The Commission believes that the inequalities in health outcomes previously described are avoidable and therefore unjust. It considers health as a marker of development. And that contributing to development (and ultimately health) is both national economic growth and empowerment; empowerment of individuals, communities and nations. So what is meant by empowerment: this relates to having both basic material needs AND control, power and agency to lead lives with dignity and security
So what do we do about that? Tell people to exercise more, eat right and reduce their stress? And that would work – let’s say if you had groceries in your neighborhood that carried fresh fruits and vegetables, if you weren’t afraid of violence in your community, if you had recreation areas close to your home and you had control over things that create stress in your life – like institutional racism, economic opportunities and pollution in you neighborhood. Dr. Troutman, the Director of Public Health and Wellness and a nationally renowned expert, always explains the basic premise of the shift we need to make – Baby story.
MIKE BRAMER Gain stakeholder input from Corner Store owners and make recommendations on how to overcome barriers to stocking and marketing fresh, healthy foods. Expand Farmers’ Markets and improve marketing capability. Support efforts to develop a year-round, indoor public market. Link farms with restaurants, emergency food providers and institutions Negotiate reduced prices for CSA shares for lower-income families. Encourage and incentivize restaurants to post nutritional information on menu boards and printed materials.
COMMUNITY ISSUES FORUM PORTLAND OREGON OCTOBER 8, 2009 ADEWALE TROUTMAN, M.D., M.P.H., M.A. THE TROUTMAN GROUP Creating Health Equity; Social Justice, Human Rights and the Social Determinants of Health
Biological/Behavioral Determinants vs Social Determinants
Creating Health Equity vs. eliminating Health Disparities
The Troutman Group
TRADITIONAL SOCIAL JUSTICE How can we address risky behavior and target vulnerable populations? How can we target the health depriving conditions and policies that make people vulnerable? Why do people smoke? What economic policies and social conditions predispose people to the stress that encourages smoking? How can we create more green space, bike paths, and farmers’ markets in disadvantaged neighborhoods? What policies and institutional practices by government and corporations discourage access to transportation, recreational resources, and access to nutritious foods in neighborhoods where population is poorest? How can we promote greater personal responsibility for health? How can we create social responsibility and public accountability to protect the public good? How do we treat the consequences of health inequity? How does the prioritization of profit over human need and ecological sustainability affect health inequity? Overarching social justice questions: Why do those who make decisions that negatively affect health make those decisions? Why do they have that power?
“ Health equity is the realization by ALL people of the highest attainable level of health. Achieving health equity requires valuing all individuals and populations equally, and entails focused and ongoing societal efforts to address avoidable inequalities by assuring the conditions for optimal health for all groups, particularly for those who have experienced historical or contemporary injustices or socioeconomic disadvantage.”
Systemic, avoidable, unfair and unjust differences in health status and mortality rates and in the distribution of disease and illness across population groups. They are sustained over time and generations and beyond the control of individuals
Preamble to the constitution of the WHO states “ The enjoyment of the highest standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief,economic or social condition
In El Salvador, if mothers had no education their babies have 100 chances in 1000 of dying in their first year of life; if mothers have at least secondary education the infant death rate is a quarter of that (World Bank 2006) The Troutman Group
A fragmented non system of sick care where inequity is common, prevention and wellness are after thoughts and outcomes correlate to societal status The Troutman Group
Universal access to a single standard of high quality care National Health Insurance Single Payer The Troutman Group
Health in All Policies addresses the effects on health across all policies such as agriculture, education, the environment, fiscal policies, housing, and transport . It seeks to improve health and at the same time contribute to the well-being and the wealth of the nations through structures, mechanisms and actions planned and managed mainly by sectors other than health. Thus HiAP is not confined to the health sector and to the public health community, but is a complementary strategy with a high potential towards improving a population’s health, with health determinants as the bridge between policies and health outcomes.
Phillis Wheatley Students present Photo-voice Exhibits on Health Policy Issues
Presentation to policy makers ( Mayor Metro Council, Board of Health, Business Community
If my community were healthy it would look like, no people littering, people riding bikes, no people dealing drugs, kids playing at the park, no gunshots, parents and kids walking their dogs, no people smoking, parents taking their baby’s in a stroller to the park to walk them around the park. Denzel: age 10
My neighborhood has many train tracks and a really big factory that does something, I don’t know what. There is a church, a community center but there is no store close to where I live. D’coreyan: age 10
Every day I go to the community center on the side of it, they are selling drugs or showing off their guns and sometimes I am scared to walk pass because I think they will shoot me. Michael: age 10