Goal / Mission

Blue Cross Blue Shield of Minnesota (BCBS MN) hoped to reduce inequities affecting diverse and underserved communities through an organizational and systemic approach to racial and health equity. They hoped to create more equitable and diverse coalitions and community partnerships to enact change through a commitment to installing internal institutional equity policies guided at all levels of organizational work.

Description

Blue Cross Blue Shield of MN prioritized embedding equity into coalition building and development of its community partnership relationships to provide a sustainable framework for tobacco policy work. By applying the principles of Policy, Systems, and Environmental (PSE) Change and Health in All Policies (HiAP) to its community engagement work, BCBS MN was able to develop comprehensive, equity centered coalition cohorts and gather inclusive and diverse community partners to combat racism and tobacco in public health policy/legislation.

BCBS MN began with creating equity policies applied to their internal organizational  vendor contracts, procurements, human resources (HR) department, and Diversity, Equity, and Inclusion (DEI) work and disseminated these ideals to all employees from C-suite administration leadership and management down to hourly workers, extended clients (insured and insurers), and community partners. Ecological policy work was then further rolled out from baseline equity principles to influence policy makers and restructure policy agenda through equity centered advocacy from community partnerships and external work. This constituted structural rather than simply programmatic change to ensure sustainability and success.

BCBS MN conducted a community assessment and began developing coalitions based around the communities’ professional and personal interests in civic engagement, public health, health disparities, tobacco control, historico-cultural socioeconomic concerns, social determinants of health, and desire to advance equity and eliminate racism. Through gathering of community input, BCBS was able to build more comprehensive community infrastructure for groups such as Coalition of Asian Leaders and Doctors and Physicians of Color and allow for cross collaborative coalition work for tobacco control. This strengthened the community agenda for tobacco work among diverse community populations through shared a shared interest for healthy living. BCBS MN provided a platform for different coalitions to come together for equity-centered approaches to tobacco control.

 Implementation Process

• Devise equity-centered framework for rollout to BCBS MN as an organization an as a blanket policy in aspects of work/care
• Develop planning team with equity-centered internal policies
  • Identify initial planning team
  • Discuss additional needed stakeholders and disciplines/sub sectors in community that will be helpful for coalition work and add additional planning team members
• Develop coalition from various shared interest cohorts using inclusive equity principles
  • Identify steps to form coalition including needed subsectors and stakeholders and champions
  • Contact community members to create coalition representative body and involve stakeholders and champions identified
• Partner with different organizations and build relationships with community members
  • Map agency resources and needs
  • Perform community assessment and create educational awareness of issues for policy change
• Present information to community leaders to create a critical mass for change and encourage leaders to consider policy change priorities as part of policy agendas

 Impact / Results / Accomplishments / Outcomes

The impact of the work by BCBS MN allowed for successful coalition development among several key groups including a shared agenda for tobacco control policy change work from Coalition of Asian Leaders and Doctors and Physicians of Color. BCBS was instrumental in developing the state tobacco control programs and state coalitions in Minnesota. BCBS MN was successful through promoting its shared equity policies and relationship building with diverse community leaders and community based organizational partnerships.

While BCBS MN does continue to face resistance from many leaders in tobacco policy, it has transformed how policy makers, business leaders, and community partners think about infusing equity principles in its tobacco control work. This includes the use of culturally sensitive and linguistically appropriate communication with the community and consideration for the social determinants of health in reducing tobacco use. Such comprehensive equity approaches to tobacco control work will hopefully contribute to  increasing tobacco cessation to ensure healthy individuals and thriving communities in Minnesota.

Lessons Learned

The success of BCBS MN’s experience in embedding equity in coalition building, community partnerships, and civic engagement can be applied and adapted through the following lessons learned:

• Successful agendas are ever evolving and are based on movement and adaptability
• As one pursues equity and continues to create coalitions for community organizing, one must build power and support within community groups that experience inequities and draw from their input and expertise to build community capacity and develop champions to lead
• Partnerships are essential for success in tobacco control. It is critical to expand the participation beyond the usual group of stakeholders in public health
• Engaging civil society and community partners facilitates the mobilization process and expands the reach of tobacco control program staff
• Building capacity on an ongoing basis among all tobacco control stakeholders is pivotal to the successful translation of policies into population behavioral change
• Community engagement ensures broad ownership of tobacco control and facilitates policy and social norms change
• Community-based tobacco-free policies may be limited in scope, but these initiatives set the stage for a community-led process to adopt tobacco-free social norms which can eventually expedite successful passage and implementation of national tobacco control policies

About this Promising Practice (Contact information)

1. Organization(s): Blue Cross Blue Shield of Minnesota
2. Primary Contact(s): Rod Lew – APPEAL Staff; [email protected] and BCBC MN staff Vayong Moua; [email protected]
3. Authors: APPEAL Staff with informant interviews from BCBC MN staff Vayong Moua
4. Topic(s): Coalition Building, Community Capacity, Community Partnerships, Policy Champions
5. Source: APPEAL Staff with informant interviews from BCBC MN staff Vayong Moua
6. Date of Publication: N/A
7. Date of Implementation: 2019
8. Location: Minnesota
9. More details (web address for study):
   1. https://www.cdc.gov/cpr/readiness/healthcare/documents/CPF-Chapter-2.docx and https://open.mitchellhamline.edu/mhlr/vol44/iss4/4/
10. Target Audience: Tobacco Control Coalitions, Policy Makers, Community Based Organizations, DEI Departments, and PSE Workers