has access to a diverse network of public health professionals and academic experts who can assist in sharing their expertise.

Countering Diabetes
with the Aid of a Heluna Health Dietitian

In 2020, feeling depressed and tired, Martha Rojas went to Angeles Community Health Center, a federally qualified health center (FQHC) serving low-income people in Los Angeles. With high blood sugar levels and weighing nearly 300 pounds, she was diagnosed with diabetes.

Countering Diabetes
with the Aid of a Heluna Health Dietitian

In 2020, feeling depressed and tired, Martha Rojas went to Angeles Community Health Center, a federally qualified health center (FQHC) serving low-income people in Los Angeles. With high blood sugar levels and weighing nearly 300 pounds, she was diagnosed with diabetes…

Spotlight Stories

Learn more about some of our partners and direct service programs working to improve health outcomes in our communities.

Spotlight Stories

Learn more about some of our partners and direct service programs working to improve health outcomes in our communities.

Heluna Health’s Smart Bet on Research

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Heluna Health has been gathering and analyzing data on the effectiveness of its programs for decades, so it made sense when Heluna Health’s CEO, Dr. Blayne Cutler, hired Dr. Jo Kay Ghosh as the nonprofit’s first Director of Research and Evaluation in 2021. With 20 years of experience in population health or related research, Ghosh was charged with building a team to expand research work across the organization. Its studies in population health could lead to insights that would help communities, and the group would also support Heluna Health partners if they needed program assessment, expanding the types of services Heluna Health could offer clients. A research and evaluation team extends Heluna Health’s thought leadership in population health and allows the organization to expand into new and vital areas of investigation, such as climate and environmental health.

In just over two years, Ghosh and her team of investigators have already authored peer-reviewed research papers in health journals and presented their work at scientific conferences. Ghosh developed a series of data briefs as one way to highlight the research that her team conducts. She describes these data briefs as “a deep dive into a piece of population health data that would be of value to a public audience.” The first data brief, released in early 2023, presented the results of a national research study showing regional differences in access to social safety net services that could affect community response to and recovery from communicable disease outbreaks. The second data brief, released in August 2023, concerned the impacts of wildfires and what people can do to protect their health. Ghosh and her team focused on the noxious smoke from wildfires in 12 Western states. Results of a representative panel survey showed that 40% of all adult residents in these states reported being impacted by wildfire smoke in the past three years. Nearly half also reported not having a high level of knowledge about what can be done to prepare for the effects of wildfire smoke. Heluna Health also provided a companion resource document to give people practical information on how to prepare.

“The chance of being so directly impacted that you need to evacuate because of a wildfire is pretty rare,” Ghosh says. “But the chances of being impacted by smoke from wildfires is really high. More and more, we’re recognizing that these types of environmental health threats are going to become increasingly common as climate change makes for longer periods of drought.”

As for the evaluation half of the team’s work, Heluna Health is partnering with the Los Angeles County Department of Public Health on a federal government initiative called “Ending the HIV Epidemic (EHE),” aiming to end HIV in the U.S. by 2030. Ghosh’s team is evaluating how feasible it is for clinics and other community organizations that serve people with HIV to implement interventions with the level of funding that they have received. Another project involves an assessment of the birth and professional skills training program for doulas developed and offered by SisterWeb San Francisco Community Doula Network, a partner of Heluna Health. For that project, Heluna Health received a $100,000 grant from Unihealth Foundation to support the evaluation.

“The purpose of a program evaluation is to identify what works and what doesn’t work,” Ghosh says. “Some assessments focus on how much a program costs in relation to its benefits. Some look at how many people are helped and how a program can be more effective so it can reach more people. Others measure health outcomes.”

“There will be increasing need for population health research as problems become even more complex,” says Dr. Cutler. “Climate change, for example, introduces many new community health challenges, creating an opportunity for Heluna Health to lead in offering research insights and resources to help communities better understand, prepare for, and respond to these shifting realities.”

“We want to reach a range of audiences so that pertinent information resulting from our research can be put to use,” Ghosh says. “In the two and a half years we’ve been here, we’ve created a brand new research and evaluation group. We’re still refining it, but we have been able to produce some good work and we are building capacity to do more.”

WILDFIRE SMOKE IMPACTS IN THE WEST*

*Wildfire Smoke Impacts in Western States and Gaps in Household Preparedness, Heluna Health Insights: Data Brief, Vol. 1, Issue 2, August 2023.

