Som ph cert t scharmen 072010

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Presentation to UNM Medical Students, July 21, 2010, Public Health Certificate Course

Presentation to UNM Medical Students, July 21, 2010, Public Health Certificate Course

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  • YOU ARE ASSIGNED TO PROFILE A COMMUNITY. In other words, you will be describing many of the health and social conditions of a particular neighborhood in Albuquerque and Bernalillo County. You will be using maps and tables – provided to you in the SharePoint directories – to inform yourselves about these conditions. You will also be visiting those neighborhoods, conducting a ‘windshield survey,’ observing activities at the community centers, and, hopefully, meeting and talking to the people who live in these communities. Let’s use this map to become familiar with the lay-out of the city and county, as you will be seeing it in the many maps supplied to you by the ABC HEAT project. Ask: How many of you know Albuquerque well? Point out: freeways, Big I, river, downtown, UNM, Community Centers and zip codes. I am going to tell you a bit about ABC HEAT and then I would like to show you some of the same maps you saw in the video this morning, but this time the maps will depict those same conditions in our own Albuquerque.

Transcript

  • 1. THE COMMUNITY AS PATIENT Health and Social Indicators of Albuquerque Neighborhoods TOM SCHARMEN ABC HEAT Albuquerque - Bernalillo County Health Equity Assessment Tool BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 2. Assigned Communities Albuquerque & Bernalillo County, NM YOU ARE ASSIGNED TO PROFILE A COMMUNITY This map can be found in the SharePoint Directory 2 Assigned Communities & Selected Boundaries
  • 3. A Project of the Bernalillo County Place Matters Team   ABC HEAT is a collaborative health equity initiative with the goal of providing communities and decision-makers in our city & county with evidence to build health into public and private policies and practices.   We believe that decision-makers must have reliable data on health status, disparities, and the effects of social determinants of health. These data must be monitored at the local level in collaboration with the people and families who live there, and funding must be available to promote community participatory assessment to understand these health effects and to promote the application of findings to decision-makers. ALBUQUERQUE - BERNALILLO COUNTY HEALTH EQUITY ASSESSMENT TOOL BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 4. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL Patients have a right to know their past and present medical status and to be free of any mistaken beliefs concerning their conditions. Only through full disclosure is a patient able to make informed decisions regarding future medical care. -AMA Code of Medical Ethics Patients have the right to know their treatment options and take part in decisions about their care. Patients have the right to accurate and easily-understood information about their health plan, health care professionals, and health care facilities. -Patient's Bill of Rights Communities also have the right to know . . . “strategies in the health field need to be connected with strategies in sectors such as education, housing, public safety, economic development, and community planning.” -Joint Center for Political and Economic Study
  • 5. Assigned Communities Albuquerque & Bernalillo County, NM YOU ARE ASSIGNED TO PROFILE A COMMUNITY – DEFINED BY ZIP CODE AND COMMUNITY CENTER . . . The following maps can be found in the SharePoint Directory 2 Assigned Communities & Selected Boundaries
  • 6. Zip Codes Albuquerque & Bernalillo County, NM THE REFERENCE MATERIALS ON SHAREPOINT ARE MAPS AND TABLES: SOMETIMES AT THE ZIP CODE LEVEL . . .
  • 7. Zip Codes and Census Tracts Albuquerque & Bernalillo County, NM SOMETIMES AT THE CENSUS TRACT LEVEL . . .
  • 8. Zip Codes and Elementary Schools Albuquerque & Bernalillo County, NM SOMETIMES AT THE ELEMENTARY SCHOOL LEVEL . . .
  • 9. Zip Codes and HEAT Communities Albuquerque & Bernalillo County, NM AND SOMETIMES AT THE HEAT COMMUNITY LEVEL . . . HEAT COMMUNITIES ARE AGGREGATIONS OF 4-8 CENSUS TRACTS EACH.
