0
Focus on Determinants of Health and
Evidence-Based Actions
Jim Grizzell, MBA, MA, CHES, ACSM-HFS, Cal Poly Pomona; Karen M...
Learning Outcomes
 Explain determinants of health and action
model
 Define evidence-based public health
 Describe how t...
Agenda
 Who’s leading the Healthy People initiative?
 Rationale for using social determinants of health
and evidence-bas...
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
4
Vice-Chairs and Members
Healthy People 2020 Advisory Committee
 Jonathan E. Fielding, MD, MPH, MA, MBA
 Director and Pub...
Rationale for SDOH and EB
Actions
 Past Healthy People documents
 Catalogues of burden of ill-health, disability and
pre...
Overarching Goals of Healthy People
2020
 Address the factors that contribute to our
collective health and illness by
 c...
Healthy Campus 2020 Overarching
Goals
 Create social and physical environments
that promote health, safety and learning
...
Healthy Campus 2020 Mission
 Identify nationwide health improvement priorities in
higher education
 Increase awareness a...
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
10
From Sept 17-18, 2009 meeting slides
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
11
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
12
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
13
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
14
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
15
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
16
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
17
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
1818
Over the life span
Living and working
conditi...
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
19
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
20
* Evidence-based, HIA positive health impacts, ...
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
21
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
22
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
23
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
24
 World Health
Organization
 Ottawa Charter
 Healthy settings,
cities, worksites,
schools
Think Health Agenda and Health...
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
26
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
27
Social-EcologicalModels
A New Paradigm: The Ecological
Approach to Campus Health
 Views the connections
among health, learning,
and the campus
st...
Using the Ecological Perspective on
Campus
 Establish a Working Group
 Identify Campus Values
 Assess Student Health Da...
Influencing Factors
Individual
People
Community
Characteristics of the:
Place
Organization
Healthy Campus 2020: Determinan...
Environmental Influences
Behavior settings: Rituals,
student organizations
Cultural Influences: Customs,
traditions, value...
Stress:
Environmental Influences
Financial concerns
ISO – global troubles
Relationships w/friends
Lack of friends/commuter...
Keys to Effective Use of the
Ecological Perspective
 Expand the focus beyond
health information and
programming
 Integra...
Evidence-Based Public Health
Actions
 Origins of movement to EBPH, roots in EBM
 Prior to 1970s: “Uninformed intuition, ...
Evidence-Based Public Health
Actions
 Categories of social
decision making
1. Independent of context
2. Context sensitive...
Sources for Evidence-Based Actions
 NIAAA
 www.niaaa.nih.gov/
 Higher Education Center for
 www.highereducationcenter....

 http://www.nrepp.samhsa.gov
 Higher Education Center for Adrug
 www.higheredcenter.org/prevention/strategic-planning...
Tags for Use in Database
Queries
 Settings
 Government
 Private
health/healthcare
sector
 Education
 Workplaces
 Com...
Healthy Campus 2020: Determinants of Health and Evidence-
Based Actions
39
Click on image to go to web site www.nrepp.samh...
Summary & Questions
 Who’s leading the Healthy
People initiative?
 Rationale for using social
determinants of health and...
Resources
 Links to this presentation and reference files
 www.csupomona.edu/~jvgrizzell/hc2020/acha2010presentatio
ns.h...
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Social Determinants of Health

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Transcript of "Social Determinants of Health "

  1. 1. Focus on Determinants of Health and Evidence-Based Actions Jim Grizzell, MBA, MA, CHES, ACSM-HFS, Cal Poly Pomona; Karen Moses, MS, RD, CHES, Arizona State University Michelle Burcin, PhD, MPH, CHES, University of South Carolina; Cynthia Burwell, EdD, CHES, Norfolk State University Healthy Campus 2020
  2. 2. Learning Outcomes  Explain determinants of health and action model  Define evidence-based public health  Describe how to use the Healthy People 2020 online database of evidence-based actions and strategies Healthy Campus 2020: Determinants of Health and Evidence-Based Actions22
  3. 3. Agenda  Who’s leading the Healthy People initiative?  Rationale for using social determinants of health and evidence-based actions  What are social determinants of health?  Steps that can be taken by Healthy People 2020 users  NASPA’s campus ecology model  What is evidence-based public health?  Strategies to broaden the evidence-base for public health  For higher education: resources for identifying evidence-based actions  Resources and References Healthy Campus 2020: Determinants of Health and Evidence-Based Actions3
  4. 4. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 4
