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    Samantha Raphelson

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    In this May 2, 2018 photograph provided by Kensington Palace, Britain's Princess Charlotte cuddles her brother Prince Louis, on her third birthday, at Kensington Palace, in London.

    In this May 2, 2018 photograph provided by Kensington Palace, Britain's Princess Charlotte cuddles her brother Prince Louis, on her third birthday, at Kensington Palace, in London.

    Duchess of Cambridge/AP

    The Duke and Duchess of Cambridge released two new photos of the newest addition to the royal family, Prince Louis, on Sunday.

    The first official photos of the fifth in line to the British throne were taken by Princess Kate Middleton at the home of her and Prince William in Kensington Palace. Prince Louis Arthur Charles has not been seen in public since he was multistrap flat sandals Black Tom Ford yGShQil9
    April 23 at St. Mary's Hospital in central London.

    The first snapshot was taken on April 26, just three days after the little prince was born. The second photo, taken on Princess Charlotte's third birthday on May 2, shows the older sister planting a gentle kiss on her baby brother's forehead. The photo signifies Princess Charlotte passing the royal torch to her younger sibling, as it mimics a portrait taken of the princess and big brother Prince George, 4, in June 2015.

    "The Duke and Duchess would like to thank members of the public for their kind messages following the birth of Prince Louis, and for Princess Charlotte's third birthday," Kensington Palace tweeted on Sunday.

    This image of Prince Louis was taken by The Duchess of Cambridge at Kensington Palace on 26th April.The Duke and Duchess would like to thank members of the public for their kind messages following the birth of Prince Louis, and for Princess Charlotte’s third birthday.

    Prince William and Princess Kate said in a statement that they are "very pleased" to share the photos. Kate, who studied art history at the University of St. Andrews, is an avid photographer who has previously taken official portraits of her children.

    The two youngest royals donned family hand-me-downs for the official portraits. Princess Charlotte is pictured in a blue and white cardigan worn by Prince George in a family portrait for the Queen's 90 th birthday in April 2016, according to The New York Times. Prince Louis' comfy white outfit was also previously worn by his sister in the aforementioned portrait taken after she was born.

    Growing national awareness, research evidence of health determinants

    Another key enabling factor was the extensive evidence that the social and built environment are more significant predictors of health than access to health care. Reports from Printed Leather Sandals with Plateau Spring/summer Tods GMwFaZvEPt
    , Centers for Disease Control , the Institute of Medicine , World Health Organization , and others provided credible evidence that health is determined by socioeconomic factors and environment. They helped confirm that OHE and HEECJ’s perspective “was not just someone’s opinion” but rather rooted in compelling data that illustrated a need to do more work upstream.

    In 2016, the Office of Health Equity started to consider how they could use data to make the case for health equity. This led to thinking about: a) what data was already being collected, b) how it was being presented and shared, and c) how the data helped perpetuate (or mitigate) narratives around who/what was responsible for poor health and what needed to change to address inequities.

    Discussions and changes in reporting population health data

    Previously, many CDPHE staff felt their responsibility was to release data for public consumption, but not to interpret the data — they did not want to be viewed as biasing the data. For example, staff released reports stating that people of color had worse health outcomes without any contextual description or data on social or neighborhood conditions.

    Through conversations with OHE staff, CDPHE staff began to recognize that the public has a worldview, and that worldview shapes how individuals see and interpret data, no matter what the data says. Building on the example above, if the public keeps seeing that people of color have higher rates of morbidity and mortality without context to help them interpret the data, it may lead some people to focus on individual behaviors.

    To address this, OHE staff, epidemiologists, and other staff working with data began to consider the structural factors leading to these outcomes and began explicitly discussing those in data briefs and reports. For example, CDPHE issued a data brief on homicide rates in Colorado, and after stratifying the data they found that males of color were most likely to be involved in homicides. Before releasing the data, CDPHE staff had a conversation about the structural factors leading to homicide, and added language DRESSES Kneelength dresses Jenny Packham g2l66
    about the neighborhood and social factors and structural reasons that lead men of color to be more likely to be involved in homicide.

    Incorporating equity into evaluation measures

    OHE also began conversations with department staff about including health equity metrics in ongoing performance and evaluation measures. Specifically, OHE is now working with staff doing performance monitoring/quality improvement to incorporate meaningful measures to ensure staff are on the right path to advancing equity in their day-to-day work. OHE is also working with program evaluators to examine access to department resources and services and whether health equity is advanced through the department’s programs. For example, rather than just use a traditional public health measure of how many vaccinations were administered or screenings delivered, there should be analysis of who received those vaccinations and screenings, whether they were the populations most in need, and whether community partnerships were built to help expand outreach. Although sometimes the metrics are defined by the federal government or funders, there is often an opportunity to add additional measures into survey and evaluation instruments.

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