  • 10. This COLLECTION OF ZIP CODE MAPS & TABLES can be found in the SharePoint Directory 3 Zip Code Maps and Tables, 2005
  • 11. SHAREPOINT DIRECTORIES: YOUR ASSIGNED COMMUNITY OLDER ZIP CODE MAPS HEALTH COUNCIL DOCS (FOR WEDNESDAY) YOUR WORKSHEETS NEWER CENSUS TRACT MAPS LINKS (OPTIONAL ACTIVITY)
  • 12. A Project of the Bernalillo County Place Matters Team   ABC HEAT is a collaborative health equity initiative with the goal of providing communities and decision-makers in our city & county with evidence to build health into public and private policies and practices.   We believe that decision-makers must have reliable data on health status, disparities, and the effects of social determinants of health. These data must be monitored at the local level in collaboration with the people and families who live there, and funding must be available to promote community participatory assessment to understand these health effects and to promote the application of findings to decision-makers. ALBUQUERQUE - BERNALILLO COUNTY HEALTH EQUITY ASSESSMENT TOOL BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 13. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 14. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 15. This map can be found in the SharePoint Directory 4 ABC HEAT COMMUNITY FILES, 2008-2010 4 ABC Mortality Indicators >>> 3 Chronic Disease Mortality
  • 16. PLACE MATTERS – ABC HEAT Source: Deaths - NMDOH-BVRHS; Population - Geolytics, Inc. Life Expectancy Comparisons USA (2003)* 77.4 years NM (2001-03)* 77.3 years Bernalillo County (2001-05) 77.6 years *Source: NCHS, US Born Only Life expectancy is a key measure of the health status of a population. It is defined as the average number of years a baby born in a particular area or population can be expected to live if it experiences the current age-specific mortality rates of that particular area or population throughout its life. These estimates use the methods described by Chiang, 1968 (see references). LIFE EXPECTANCY AT BIRTH Both Sexes, 2001-2005 Bernalillo County HEAT Communities (Range – 9 years) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL DOES WHERE WE LIVE INFLUENCE HOW LONG WE LIVE?
  • 17. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL HOW MUCH DOES RACE INFLUENCE HOW LONG WE LIVE? Difference = 1 - 4 yrs
  • 18. PLACE MATTERS – ABC HEAT Source: Deaths - NMDOH-BVRHS; Population - Geolytics, Inc. Census Tracts left blank had either insufficient data or a standard error less than 2.5 LIFE EXPECTANCY AT BIRTH Both Sexes, 2001-2005 Bernalillo County CENSUS TRACTS (Range – 22+ years) Life Expectancy Comparisons USA (2003)* 77.4 years NM (2001-03)* 77.3 years Bernalillo County (2001-05) 77.6 years *Source: NCHS, US Born Only Life expectancy is a key measure of the health status of a population. It is defined as the average number of years a baby born in a particular area or population can be expected to live if it experiences the current age-specific mortality rates of that particular area or population throughout its life. These estimates use the methods described by Chiang, 1968 (see references). BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL HOW MUCH DOES PLACE INFLUENCE HOW LONG WE LIVE?
  • 19. Source: World Health Organization, Report of the Commission on the Social Determinants of Health , 2008.  See also Robert Wood Johnson Foundation Report, Beyond Health Care:  New Directions to a Healthier America and CDC, Healthy People 2020 . BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 20. PLACE MATTERS – ABC HEAT Source: GeoLytics. 2008 High School Education Completed BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 21. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL This map can be found in the SharePoint Directory 4 ABC HEAT COMMUNITY FILES, 2008-2010 2 ABC Social Indicators >>> Neighborhood Social Indicators
  • 22. FREE OR REDUCED-PRICE LUNCH BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 23. FOURTH GRADE READING SCORES (% PROFICIENT) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 24.
    • Health Disparities : Statistical differences in health that occur among populations defined by specific characteristics.
    • Health Inequalities : The systematic and avoidable differences in health outcomes between social groups such that poorer and/or more disadvantaged people are more likely to have illnesses and disabilities and shorter lives than those who are more affluent.