  5. 5. Vice-Chairs and Members Healthy People 2020 Advisory Committee  Jonathan E. Fielding, MD, MPH, MA, MBA  Director and Public Health Officer  Los Angeles County, Department of Public Health  Professor of Health Services and Pediatrics and Co-Director  UCLA Center for Healthier Children, Families and Communities  Shiriki K. Kumanyika, Ph.D, M.P.H.  Professor of Biostatistics and Epidemiology  Department: Biostatistics and Epidemiology  University of Pennsylvania School of Medicine, Center for Clinical Epidemiology and biostatistics  William Douglas Evans, PhD; Vincent Felitti, MD; Everold Hosein, PhD; Lisa Iezzoni, MD, MSc; Abby King, PhD; Ronald Manderscheid, PhD; David Owen Meltzer, MD, PhD; Eva Moya, LMSW; Patrick Remington, MD, MPH; David Siegel, MD, MPH; Adewale Troutman, MD, MPH Healthy Campus 2020: Determinants of Health and Evidence-Based Actions5
  6. 6. Rationale for SDOH and EB Actions  Past Healthy People documents  Catalogues of burden of ill-health, disability and premature death  Set of targets for reducing burden  What was missing?  Guidance on potential actions for achieving targets  Relative effectiveness of actions  Advisory Committee recommendation  Tie goals and objectives to evidence-based interventions that guide effective action and accountability Healthy Campus 2020: Determinants of Health and Evidence-Based Actions6
  7. 7. Overarching Goals of Healthy People 2020  Address the factors that contribute to our collective health and illness by  calling for healthy places & supportive public policies  placing emphasis on the determinants of health  Reflect Advisory Committee recommendations  Redirect our attention from health care to health determinants  “Health determinants should be a primary focus of Healthy People 2020:  health care, a secondary focus.” Healthy Campus 2020: Determinants of Health and Evidence-Based Actions7 Phase 1 Report: Recommendations for the Framework and Format of Healthy People 2020, October 28, 2008. Page 20.
  8. 8. Healthy Campus 2020 Overarching Goals  Create social and physical environments that promote health, safety and learning  Supports efforts to increase academic success, student retention and life long learning  Eliminate preventable disease, disability, injury, and premature death  Achieve health equity, eliminate disparities, and improve the health of the entire campus community  Promote healthy development and health behaviors across every stage of life Healthy Campus 2020: Determinants of Health and Evidence-Based Actions8
  9. 9. Healthy Campus 2020 Mission  Identify nationwide health improvement priorities in higher education  Increase awareness and understanding of determinants of health, disease, and disability and the opportunities for progress  Provide measurable objectives and goals that can be used at institutions of higher education  Engage multiple constituents to take actions to strengthen policies, improve practices, and empower behavior change that are driven by the best available evidence and knowledge  Identify and promote relevant assessment, research and data collection needs Healthy Campus 2020: Determinants of Health and Evidence-Based Actions9
  10. 10. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 10 From Sept 17-18, 2009 meeting slides
  11. 11. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 11
  12. 12. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 12
  13. 13. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 13
  14. 14. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 14
  15. 15. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 15
  16. 16. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 16
  17. 17. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 17
  18. 18. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 1818 Over the life span Living and working conditions may include: • Psychosocial factors  Employment status and occupational factors  Socioeconomic status (income, education, occupation)  The natural and built c environments  Public health services  Health care services Dotted lines denote interaction effects between and among the various levels of health determinants IOM model of multiple determinants of health used to develop Action Model for Healthy People 2020. Dahlgren, G. (1995) European Health Policy Conference: Opportunities for the Future. Vol. 11 – Intersectoral Action for Health. Copenhagen: WHO Regional Office for Europe Social-EcologicalModels
  19. 19. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 19
  20. 20. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 20 * Evidence-based, HIA positive health impacts, ROI >1:1 ** SMART: Specific, measurable, achievable, relevant, time-specific NOTE: added planning model & learning & playing conditions NOTE
  21. 21. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 21
  22. 22. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 22
  23. 23. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 23
  24. 24. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 24
  25. 25.  World Health Organization  Ottawa Charter  Healthy settings, cities, worksites, schools Think Health Agenda and Healthy Settings to Enhance Health & Learning25 “We shape our [campuses]; thereafter, they shape us.” - Winston Churchill
  26. 26. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 26
  27. 27. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 27 Social-EcologicalModels
