Serving The Underserved Facing Failure & Choosing Change
Upcoming SlideShare
Loading in...5
×
 

Serving The Underserved Facing Failure & Choosing Change

on

  • 1,725 views

Dr. Kinney reviews where we stand in health care, how it relates to the underserved, and what we can do to change it!

Dr. Kinney reviews where we stand in health care, how it relates to the underserved, and what we can do to change it!

Statistics

Views

Total Views
1,725
Views on SlideShare
1,724
Embed Views
1

Actions

Likes
1
Downloads
11
Comments
0

1 Embed 1

http://www.slideshare.net 1

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Serving The Underserved Facing Failure & Choosing Change Serving The Underserved Facing Failure & Choosing Change Presentation Transcript

  • START YOUR PRE-TEST THANK YOU! SERVING THE UNDERSERVED POPULATIONS OF IL: FACING FAILURE AND CHOOSING CHANGE Deleshia “Dyi” Kinney, M.D., M.A.T. Health Care Advocate www.drkinney.webnode.com
  • START YOUR PRE-TEST THANK YOU! ACKNOWLEDGEMENTS 2008 IL WOMEN'S HEALTH CONFERENCE IL Dept. of Public Health Special Thanks to: Brenda Blasko Marbella Marsh IL Dept. of Public Health Ann Locke & Sandra Woods Springfield Urban League Health Initiative
  • START YOUR PRE-TEST THANK YOU! AGENDA
      • Pre-Test (5 min) ‏
      • Welcome / Overview of Objectives (10 min) ‏
      • Small Group discussion (if permissible) (30 min) ‏
      • Review & Resources (5 min) ‏
      • Questions & Conclusions (10 min) ‏
  • START YOUR PRE-TEST THANK YOU! OBJECTIVES
      • WHERE WE ARE NOW
      • DEFINE THE PROBLEM
      • DISCUSS
      • PRACTICAL SOLUTIONS
  • START YOUR PRE-TEST THANK YOU! WHERE WE STAND The Common Wealth Fund: The National Scorecard The Agency for Health care Research & Quality (AHRQ): National Healthcare Disparities Report
  • START YOUR PRE-TEST THANK YOU! National Scorecard DIMENSIONS OF HIGH PERFORMANCE HEALTH SYSTEM (2006 – 2008)‏
  • START YOUR PRE-TEST THANK YOU! National Scorecard 67 65 2006 2008 OVERALL
  • START YOUR PRE-TEST THANK YOU! National Scorecard 70 71 2006 2008 EQUITY
  • START YOUR PRE-TEST THANK YOU! AHRQ DIMENSIONS OF QUALITY
    • Effectiveness of Care
    • Patient Safety
    • Timeliness
    • Patient Centeredness
    • Overall Results
    • SPECIFIC CLINICAL CONDITIONS
    • CARE TYPE SETTINGS
  • START YOUR PRE-TEST THANK YOU! AHRQ 2.3% 1.5% 1994-2005 1999 - 2005 OVERALL RATE OF IMPROVEMENT
  • AHRQ
    • Blacks 10 times new AIDS cases, greater proportion of children hospitalized for asthma
    • Asians 65+ more likely than whites to lack pneumonia immunization
    • AI/AN 2 times more likely to lack prenatal care
    • Hispanics 3 times the new AIDS cases
    National Health Disparities Report
  •  
  • START YOUR PRE-TEST THANK YOU! Public Health “ ... the combination of science, practical skills, and values directed to the maintenance and improvement of the health of all the people. It is a set of efforts organised by society to protect, promote, and restore the people's health through collective and social action. ...but the goal remains the same - to reduce the amount of disease, premature death, and disease-produced discomfort and disability in the populations.”
  • START YOUR PRE-TEST THANK YOU! CONCLUSION SYSTEM IS BROKEN
  • START YOUR PRE-TEST THANK YOU! QUESTION #1
      • DEFINE:
      • UNDERSERVED
      • INEQUALITY
      • INEQUITY
      • HEALTH DISPARITIES
      • SPECIAL POPULATIONS
  • START YOUR PRE-TEST THANK YOU! U.S. Dept. of Health and Human Services
        • Medically Underserved Areas
        • urban, rural, public, population groups, facilities
    • Medically Underserved Populations
        • economic, linguistic, or cultural barriers
  • START YOUR PRE-TEST THANK YOU! Merriam Webster
      • Definition
    • They are under resourced, not having sufficient resources
  • START YOUR PRE-TEST THANK YOU! Often Forgotten Subpopulations
    • Don't forget subpopulations
    • Migrant Workers & other immigrants
    • Asian: Phillipinos, Chinese, Japanese, Vietnamese etc.
    • Middleasterners
    • Women, children, elderly, low-income, racial/ethnic minorities
    • CAN CHANGE
  • START YOUR PRE-TEST THANK YOU! HEALTH INEQUALITY “… is the generic term used to designate differences, variations, and disparities in the health achievements and risk factors of individuals and groups…that need not imply moral judgment… Refer to measurable differences in outcomes.