    • Health Inequity : Differences in health that are avoidable, unfair, or stemming from injustice.
    • 1 Whitehead, WHO, 1990
  • 25. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 26. Average Annual Age-Adjusted Death Rates in Persons 35-74 Years By Race/Ethnicity and Poverty Level Bernalillo County, 1996-2005 HEART DISEASE MORTALITY by Census Tract Poverty Level BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 27. This map can be found in the SharePoint Directory 4 ABC HEAT COMMUNITY FILES, 2008-2010 4 ABC Mortality Indicators >>> 4 Injury Mortality
  • 28. UNINTENTIONAL INJURY MORTALITY Average Annual Age-Adjusted Death Rates in Persons < 75 Years By Census Tract Poverty Level, Bernalillo County, 1996-2005 W. ATHAS, PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL POVERTY
  • 29. PEDESTRIAN DEATHS BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHHS
  • 30. This map can be found in the SharePoint Directory 4 ABC HEAT COMMUNITY FILES, 2008-2010 4 ABC Mortality Indicators >>> 3 Chronic Disease Mortality
  • 31. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 32.  
  • 33. PLACE MATTERS – ABC HEAT Source: Farm to Table, 2008 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL FOOD STORE DENSITY
  • 34. In a healthy population of normal children, the expected proportion overweight or obese is 15%. - CDC, 2000 OVERWEIGHT OR OBESE ELEMENTARY SCHOOL CHILDREN APS HEALTHY ASSESSMENT PROJECT PANAC
  • 35. FAST FOOD RESTAURANTS, ALBUQUERQUE CITY BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL PLACE MATTERS – ABC HEAT Source: City of Albuquerque, Environmental Health Dept
  • 36. A COMMUNITY PROFILE A DESCRIPTIVE EXERCISE a multi-purpose tool for community decision-making
            • participatory research,
            • program planning,
            • priority setting and targeting,
            • grant proposals,
            • policy discussions,
            • environmental and health impact assessments,
    ONE NEIGHBORHOOD, MANY MEASURES AND INDICATORS JUXTAPOSITION OF SOCIAL ISSUES AND HEALTH OUTCOMES THE FIRST STEPS OF A DIAGNOSIS, BUT WITHOUT THE SURE-FIRE PRESCRIPTION
  • 37. AN EXAMPLE OF A COUNTY PROFILE: This PROFILE can be found in the SharePoint Directory 6 Bernalillo County Community Health Council Files, 2009
  • 38. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL NUMBER OF PUBLIC CLINICS
  • 39. Source: NM CYFD, 2009 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL DAY CARE SERVICE CAPACITY, 2009
  • 40. Source: GeoLytics, 2005 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL NUMBER OF CHILDREN UNDER 10 YRS
  • 41. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL PLACE MATTERS – ABC HEAT Source: NMRLD, Alcohol and Gaming Division, 2008 ALCOHOL AVAILABILITY, 2008 BERNALILLO COUNTY HEAT COMMUNITIES LICENSED LIQUOR ESTABLISHMENTS
  • 42. PLACE MATTERS – ABC HEAT Source: UNM Institute for Social Research, APD only Serious Crimes = Homicide, Rape, Arson, Aggravated Assault, Robbery, Burglary, Motor Vehicle Theft and Larceny. MAJOR CRIME, ALBUQUERQUE CITY BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 43.
    • FACTS ABOUT ADULT PRISON ADMISSIONS
    • Residents from neighborhoods that have the most people going to prison (incarcerated) are imprisoned up to 30 times more often than the lowest.
    • Two of Albuquerque’s 16 neighborhood areas (87102 and 87105) account for 35% of all prison admissions from the city.
    • 24% of all prison admissions from Albuquerque were admitted on the basis of violations of parole.