  28. 28. A New Paradigm: The Ecological Approach to Campus Health  Views the connections among health, learning, and the campus structure  Explores relationships between and among individuals and the learning communities that comprise the campus environment Healthy Campus 2020: Determinants of Health and Evidence-Based Actions28 This section presented by Karen Moses
  29. 29. Using the Ecological Perspective on Campus  Establish a Working Group  Identify Campus Values  Assess Student Health Data  Analyze Campus Health Concerns Through an Ecological Lens:  Environmental influences  Individual influences  Develop a Plan Healthy Campus 2020: Determinants of Health and Evidence-Based Actions29
  30. 30. Influencing Factors Individual People Community Characteristics of the: Place Organization Healthy Campus 2020: Determinants of Health and Evidence-Based Actions30
  31. 31. Environmental Influences Behavior settings: Rituals, student organizations Cultural Influences: Customs, traditions, values Economic Forces: Student financial stability, budget Inhabitants: Diversity, Athletics, Greek, campus communities, etc. The location of the campus The weather The constructed designs Landscapes Organizational Structure Policies Organizational Climate Political Climate Conservative/liberal Pro education? Reinforcement and Rewards For healthy org & indiv behaviors Place People Organization Community Healthy Campus 2020: Determinants of Health and Evidence-Based Actions31
  32. 32. Stress: Environmental Influences Financial concerns ISO – global troubles Relationships w/friends Lack of friends/commuters Irresponsible drinkers Uninvolved students Warm climate Lack of parking High traffic Campus size—distances Crowding—long lines Services--lack of info Depts disconnected Too many steps Weak policy enforcement Inconsistent messages State budget crisis Increase in tuition/fees Rewards for over commitment Culture of stress Place People Institution Community Healthy Campus 2020: Determinants of Health and Evidence-Based Actions32
  33. 33. Keys to Effective Use of the Ecological Perspective  Expand the focus beyond health information and programming  Integrate responsibility for health across student affairs and academic units  Provide supportive environments and reduce barriers to optimal outcomes  Promote leadership and involvement by multiple partners Healthy Campus 2020: Determinants of Health and Evidence-Based Actions33
  34. 34. Evidence-Based Public Health Actions  Origins of movement to EBPH, roots in EBM  Prior to 1970s: “Uninformed intuition, unsystematic clinical experience, . . .”*  1984: US Preventive Services Task Force  EBPH “is the development, implementation, and evaluation of effective programs and polices in public health through application of principles of scientific reasoning, including systematic uses of data and information systems, and appropriate use of behavioral science theory and program planning models.”Healthy Campus 2020: Determinants of Health and Evidence-Based Actions34
  35. 35. Evidence-Based Public Health Actions  Categories of social decision making 1. Independent of context 2. Context sensitive 3. Anecdotal  Assessing interventions 1. Systematic reviews 2. Health impact assessments (HIAs) Healthy Campus 2020: Determinants of Health and Evidence-Based Actions35
  36. 36. Sources for Evidence-Based Actions  NIAAA  www.niaaa.nih.gov/  Higher Education Center for  www.highereducationcenter.org  s  www.samhsa.gov/ebpwebguide/index.asp  Guide to  www.thecommunityguide.org/index.html Healthy Campus 2020: Determinants of Health and Evidence-Based Actions36
  37. 37.   http://www.nrepp.samhsa.gov  Higher Education Center for Adrug  www.higheredcenter.org/prevention/strategic-planning Strategic Planning  CDCynergy Social M Strategic & Intervention Planning  www.orau.gov/cdcynergy/soc2web/Content/phase01/phase01. htm Healthy Campus 2020: Determinants of Health and Evidence-Based Actions37 Sources for Evidence-Based Actions
  38. 38. Tags for Use in Database Queries  Settings  Government  Private health/healthcare sector  Education  Workplaces  Communities  Institutional settings  Regional/national Organizations  Users  Roles  Healthy People Objectives  Target Population  Selection criteria  Approving body  Examples and resources  Key words Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 38
  39. 39. Healthy Campus 2020: Determinants of Health and Evidence- Based Actions 39 Click on image to go to web site www.nrepp.samhsa.gov/find.asp
  40. 40. Summary & Questions  Who’s leading the Healthy People initiative?  Rationale for using social determinants of health and evidence-based actions  What are social determinants of health?  Steps that can be taken by Healthy People 2020 users  NASPA’s campus ecology model  What is evidence-based public health?  Strategies to broaden the evidence-base for public health  For higher education: resources Healthy Campus 2020: Determinants of Health and Evidence-Based Actions40
  41. 41. Resources  Links to this presentation and reference files  www.csupomona.edu/~jvgrizzell/hc2020/acha2010presentatio ns.htm  Presenters Healthy Campus 2020: Determinants of Health and Evidence-Based Actions41  Jim Grizzell, MBA, MA, CHES, ACSM-HFC  California State Polytechnic University, Pomona  jvgrizzell@csupomona.edu  (909) 856-3350  Cynthia Burwell, EdD, CHES  Norfolk State University  cburwell@nsu.edu  (757) 823-9494  Karen Moses, MS, RD, CHES  Arizona State University  karen.moses@asu.edu  (480) 965-1360  Michelle Burcin, PhD, MPH, CHES  University of South Carolina  mburcin@mailbox.sc.edu  (803) 777-4752
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