Upcoming implementation of the Affordable Care Act, pending immigration reform and California’s new school funding overhaul are opportunities to advance equity and justice for more people, said speakers at a poverty conference in Pacoima June 13.In his welcoming remarks at the 6th annual poverty conference sponsored by MEND (Meet Each Need with Dignity), Dr. Robert Ross, president and CEO of The California Endowment, urged those attending the event centered on healthcare reform for low income individuals not to lose sight of “this critical moment in time.” Ross said attendees representing nonprofit agencies, healthcare professionals and funding groups should be cognizant of the “significant opportunities in front of us, that if we manage well and thoughtfully and with courage over the next two years, we can benefit an entire generation that comes behind.” He noted that the simultaneous implementation of ACA comes on the verge of Congress’ anticipated passage of comprehensive immigration reform at the same time as California’s recent reengineering of its school funding formula giving more money to school districts with a higher population of needy students. These three events, he pointed out, open a window of opportunity in the upcoming months to affect positive change in disadvantaged communities.“On schools, on immigration, on health care, there’s significant opportunities to move our systems of care in the right kind of direction even in the absence of a robust and bold direct assault on poverty itself,” said Ross, who serves on the board of Covered California, the state’s new health insurance exchange created to develop an organized marketplace where legal residents of California can buy health coverage that cannot be denied or canceled if the enrollee is sick or has pre-existing health conditions.Keynote speaker Jonathan Fielding, MD, MPH, director and health officer of the Los Angeles County Department of Public Health, emphasized that ACA presents “incredible” opportunities for prevention, including covered preventative health services offered with no co-payments or deductibles. He noted that DPH was working in concert with Covered California to enroll local uninsured individuals, particularly children. “There’s no reason that any child should not be enrolled in some program,” said Fielding. He added that his agency is trying to insure that ACA implementation provides a full set of services. “Three areas we spend a lot of time dealing with are issues of HIV/AIDS; issues of substance abuse — probably the number one preventable health problem — [and] children with special health care needs who have very serious health care problems.”Fielding admitted that health reform comes with “a lot of challenges.” Among them are problems in terms of having enough health care practitioners to handle increased numbers of insured people seeking health care and having a safety net in place to handle the estimated 1 million uninsured in L.A. County who are not legal residents, therefore not covered by ACA. There is also, he said, a critical need for a much more knowledgeable health care consumer base as well as a need for a lot more consumer protection.While Fielding considers health care a “moral imperative and a right,” he pointed out that it’s not going to dissolve the “terrible inequities and disparities” in terms of health within the population. “We have to focus on the underlying determinants of health: the physical, the social, [and] economic environments,” which directly affect people’s health.“We have to think of poverty not just as a terrible plague but as a poison; poverty poisons health in so many direct and indirect ways,” said Fielding. He cited a widely-published study done in L.A. County looking at childhood obesity prevalence among fifth, seventh and ninth graders in terms of economic hardship index. It revealed that children in families living in poor areas have a 1 in 3 obesity rate while children in families living in wealthier regions have a 1 in 5 obesity rate.“We have to relate in our economic world with what’s going on in our health world,” said Fielding, who added that partial antidotes to the poisoning effect of poverty include prenatal care, exclusive and sustained breastfeeding, early childhood education, and graduation from high school. He noted that the percentage of adults who have not gained a high school diploma or GED falls disproportionately on the Hispanic population, with 46 percent of Hispanics lacking a high school diploma.“My hope is that the revision in funding formula [for California schools] that’s just been announced will make a difference,” said Fielding. “Overall, if you look at what’s made a difference in education and health and in the quality of life over time, it’s policies. Changes in policies have made a big difference.”According to Fielding, health reform has “kick-started” changes but “more work is needed to improve our social environment and our physical environment as an important partner in that. Public health has to be helpful in engaging partners in both looking at the short- and long-term because ultimately what we want is healthy communities. We need health in all our policies.”Information on MEND, the largest multi-service, poverty relief agency in the San Fernando Valley, is available at www.mendpoverty.org. Covered California information can be found at www.coveredca.com. {gallery width=100 height=100}gallery/2013/0621/poverty/{/gallery}