“My charge is to raise visibility about the work that Heluna Health does as a whole that may be complementary to what our program partners do,” Ghosh says. “We can also support clients by providing evaluation services as part of a package of services.”

Jo Kay Ghosh, PhD

Director of Research and Evaluation, Heluna Health

Leading the Nation in WIC Research

Heluna Health’s Women, Infants, and Children (PHFE WIC) program is not only the largest WIC agency in the U.S., but it’s also the only one with a research department. Our researchers are often the first to uncover when nutritional programs are working, and also when improvements can be made.

Welcome to CinnaMoms Crenshaw in Inner-City Los Angeles

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In the Crenshaw District of South Central Los Angeles, within the Obama Women, Infants, and Children (PHFE WIC) program office, is a well-appointed suite decorated with purple couches and lounge chairs, pastel-colored walls, potted plants, a children’s play corner, and a kitchen area. When entering the space, visitors should feel at home. Opened in August 2023, this is the first dedicated center for CinnaMoms, the Heluna Health program focused on serving Black/African American women.

“This space is about rest, nest, and connect,” says Dr. Toncé Jackson, co-founder and Director of CinnaMoms and Senior Health Equity Manager for Heluna Health’s WIC program. “We wanted to create a space so that if women want to rest, they can do so here. Nesting refers to preparing for birth—preparing for the next chapter in a pregnant woman’s life.” As for connecting, Jackson says, “We want families from the Crenshaw District to connect with each other and to the larger maternal health system” when visiting the CinnaMoms center.

CinnaMoms Crenshaw was created with funds from Heluna Health. Eventually, Jackson says, there could be a dedicated CinnaMoms space in every WIC location in Los Angeles neighborhoods with a sizable Black population. But Jackson would also like CinnaMoms to spread beyond the L.A. region, even to other states.

Disparities in health outcomes show that there is a clear need to help Black mothers through their pregnancies and in the immediate years after they have given birth. Black women are three times more likely to die from a pregnancy-related cause than white women, and are also more likely to be hospitalized for postpartum depression than women from other racial or ethnic groups. And while the advantages of breastfeeding are widely known, Black women have the lowest rates of starting and continuing breastfeeding compared to other racial and ethnic groups in the U.S. For the women it serves, CinnaMoms provides the resources and information these women need for healthy birth and postpartum experiences.

Jackson got the idea for CinnaMoms in 2015, when she was leading breastfeeding education in Heluna Health’s WIC headquarters. “I noticed that at our WIC, Black women were breastfeeding at a lower rate than Latinos and whites,” Jackson says. While pursuing a master’s in public health, she learned that the low rate of breastfeeding among Black women was not due to a lack of interest, but to a lack of access to lactation consultants from communities of color, the historical marketing of formula in the Black community, and other social and economic factors. Studies showed that having access to peer counselors or lactation consultants of color or support groups would help improve breastfeeding outcomes for Black women. “I said, ‘We can do something about this.’”

CinnaMoms launched in 2015, with meetings held every other month in the five local WIC centers near large Black populations. Discussions were not only about breastfeeding, but about maternal health overall, including nutrition and the importance of doulas and midwives. In 2021, CinnaMoms received a grant from the U.S. Department of Agriculture, enabling Jackson to hire three peer staff members, to conduct outreach, and to survey CinnaMoms participants. Positive survey results helped convince Heluna Health to invest in a dedicated CinnaMoms space.

During the COVID-19 pandemic, when Heluna Health’s WIC transitioned to remote services, CinnaMoms began holding its support circles through Zoom. While virtual meetings are easy to attend, they cannot replace the intimacy of in-person interactions, which informed CinnaMoms’s decision to open the Crenshaw space.

For Jackson, opening up more CinnaMoms spaces is one part of her effort for empowerment. “I want to create an ambassador program, so we can show other WIC agencies how to replicate CinnaMoms,” she says. “This feels good,” Jackson says. “It reminds me of the power of creativity, the power of support from our leadership, the power of having a vision and seeing it through. We’ve been able to create a community. Hearing our families say, ‘This is for us,’ was a vision realized.”

BREASTFEEDING INITIATION IN THE U.S.

Chiang, et al., Racial and Ethnic Disparities in Breastfeeding Initiation—United States, 2019. MMWR Morb Mortal Wkly Rep 2021;70;769-774.

“My third and fourth born were exclusively breastfed. The knowledge and the support I gained from CinnaMoms and WIC kept me going.”

