David Skoczulek and CT DPH Commissioner Jewel Mullen
David Skoczulek, Connecticut Health Foundation (CT Health) Leadership Fellow, Class of 2011, is addressing racial and ethnic health disparities from multiple angles: changing how boards of health talk to each other, creating diversity policies, collecting meaningful data, and more.
“The Fellows program gave me a much more keen and developed understanding of systems change and how race and ethnicity impact health in a very pervasive way. Now I apply the health equity lens to nearly every professional service setting. The fellows program gave me the vocabulary, equipment and network to keep taking steps forward,” said David when I spoke with him.
David is the Director of Business Development and Community Relations for the Ambulance Service of Manchester, LLC & Aetna Ambulance Service, Inc. He’s also the Chairman of Board of the North Central District Health Department, where he and his coalition successfully persuaded the other Board members to incorporate the tenets of health equity into future policy-making through the creation of a standing Health Equity Committee.
Since becoming a full-fledged Fellow, David has continued to advance health equity through his influence in the public health realm. Here are just two of his many activities.
- As a new member of the Board of the Connecticut Public Health Association (CPHA), he is part of a team working to create the first State Association of the Local Boards of Health (SALBOH) for Connecticut.
- In his role at the Ambulance Service of Manchester and Aetna Ambulance, he has changed the website to reflect its commitment to diversity, worked with his Human Resources Department to write diversity and health equity policies, and advocated for the capture of data related to the race and ethnicity of people who use emergency medical services (EMS).
The SALBOH
Let’s break these down. A SALBOH is a network of local health district board members. Boards are constituted of professionals from all walks of life whose knowledge base of public health or health equity ranges from limited to proficient.
To fill that gap in knowledge, David advocated for the creation of a SALBOH. The SALBOH was officially adopted and named the Connecticut Association of Boards of Health (CABOH). As CABOH activities create a level knowledge base about health equity, board members can advocate for a variety of health equity initiatives, including the use of the Health Equity Index to start the conversation on health equity.
The systems change potential here is significant. If the boards of public health have health equity embedded into their policies and practices, health outcomes for people of color can begin to change.
Data Capture
Now, why is capturing the race and ethnicity of EMS users important? Every time EMS visits a resident of Connecticut, EMS staff will fill out a report that captures a variety of data, some of which are mandated by the state, and some of which are not. Race and ethnicity are categories that are optional.
The State of Connecticut mandates that EMS patient care reports are electronic and capture a certain amount of data about the patient and their care. This information can be used for syndromic surveillance and other real-time public health issues. It can also be used to create an EMS database from which to draw retrospective data, perform clinical trials and measure levels of care. Currently race and ethnicity are not a required field.
This data are not required as the fear is that race or ethnicity will be associated with care and disposition. This thought assumes equitable care exists. In reality, without collecting this data there will be no information on how EMS response and care, disposition, diversion and other issues have an impact on people and communities of color. David continues to advocate within his organization and beyond to include this data.
David is an active member of the Fellows, even participating in the interview process for the 2012 class. What questions would you have for him about the systems he is trying to change?