Invited presenter: Using the Public Health Toolbox PH370, University of Illinois School of Public Health, October 25, 2017.

1. Health Equity, WePLAN2020,
& Community Health
Improvement Planning at
the Cook County
Department of Public Health
Jim Bloyd, MPH, DrPH(c)
Regional Health Officer
October 25, 2017
PH370 Using the Public Health Toolbox
University of Illinois at Chicago
School of Public Health

2. Cook County Department of Public Health
But stand up,
you, stand up,
but stand up with me
and let us go off
together
to fight face to face
against the devil’s
webs,
against the system
that distributes
hunger,
against organized
misery.
(Pablo Neruda, 1972, p. 99, cited by Pickett &
Dorling, (2010).
Pero levántate,
tú, levántate,
pero conmigo levántate
y salgamos reunidos
a luchar cuerpo a cuerpo
contra las telarañas del
malvado,
contra el sistema que
reparte el hambre,
contra la organización de
la miseria.
(Pablo Neruda, 1972, p. 99, cited by Pickett & Dorling,
(2010).
Source: http://www.poema-de-amor.com.ar/mostrar-
poema.php?poema=13301

3. Cook County Department of Public Health
Our collaboration has
yielded a plan that will
guide the activities of
both CCDPH and
community partners - all
of us who make up the
local public health
system - for the next five
years. The information
included here will help
residents, institutions,
and leaders of Cook
County by informing
their work to prevent
illness and disease,
improve population
health, and move
towards health equity.
Terry Mason, MD
Chief Operating Officer

4. Cook County Department of Public Health

5. Cook County Department of Public Health
WePLAN2020 p. 20

6. Cook County Department of Public Health
WePLAN2020 p.11

7. Cook County Department of Public Health
150 community
participants

8. Cook County Department of Public Health
MAPP Assessment 1:
Local Public Health System Assessment
• Comprehensive assessment of all of
the organizations and entities that
contribute to the public’s health
– What are the activities, competencies
and capacities of our local public health
system?
– How are the Essential Services being
provided to our community?

9. Cook County Department of Public Health
MAPP Assessment 2: Community Health
Status Assessment
• Identifies priority issues related to
community health and quality of life
– How healthy are our residents?
– What does the health status of our
community look like?

10. Cook County Department of Public Health
MAPP Assessment 3:
Community Themes and Strengths
Assessment
• Provides an
understanding of
the issues
residents think are
important
– What is important
to our community?
– How is quality of
life perceived in
our community?
– What assets do we
have that can be
used to improve
community
health?
Survey at
http://ow.ly/RNBrE
Question 37

11. Cook County Department of Public Health
CCDPH @CookCoHealth
Tell us if housing, health svcs, jobs,
schools, transportation & recreation
support healthy living in your community.
http://ow.ly/RNBrE

12. Cook County Department of Public Health
MAPP Assessment 4: Forces of
Change Assessment
• CCDPH Used the NACCHO’s MAPP
Equity Supplement
• Identifies forces, such as legislation,
technology and other issues that affect
the context in which the community
and its public health system operates
– What is occurring or might occur that
affects the health of our community or the
local public health system?
– What specific threats or opportunities are
generated by these occurrences?

13. Questions to identify forces
of change:
• What has occurred recently
that may affect our local public
health system or community?
• What may occur in the
future?
• What specific threats or
opportunities are
generated by these
occurrences?
• What patterns of decisions,
policies, investments, rules,
and laws affect the health of
our community?
• Who benefits from these
patterns?
• Whom do these patterns
harm?
• Who or what institutions have
the power to create, enforce,
implement, and change these
decisions, policies,
investments, rules, and laws?
• What interests support or
oppose actions that
contribute to health
inequity?
Forces of change: environmental forces – factors,
trends, or events, that are or will affect the
community and the local public health system
Social determinants of health: resources
necessary for social and physical environments for
good health for all
Housing * Money * Wealth * Education * Transportation *
Health Care * Community Design * Food & Agriculture * Social
Services * Employment * Working Conditions * Social Inclusion
vs. Exclusion * Public Safety* Daily Living Conditions
Health: a complete state of, physical, mental,
and social well-being and not merely the
absence of disease or infirmity (WHO 1948)
Health equity: the realization by all people of
the highest attainable level of health
(Troutman)
A Forces of Change Assessment Framework Emphasizing the Social Determinants of Health

14. Cook County Department of Public Health

15. Cook County Department of Public Health
WePLAN2020
People without great wealth have
power when they unite to advocate
for their interests. This happens
through social movements, advocacy
of elected officials, and requires
organizing.
Forces of Change Assessment page 1.

