San Joaquin Counties, CA

Team Profile Summary

California’s San Joaquin Valley is home to enormous agricultural production and associated wealth, environmental degradation, and grinding poverty for both rural farm families and abandoned urban neighborhoods:  in this place, the intersections of neighborhood quality of life and unequal life and health opportunities face us each day.  Broad inequities in health are at least in part created and sustained by cumulative exposure to poverty, inadequate housing and transportation, poor air and air quality, and access to jobs, schools, and recreation.  The Collaborative for Health Equity: San Joaquin Valley (SJV) Where People, Place and Power Matters is a collaborative effort between the Central Valley Health Policy Institute at Fresno State and leading regional and neighborhood organizations and individuals working for equity in population health, access to culturally respectful health care, safe air and water, healthy food access, physical activity environments, and affordable, sustainable housing and development.   Our collaboration creates a network for sharing information and interpretation of historical and current living conditions, ensures the dissemination and application of new concepts and research findings, and assists members in framing policy positions and program directions.

Core Team Profile Details

John Capitman, Ph.D., is the Executive Director of the Central Valley Health Policy Institute and Nickerson Professor of Public Health at Fresno State. Capitman leads Institute activities in applied health research, policy analysis, technical assistance, and education. His current research focuses on how social, economic, and environmental factors influence population health in the San Joaquin Valley and increasing the capacity of local organizations to address these factors. Capitman also co-facilitates the Health Policy Leadership Program and teaches about rural health and health disparities. Capitman also serves on the Governing Board of the San Joaquin Valley Air Pollution Control District. Contact information: 559.228.2157 or [email protected]

Marlene Bengiamin, Ph.D., is the Research Director at Central Valley Health Policy Institute at Fresno State. Bengiamin co-leads the institute’s research and administrative activities. Bengiamin is among 480 individuals worldwide who have been trained by Harvard Medical School and internationally acclaimed faculty in mental health and trauma and recovery. Her current work includes analysis of vital San Joaquin Valley health challenges such as maternal mental health, adequacy and quality of health care for uninsured and underinsured adults, adequacy of prenatal care, environmental influences on health, and social determinants of rural/urban disparities, Regional health policy leadership development and health professional shortages. Contact information: 559.228.2167 or [email protected]

Sandra Celedon-Castro, a public health practitioner and Hub Manager for Fresno Building Healthy Communities, is responsible for guiding and supporting multi-sector, diverse stakeholder collaboration in order to foster and encourage thriving communities where all children and families can live healthy, safe and productive lives. Sandra adheres to the public health principles which recognize that all people must have access to the resources necessary for health and that people and their physical environment are interdependent; when one is damaged it will have an adverse effect on the other. This is why she dedicates herself to building healthy communities. Contact information: [email protected].

Venise Curry, M.D., is the Regional Director of Communities for a New California Education Fund, and advocate for equitable resources, empowering families and addressing issues of quality education, access to health care, and clean air, using the organizing principle that “organized people, plus organized resources, plus changing the narrative equals power. She has applied her clinical background and experience to educating and empowering families about issues they have identified as important- education, land use and environmental justice. Contact information: [email protected].

Kevin Hamilton, RRT, RCP ED, is the Executive Director of the Central California Asthma Coalition, and leads regional initiatives to address the root causes of asthma inequalities, support schools and other child serving organizations in managing environmental exposures and care for asthmatic children, and demonstrates key interventions to improve clinical care management for asthmatics. He has been a key leader in regional environmental quality initiatives and collaborative efforts to reduce neighborhood, racial/ethnic and social class inequalities in health.

Cassandra Joubert, ScD, is the Director of the Central California Children’s Institute at California State University, Fresno.  She is currently a member of the Editorial Board of the American Journal of Public Health, and the principal author of a book on children’s mental health. She has served on a number of nonprofit boards focusing on children’s issues, and has been an advocate for children throughout her career. Contact information: 559.228.2166 or [email protected]

Amanda Conley, M.A., is a communication specialist at the Central Valley Health Policy Institute at Fresno State. Conley received a Bachelor of Arts in Mass Communication and Journalism from California State University, Fresno and a master’s degree in Sociology from San Jose State University with an emphasis in social inequality. She has professional experience in both communication and institutional research and evaluations. Contact information: 559.228.2159 or [email protected]

Tania Pacheco-Werner, Ph.D., is a Postgraduate Fellow at the Central Valley Health Policy Institute and Adjunct Faculty in the Department of Sociology at Fresno State. Her areas of research include policy analysis, immigrant and men’s health, health-seeking behavior, food and environment systems, and methodology. Contact information: 559.228.2162 or [email protected]