    (Adults only) Source: NM Dept of Corrections, NM CYFD; Analysis: The After Prison Initiative, Open Society Institute, 2003
    • FACTS ABOUT YOUTH ADMITTED TO JUVENILE JUSTCE CUSTODY
    • In Martinez Town / Barelas (87102) and West Mesa (87121), youth are placed in detention at nearly 10 times the rate of youth in the West Side (87120) and Paradise Hill (87114) neighborhoods.
    • The South Valley (87105), SE Heights (87108) , West Mesa (87121), Martinez Town / Barelas (87102) neighborhood areas account for 50% of all juveniles admitted to custody from Albuquerque’s 16 neighborhood areas.
    PRISON ADMISSION: ADULTS & YOUTH BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 44. Source: City of Albuquerque, Environmental Health Dept., Air Quality Division, July 2009 PERMITTED STATIONARY SOURCES OF POLLUTION, 2009 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 45. If the permit is extended, PM 2.5 in this area will increase by 59.1%. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 46. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Age-Adjusted Death Rates, All ages, Years 1990 through 2005, N = 166 ASTHMA MORTALITY The neighborhoods east of the American Cement Corp plant registered the 3rd highest asthma death rate in the county for the period 1990-2005. - NM Vital Records From 1998 to 2002, 163 children under age 5 living in zip code 87107 were hospitalized for acute asthma. - NM Health Policy Commission BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL American Cement Corporation
  • 47. EXISTING BURDEN OF ILLNESS & DEATH IN LOCAL AREA Rates = Deaths per 100,000 Residents BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL
  • 48. http://www.koat.com/news/22805273/detail.html
  • 49. SHAREPOINT DIRECTORIES: YOUR ASSIGNED COMMUNITY OLDER ZIP CODE MAPS HEALTH COUNCIL DOCS (FOR WEDNESDAY) YOUR WORKSHEETS NEWER CENSUS TRACT MAPS LINKS (OPTIONAL ACTIVITY)
  • 50. Assigned Communities Albuquerque & Bernalillo County, NM YOU ARE ASSIGNED TO PROFILE A COMMUNITY – DEFINED BY ZIP CODE AND COMMUNITY CENTER . . . The following maps can be found in the SharePoint Directory 2 Assigned Communities & Selected Boundaries
  • 51. Zip Codes Albuquerque & Bernalillo County, NM THE REFERENCE MATERIALS ON SHAREPOINT ARE MAPS AND TABLES: SOMETIMES AT THE ZIP CODE LEVEL . . .
  • 52. Zip Codes and Census Tracts Albuquerque & Bernalillo County, NM SOMETIMES AT THE CENSUS TRACT LEVEL . . .
  • 53. Zip Codes and Elementary Schools Albuquerque & Bernalillo County, NM SOMETIMES AT THE ELEMENTARY SCHOOL LEVEL . . .
  • 54. Zip Codes and HEAT Communities Albuquerque & Bernalillo County, NM AND SOMETIMES AT THE HEAT COMMUNITY LEVEL . . . HEAT COMMUNITIES ARE AGGREGATIONS OF 4-8 CENSUS TRACTS EACH.
  • 55. This COLLECTION OF ZIP CODE MAPS & TABLES can be found in the SharePoint Directory 3 Zip Code Maps and Tables, 2005
  • 56.
    • LEARN HOW TO FIND YOUR OWN DATA
    • “ Online Tools for Community Assessment”
    • Optional Activity (extra credit to earn “A”)
    • Computer Lab, MED 2 (next to the cafeteria)
    • 2 SESSIONS:
      • Monday, July 26, 6:00-7:30
      • Tuesday, July 27, 6:00-7:30
  • 57. Thomas N. Scharmen, M.A., M.P.H., Epidemiologist Regions 1 & 3, Office of Community Assessment, Planning and Evaluation Public Health Division, New Mexico Department of Health North Valley Public Health Office 7704-A 2nd St, NW Albuquerque, NM 87107 Telephone: 897-5700 ext 126; Fax: 897-1010 E-mail: [email_address] JULY 2010 Thank You
  • 58.  
  • 59.