Caribbean Center for Health Equity (CCHE)
Health Equity Matters
Inequality is a major barrier to good health. According to the Pan American Health Organization/World Health Organization (PAHO/WHO), persistent inequities across gender, race and socioeconomic groups in the Caribbean compound every major health challenge facing the region.
It has been shown that access to health care for women of indigenous and African descent in the Caribbean has been stymied by deep discrimination, including patient blaming, neglect, verbal or physical abuse and disregard for traditional beliefs.
- In response to the identified socio-economic determinants of health in the Caribbean region, PAHO/WHO launched a new Commission on Equity and Health Inequalities in the Region of the Americas to focus on the profound effects that non-health social factors have on health outcomes.
- This is among the first large-scale effort to gather evidence on health inequities in the Region of the Americas.
- In support of these initiatives, the Windward Islands Research and Education Foundation (WINDREF) has established the Caribbean Center for Health Equity (CCHE) at St. George’s University (SGU) in Grenada.
- WINDREF and SGU have been involved over the last 20 years in many applied research projects related to health disparities.
CCHE will serve to coordinate regional efforts to promote health equity from within the region, and will include a regional network of partner governmental, academic and community based institutions, related researchers and practitioners. In addition, CCHE will support students in education, research and service work on health equity.
A Caribbean free from health inequities
Serve as a center of excellence in education, research and knowledge translation towards addressing social determinants of health and providing accessible and equitable health for the Caribbean region.
The principal goal of the proposed CCHE is to promote equity among the Caribbean society by reducing the impact of social determinants of health.
- Establish a regional network of key partners focused on promoting health equity
- Establish an advisory board composed of experts and key policymakers from throughout the Caribbean
- Identify priority areas of health inequity across territories in the Caribbean
- Seek resources to fund and support participatory action based research, epidemiological and population-based studies, education initiatives, and policy development and implementation among Caribbean regional stakeholders
- Align CCHE work with work plans and agendas for regional governments and institutions
- Monitor and evaluate all community based research programs to inform efforts that promote health equity or remove barriers to achieving equity
The CCHE will exist as a Program within WINDREF. Other currently existing centers and programs in WINDREF include the United Nations Framework Convention on Climate Change Regional Collaborating Center (UNFCCC, RCC), Sports for Health, Caribbean Ecohealth, Renewable Energy and Energy Efficiency, Bioethics, and Brain Initiative, among others.
Similar to these other programs, the CCHE would be established with a director, deputy director, and expert advisory board of vested individuals and investigators who will provide support and oversight of the Center’s activities. The CCHE will utilize the administrative capability and physical space provided by WINDREF in Grenada (located on SGUs True Blue campus) for raising and tracking funds for the program.
The CCHE will report to the Board of WINDREF (via the Director of WINDREF), and will provide an annual report to the Director of WINDREF outlining the Center’s activities over the past year. This report will be included in the WINDREF annual report.
The CCHE as a center will be administratively aligned to the Director and Deputy Director of WINDREF, which will provide oversight and support for the work of the CCHE. The Director of the CCHE will be appointed as a Senior Research Fellow of WINDREF and will be able to access resources and technical support through the Director and Deputy Director of WINDREF.
The CCHE will join and coordinate ongoing local and regional initiatives at WINDREF, which also serve to address several health equity needs for the region including areas of promoting health equity. Specific programs with a focus on Health Equity will be aligned to the CCHE and the administration of the CCHE will be organized as shown in the Figure below.
Reach Within (RW), a registered charity in Grenada, Caribbean and 501 (c ) 3 in New York,U.S., is the principal project of CCHE. RW addresses the biopsychosocial needs of young people who have experienced chronic trauma that repeats over time, creating toxic stress in the body/mind – such as from child abuse, child neglect, or the witnessing of violence -and acute or sudden trauma such as from a climate disaster that may have lasting impact. Trauma in itself does not guarantee negative consequences for youth, but a lack of treatment and support can be the catalyst for extreme deleterious effects.
Scores of research studies have demonstrated that, without access to effective treatment, unresolved trauma can adversely affect the brain and nervous system, giving rise to mental health challenges that lead to youth disengagement, and as a result, a host of other issues. This includes violence, low education levels, low workforce entry, poor relationships, poverty, and
homelessness, collectively impacting the overall well-being of communities.
RW’s cross-sectoral and collaborative approach includes:
Child/youth wellness curriculum across the educational and social sectors
● Positive Energy Program (PEP!) is a digital curriculum that helps children to regulate their nervous system and behaviour. Adults, including teachers and caregivers, are trained to identify trauma symptoms and deliver PEP! programs.
Youth services across economic and other community sectors
●A youth community drop-in centre in St. George’s provides individual and group counselling, mentoring, job and life skills training, advocacy, access to an emergency food/supply pantry, and a bathing facility.
Trauma Care Without Borders across the climate resilience sector
●RW dispatches immediate psychological first aid (PFA) and Skills for Psychological Recovery (SFA) to children/youth who have experienced an immediate catastrophic event. RW remains committed to ongoing care in affected communities. RW was first on the ground following Hurricane Ivan in 2004, and also provided care in Carriacou and Petite Martinique two days after Hurricane Beryl hit in July 2024.
This tested model has been delivered in some of Grenada’s highest-risk areas:
● The five residential care homes/orphanages (Father Mallaghan’s Home for Boys, SMILES, Queen Elizabeth Home, Belair Home for Children and Adolescents, and Dorothy Hopkin Home)
● The Grand Bacolet Juvenile Rehabilitation and Treatment Centre
● Richmond Hill Prison
● Communities identified as high-risk for youth violence (Mount Horne, New Hampshire, Gouyave, and others).
Other projects of CCHE include: Sport for Health, Soil Transmitted Helminths and Neglected Tropical Diseases, Saving Brains Initiative, Neurodevelopment and Vector-Borne Diseases and Women’s Health Initiatives (e.g., Breast and Cervical Cancer Screening).