Emanuel Alcala, M.A., a Research Analyst at the Central Valley Health Policy Institute at Fresno State, has presented findings on the social and environmental determinants of health that lead to poor health outcomes, which is pervasive in the region. Specifically, he investigates the health outcomes of communities with higher levels of air pollution and poverty, and documented the detrimental impacts of racial/ethnic segregation on childhood preventable hospitalizations, elderly preventable hospitalizations, and premature mortality. Contact information: 559.228.2128 or [email protected]

Problem Statement

Known as “the nation’s salad bowl”, the San Joaquin Valley is considered California’s top agricultural producing region, with five of its counties ranking among the state’s top 10 farm producers.  Other important industries in the region include gas and oil, with the deepest well and half of the largest oil fields in Kern County.  The Elkhorn Hills Naval Petroleum Reserve and Lemoore Naval Air Station are also in this bioregion.

With an estimated 3.5 million residents, San Joaquin Valley is one of the poorest regions in the United States, but also a source of enormous wealth. The San Joaquin Valley has a sizeable immigrant population with high poverty and low educational attainment. Disparities in health status within the San Joaquin Valley reflect, in part, historical geographic patterns that have resulted in vulnerable populations living in areas where conditions such as exposure to environmental hazards create greater health risks.

The overall pattern suggests that socioeconomic conditions in low-income and non-white neighborhoods make it more difficult for people in these neighborhoods to live healthy lives. The percentage of the population without a high school diploma in the San Joaquin Valley (30%) is more than twice the percentage of people in the U.S. (14.7%) without a high school diploma. The rate of premature deaths (years of potential life lost before the age 65) in the lowest-income zip codes of the San Joaquin Valley is nearly twice that of those in the highest-income zip codes. Life expectancy varies by as much as 21 years in the San Joaquin Valley depending on zip code. Areas of the San Joaquin Valley with the highest levels of respiratory risk have the highest percentage of Hispanic residents (55%), while areas with the lowest level of respiratory risk have the lowest percentage of Hispanic residents (38%). One in six children in the San Joaquin Valley is diagnosed with asthma before the age of 18, an epidemic level.

Team Objectives

The Valley continues to experience significant place-based inequities, which is a focus of the Collaborative for Health Equity: San Joaquin Valley (CHE: SJV) team’s work from both public health and health care perspectives. The CHE: SJV team serves as a convener of place-based initiatives in the region and supports their efforts to address inequities.  These activities include:

1. Research and Policy Analysis- CHE: SJV team members work with the San Joaquin Valley Public Health Consortium (SJVPHC) which is a uniquely regional approach to serving the public health needs of the San Joaquin Valley. Members of the Consortium include the Central California County Public Health Directors, Deputy and Assistant Directors, and Health Officers from Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus, and Tulare counties, and Associate members from regional academic institutions and other organizations. The vision of the SJVPHC is to achieve health equity for all residents in the San Joaquin Valley by providing leadership for a regional health agenda that addresses the social determinants of health in the San Joaquin Valley.

2. Regional Leadership Program and Training- We are committed to facilitating the development of health and healthcare policies and programs in the San Joaquin Valley. With guidance from nationally-recognized health equity experts and local and regional emerging leaders in public health, the Health Policy Leadership Health Equity Project (HPLP-HEP) was developed and evolved over the past 10 years to serve the professional growth and development of emerging local and regional leaders as they explore key issues in health policy.

3. Organizational and Community Technical Assistance– CHE: SJV team supports two Building Health Communities sites, funded by the California Endowment in the Valley providing technical assistance, in the form of policy analysis and use of evidence-based research, to organizations and teams in the Fresno Building Healthy Communities programs around framing local policy debates. At the core of Building Healthy Communities (BHC) is a commitment to addressing the social determinants of health through a place-based approach. Yet moving from the emergent science in public health that shows how neighborhoods concentrate resources and barriers for human development and well-being to real changes in the multiple local policies, environments, and programs is challenging.

1. Fellowships and Internships- CHE: SJV team offers Health Equity, Public health and health policy analysis and applied research training to post graduate and undergraduate students and emerging professionals. We conduct systematic outreach to current and prospective academic and public health partners to offer fellowship opportunities to postgraduates and emerging professionals interested in advancing health equity to develop, implement projects and disseminate findings. We also work in partnership with the UC Berkley School of Public Health “Health Career Connection” (HCC) program inspires and empowers undergraduate students and recent graduates to successfully pursue health careers by offering a 10-week health care internship during summer.