Douglas Juttee of the University of California at Berkley delivered this presentation as a part of the SOCAP 13 Conference in San Francisco.

1. The Doctor is Out: Health happens
where you live, learn, work & play
Douglas Jutte, MD, MPH
UC Berkeley School of Public
Health
SOCAP13
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4. “Actual Causes” of Premature Death
Genetics
30%
Social
Circumstances
15%
Physical
Environment
5%
Behavioral choices
40%
Medical care
10%
Source: McGinnis JM, Russo PG, Knickman, JR. Health Affairs, April 2002.

5. World Health Organization
definition of Health
“Health is a state of complete physical, mental
and social well-being and not merely the absence
of disease or infirmity”
Source: Preamble to the Constitution of the World Health Organization, June 1946

7. WHO 2008 Commission on
Social Determinants
of Health
“Certainly maldistribution of
healthcare is one of the social
determinants of health...”
“(T)he high burden of illness…
arises… because of the
conditions in which people are
born, grow, work, and age.”

8. Retrieved from: www.smartcitymemphis.com/cartoon/toxic-stress/

9. “Toxic Stress”

10. The Socioeconomic Gradient in Health
Mortality rate per 1000 - age 40 to 64 years
(Whitehall II study - Marmot & Shipley 1996 BMJ)
Mortality rate per 1000
20
17.6
15
12.4
10
7.3
4.7
5
0
Administrative
Professional and
Executive
Clerical
British Civil Service Class
Semi-skilled and
Unskilled

12. Global Life Expectancies (in years)
Source: Adapted from Global Education Project. (2004). Human conditions: World life expectancy map.
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13. 72
Washington,
D.C.
YEARS
Source: Robert Wood Johnson Foundation, Commission to Build a
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14. New Orleans
Source: Robert Wood Johnson Foundation, Commission to Build a Healthier
America
14

15. Minneapolis &
St. Paul,
Minnesota
Source: Robert Wood Johnson Foundation, Commission to Build a Healthier 15

16. addresses social injustice
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17. WHO 2008 Commission on
Social Determinants
of Health
“Reducing health inequities
is an ethical imperative.
Social injustice is killing
people on a grand scale.”

18. addresses social injustice
yields a Health ROI
thrives on disruption
$2.8
Trillion
ACA
Aging
population
18

19. People in the U.S. over 65
will double in the next 40 years

20. :
HEALTH
Welcome
20

21. addresses social injustice
yields a Health ROI
thrives on disruption
$2.8
Trillion
ACA
Aging
population
21