  • START YOUR PRE-TEST THANK YOU! HEALTH INEQUITY “ ... health equity concerns those differences in population health that can be traced to unequal economic and social conditions and are systemic and avoidable – and thus inherently unjust and unfair.” Refers to stronger view that unfair differences could be changed if willing
  • QUESTION
    • GIVEN OUR WEALTH & MEDICAL ADVANCES WHY DOES THE U.S. RANK 29TH IN LIFE EXPECTANCY?
  • START YOUR PRE-TEST THANK YOU! po
      • Definition:
      • Definition
    • Definition: They are under resourced, not having sufficient resources
  • HEALTH / CLASS LADDER
    • Health Gradient
    • Predictable
    $$$$$$$$$$$$$$ Most Healthy Most Control Least Healthy, Least Control, Most Stressed $ Least Stressed
  • QUESTION
    • WHAT DETERMINES HEALTH?
  • START YOUR PRE-TEST THANK YOU! SOCIAL DETERMINANTS OF HEALTH HEALTH POLITICAL POLICY SOCIETY CHRONIC STRESS INEQUALITY CHOICES CONTROL RACISM CONTROL
  • COMMUNITY RESOURCES
    • Food Access & Availability
    • Quality Education
    • Good Transportation / Planning
    • Affordable Housing
    • Good Jobs & Work Opportunities
    • Business Investment & Development
    • Income & Wealth
    • Social Supports
    • Public Safety
    • Green Spaces
    • Recreational
  • RESPONSIBILITY VS .
  • QUESTION
      • WHAT IS THE SOLUTION?
  • CHANGE
    • ....our way of thinking about the problem.
    • ...our way of thinking about solutions
    • ...our approach to the problem.
    • ....our approach to solutions.
    • ...our public policies.
    • ...our health care system
  • START YOUR PRE-TEST THANK YOU! CHANGE APPROACH Conventional question: How can we promote healthy behavior? Health equity question: How can we target dangerous conditions and reorganize land use and transportation policies to ensure healthy spaces and places? Conventional: How can we reduce disparities in the distribution of disease and illness? Health equity: How can we eliminate inequities in the distribution of resources and power that shape health outcomes? Conventional: How can individuals protect themselves against health disparities? Health equity: What kinds of community organizing and alliance building are necessary to protect communities?
  • QUESTION
      • WHAT POLICIES AT THE LOCAL, STATE, AND FEDERAL LEVEL MIGHT REDUCE SOCIAL AND ECONOMIC INEQUITIES?
  • CHANGE SOCIAL POLICY HEALTH POLICY
  • POTENTIAL POLICY
    • CURRENT
    • 8 hr work day
    • Min. Wage
    • Unemployment insurance
    • Free K-12 public education
    • Affirmative Action (limited) ‏
    • Social Security
    • POTENTIAL
    • Guaranteed Paid Vacation
    • Living Wage
    • Job training & Placement
    • Paid Parental leave
    • Housing Assistance
    • Universal Health care
  • CHANGE POLICY
    • Promote Understanding of Social Determinants of Health
    • Improve income
    • Improve physical environment
    • Promote racial justice
    • Promote better working conditions
    • Improve children's health
    • Universal Health Care
    • I mprove social inclusion
    • Food security and quality
    • Improve Education
    • Improve sustainable transportation
    • Improve Health Impact Assessment
  • WHERE TO START CHANGE Encourage Civic Engagement Stay connected! Realize change isn't easy but NOT impossible .
  • CHANGE POLICY
    • Identify and connect
    • Organize
    • Form committee
    • Screen and discuss PBS series: unnatural causes
    • Identify existing struggles
    • Conduct an audit
    • Form community-wide coalition
    • Ask local PHD to conduct Health Impact Assessment for proposed ordinances
    • Provide local media with facts
    • Broaden discussion
    • Organize a forum
  • QUESTION FOR THOUGHT
    • If children received universal health care and it was implemented today would everyone receive necessary care?
  • RESOURCES
    • Common Wealthfund
    • http://www.commonwealthfund.org
    • http://www.unnaturalcauses.org/
    • U.S. Department of Health and Human Services
    • http://www.ahrq.gov/
    • http://www.phac-aspc.gc.ca/sdh-dss/glos-eng.php
  • WHERE TO START CHANGE: you!!!! THANK YOU !!! .
  • Women's Health
    • Gender Disparities
    • Racial / Ethnic Disparities
      • Black women receive poorer quality of Care 53% of measures, 29 % show have worse access
      • Hispanic women receive poorer quality of care than non-Hispanic whites for 60% of measures, and poorer access for 87% of measures
    • Socioeconomic Disparities
    • Services unique to women QOC poorer in 75%