16. Cook County Department of Public Health
Healthy weight &
household income<
25th percentile
Extremely obese & household
income > 75th percentile
Healthy weight & household
income > 75th percentile
Adapted from Vega & Sribney 2017 Fig 1:Association of Body Mass Index With Age of First Onset of
Functional Limitations, by Income Group: Health and Retirement Survey, United States, 2015

17. Cook County Department of Public Health
Association of Body Mass Index With Age of First Onset of Functional
Limitations, by Income Group: Health and Retirement Survey,
United States, 2015 (Vega & Sribney 2017)

18. Cook County Department of Public Health
References/Resources
1. Chaufan, C., Yeh, J., Ross, L., & Fox, P. (2014). You can’t walk or bike yourself out of the health effects of poverty: Active school
transport, child obesity, and blind spots in the public health literature. Critical Public Health. doi:10.1080/09581596.2014.920078
1. Collaborative for Health Equity Cook County www.CHECookCounty.org info@checookcounty.org twitter: @CHECookCounty
1. Cook County Department of Public Health. (2016). WePLAN 2020 forces of change assessment. Retrieved from
https://docs.wixstatic.com/ugd/5dd873_a66a75b7c9024166a7c7dfdfcb39c567.pdf
2. Cook County Department of Public Health. (2016). WePLAN2020 improving community health and health equity for suburban cook
county . Oak Forest, Illinois. Retrieved from http://cookcountypublichealth.org/files/pdf/weplan/weplan2020-report-111416-final-lr-
for-viewing-online.pdf
3. Grotto, J. (2017). Tribune watch dog the tax divide. Chicago Tribune. Retrieved from
http://apps.chicagotribune.com/news/watchdog/cook-county-property-tax-divide
4. Human Impact Partners (2017). HealthEquityGuide.org A Human Impact Partners Project. Local health departments are building power
for health equity.
5. ILGA.Gov. SECTION 600.410 REQUIREMENTS FOR IPLAN OR AN EQUIVALENT PLANNING PROCESS Joint Committee on Administrative
Rules Administrative Code. (2017). Retrieved from http://www.ilga.gov/commission/jcar/admincode/077/077006000D04100R.htm
6. Medvedyuk, S., Ali, A., & Raphael, D. (2017). Ideology, obesity and the social determinants of health: A critical analysis of the obesity
and health relationship. Critical Public Health, 1-13. doi:10.1080/09581596.2017.1356910
7. Muntaner, C., Sridharan, S., Solar, O., & Benach, J. (2009). Commentary: Against unjust global distribution of power and money: The
report of the who commission on the social determinants of health: Global inequality and the future of public health policy. Journal of
Public Health Policy, 30(2), 163-175. doi:10.2307/40207234
8. National Association of County & City Health Officials. (2014) Mobilizing and Organizing Partners To Achieve Health Equity (Equity
Supplement). NACCHO: Washington, DC.
9. Pickett, K. E., & Dorling, D. (2010). Against the organization of misery? The marmot review of health inequalities. Social Science &
Medicine (1982), 71(7), 1231-3; discussion 1254-8. doi:10.1016/j.socscimed.2010.07.013
10. Public Health Leadership Society. (2002). Principles of the ethical practice of public health. [Pamphlet] Retrieved from
http://www.apha.org/NR/rdonlyres/1CED3CEA-287E-4185-9CBD-BD405FC60856/0/ethicsbrochure.pdf
1. Solar, O., & Irwin, A. (2010). A conceptual framework for action on the social determinants of health. Social determinants of health
discussion paper 2 (policy and practice) [The Series: The Discussion Paper Series on Social Determinants of Health provides a forum
for sharing knowledge on how to tackle the social determinants of health to improve health equity. Geneva: World Health Organization.
http://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf

19. Cook County Department of Public Health
CCDPH serves suburban Cook
County
• 125 municipalities, 30
townships, 1000+
schools
• Inequities: Wealthiest
and poorest populations
• One of 6 certified health
departments in the
County
• Jurisdiction: suburban
Cook County not served
by a municipal certified
public health department
• Question: Who governs
CCDPH?
ggg
Map: Cook County, IL
with 4 Forces of Change
Assessment Focus Group
Locations

20. Cook County Department of Public Health
Contact Information
Jim Bloyd, MPH, DrPH(c)
Regional Health Officer
Community Epidemiology and Health Planning
708-633-8314
Jbloyd@cookcountyhhs.org
cookcountypublichealth.org