Tobacco Control as a Model and Making Equity Analysis the Norm

Senior Editor Peter Wehrwein spoke with Vayong Moua, the Director of Racial and Health Equity Advocacy for Blue Cross and Blue Shield of Minnesota (BCBSMN), for this week's episode of the MHE Talks: Improving Patient Access podcast series. Wehrwein and Moua discussed healthcare equity issues, how they relate to access issues, the political determinants of health and killing of George Floyd.

Moua has been at the Minnesota Blues plan since 2005 and in his current position since 2017. Prior to working for the insurer, he worked with several community and state agencies in the areas of policy analysis, multicultural community health issues and interdisciplinary initiatives, including with the American Cancer Society on issues related to tobacco control.

He is a currently a Bush fellow and was chair from 2013 to 2019 of the Cultural and Ethnic Communities Leadership Council, a legislated council to advise the Minnesota Department of Human Services on advancing equity. He was awarded a 2019 Outstanding Refugee Award from the Minnesota Department of Human Service, an award designed to recognize civic engagement, entrepreneurship and leadership shown by members of Minnesota’s refugee community.

Below is a brief excerpt from the interview with Moua.

Going beyond a program-by-program response

From my experience across a multitude of issues, from tobacco control to food security to transportation, I've arrived at this epiphany, which is that it’s notpicking one issue over the other. I think we've been throwing programmatic solutions at these problems. You cannot have implicit bias trainings, or a multicultural potluck, or an anti-racism book club to solve this, right? I want to honor the importance of enlightenment of education. But we've been waiting for over 400 years on this racial, equity consciousness and that's not what we can rely on. So I think in the name of policy change, we have to go after the impact of policies and systems. So where I'm putting my energy is in equity integration in governance, and how we prioritize, I don't want to say, regardless of belief, but I want to say, well, you may or may not care about Hmong refugees, but it's the law; you have to disaggregate data, you have to have culturally tailored approaches, you have to fund this.

Tobacco control as a model and making equity analysis the norm

We didn’t just say smoking is bad for your health, you shouldn't do it. We actually increase the price of tobacco, we made it illegal to smoke indoors, and there was a strong public campaign to change social norms. So the same kind of template I think, applies to racial and health equity. So we're trying to embed racial and health equity into how bills (in the Minnesota state legislature are devised), assess how policies are made, the structure of the legislature, creating an equity committee in the legislative process, or maybe equity committee on your board of directors, right, or even on your editorial board — having an equity analysis — and not just a checklist — but a true practice in how you screen and how you assess your priorities. And so I want to just give you the template in which we're trying to match structural solutions to a structural problem, instead of just trying to educate and throw a health fair approach to a structural problem.