Nicole Craig

CinnaMoms participant

Partnering for Health Equity in the San Gabriel Valley

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In 2007, Carolin Eng was volunteering at a community center’s cancer support department in the San Gabriel Valley near Los Angeles and noticed a young man from China with late-stage colon cancer. An oncology nurse with a Master’s in Public Health, she later saw him at an outing for cancer patients holding hands with his wife and looking hopeless, and wondered if he had health insurance and if his condition wouldn’t have been so dire had he had access to health care early on.

Inspired to act by this patient, Eng says, “I went to the director of the center and told him that I wanted to start a clinic for uninsured new immigrants.” Many meetings followed, including with members of a group of health administrators from the area. They gave her advice and other assistance to help her launch the clinic, which she named Herald Christian Health Center. Starting with two exam rooms and two dental chairs in the city of San Gabriel, Herald Christian has spread to five facilities. The group who helped her are part of the Health Consortium of Greater San Gabriel Valley (Health Consortium), a partner program of Heluna Health.

The Health Consortium was established in 2000 to address the fragmented network of services in the San Gabriel Valley (SGV) that existed then, as well as the lack of access to primary and specialty care services for the area’s large uninsured and under-insured population. The Health Consortium has more than 150 participants, including local federally qualified health centers (FQHCs), nonprofit hospitals, behavioral healthcare organizations, health plans, city and county agencies, social health organizations, academic institutions, and many others.

Most health coalitions around the country serve as information hubs, informing members about local health-related developments. The Health Consortium of Greater San Gabriel Valley does that too, through regular meetings, webinars, newsletters, and summits, covering topics such as suicide awareness and health equity.

The Health Consortium stands out because its participants are highly collaborative. During the COVID-19 pandemic, for example, when Herald Christian Health Center was offering vaccinations and testing in several locations, Eng called Koy Parada, a nursing professor at Azusa Pacific University (APU), and a fellow member of the Health Consortium’s Steering Committee. Eng asked her if any of her students were available to help. “The students at APU needed to fulfill a public health rotation and we didn’t have extra funds to hire staff to administer tests and vaccines,” Eng says. “They gave me 15 to 20 students each day. We were able to administer 50,000 vaccines over two years. We couldn’t have done that without them.” Says Parada, “It was a time of need, we all came together, and we served. There’s no better way to educate my students.”

Under the leadership of Director Deborah Silver, the Health Consortium of Greater San Gabriel Valley has also developed projects in collaboration with its clinic and hospital partners, offering retinal telemedicine, colorectal cancer screening, and teledermatology programs for low-income adults. In 2019, the Health Consortium and its SGV Hospital Collaborative—consisting of six area nonprofit hospitals—initiated a pilot program with Union Station Homeless Services to provide housing and health care linkages to unhoused individuals discharged from five of the hospitals. A recent program, Food for All San Gabriel Valley, with lead funding from UniHealth Foundation, links hospital patients screened as food insecure with emergency food resources and medically tailored meals (MTMs), so that when they are discharged, they can continue receiving nutritious meals.

In April 2024, the Health Consortium will host the 2024 SGV Health Summit to highlight local Diversity, Equity, and Inclusion initiatives. The Summit will include a Healthcare Workforce Forum to foster linkages between healthcare organizations facing significant staffing challenges and local academic institutions training students in various health professions. “The Health Consortium is pulling together resources, leveraging strengths, and helping each other in places where we are weak,” says Silver. “We act and find solutions and engage.”

HEALTH IMPACT IN THE SGV

*June 2022 – Oct. 2023

“All of us in the Health Consortium are committed to serving the most vulnerable. Achieving health equity is hand in glove. In healthcare, it doesn’t make any sense to be in a silo. We all have strengths that we can collectively give to solve a problem. There should never be competition in who is serving the most vulnerable.”

Nancy Clifton-Hawkins

Director, Community Benefit, City of Hope

FEATURED

Getting Ready for Our Next Emergency with the Community Outbreak Preparedness Index

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Imagine a digital map of the state you live in. You can zoom in on your county and instantly see how it fares in terms of hospital surge capacity, access to healthy housing, and many other measures of outbreak preparedness.

You can also tell how your county compares to others. While not designed to help people choose the safest places to live, such a tool could help government officials better understand the vulnerable areas in their communities and use the data to make improvements. Far from a pipe dream, such a resource was launched by Heluna Health in November 2023 to help people easily gauge the preparedness of U.S. counties—starting with the 58 counties in California. Called the Community Outbreak Preparedness Index (COPI), it is the first such comprehensive assessment tool for future outbreak preparedness.

COPI INTERACTIVE MAP