FALLING BEHIND  USA Playing the   Game of HealthWithout a Scoreboard     Stephen Bezruchka MD, MPHDepartments of Global He...
AgendaPopulation Health QuizHealth OlympicsDeterminants of health  –Economic Inequality & First 1000 daysWhat needs to be ...
Health QUIZ                                           True   FalseA 15 year old girl in the US has asmaller chance of dyin...
Sri Lanka USAdult Female Mortality 1970-2010
Health QUIZ                                           True   FalseA 15 year old girl in the US a smallerchance of dying be...
US County Life Expectancy Trends 1987-2007      Female                        Male                         Ezzati et. al 2...
Health QUIZ                                           True   FalseA 15 year old girl in the US a smallerchance of dying be...
Australia, Canada, Japan, Sweden US Maternal Mortality 1970-2010
790.5                   6672406          702.5          Time magazine July 30, 2012 + web update
How healthy is the US?      Health OlympicsNumber one Gold   16-20   _______1-5   _______     21-25   _______6-10 _______ ...
HEALTH OLYMPICS 2011                5expectancy   Life                             10                                     ...
Economist April 25, 2012
African AmericanHarlem Mortality        cf.   Bangladesh
Male Life Expectancies early 2000s                                  United States (white)              74.6               ...
Maternal Mortality Rates by Race/Ethnicity,     California Residents; 1999-2008                          California Pregna...
Country without  Black – Whitehealth inequities?
Life Expectancy Race, Cuba, Brazil USCountry          Whites          Blacks            W-BCuba (1981)        71.2        ...
WHERE IS PACIFIC NW     HEALTH?
Cascadia2002NW Env Wa
CLOSER TO HOME                 Life Expectancy
Killer Facts
How healthy is the US?      Health OlympicsNumber one Gold   16-20   _______1-5   _______     21-25   _______6-10 _______ ...
1st & 4th yr US medical student   knowledge of Population Health                (2002)Question                            ...
Playing Game of       Healthwithout a scoreboard
POPULATION HEALTHHealth Inequalities (poorer people have poorer health)Early Life: critical for adult health
Harvey 2005
US MORTALITY RATES BY ZIP CODE INCOME                       Wilkinson & Pickett 2009 Spirit Level
Health and Social Problems are Worse in More Unequal                                         Countries  Index of:  • Life ...
People who create  INEQUALITY      KILL
Deaths attributable toexcess income inequality                           1/3                                 Kondo et al. ...
Early life lasts a lifetime
Womb to TombFirst 1000 days9 months –maternal grandmotherFirst two years outsideHALF of adult health programmed
SONGI want to be aBILLIONAIRE
When YOUR BELIEFS       were  SHATTERED
NYT 050515
"This is our generations  Sputnik moment,"                  State of the Union                  Jan 25, 2011
Stephen Bezruchka            sabez@uw.eduResources: readings, talks other materialhttp://depts.washington.edu/eqhlth/pages...
Bezruchka scoreboard
Bezruchka scoreboard
Bezruchka scoreboard
Bezruchka scoreboard
Bezruchka scoreboard
Upcoming SlideShare
Loading in …5
×

Bezruchka scoreboard

432 views

Published on

Published in: Education
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
432
On SlideShare
0
From Embeds
0
Number of Embeds
13
Actions
Shares
0
Downloads
3
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • http://www.healthmetricsandevaluation.org/news-events/news-release/life-expectancy-most-us-counties-falls-behind-worlds-healthiest-nations
  • Time magazine July 30, 2012 http://www.london2012.com/medals/medal-count/
  • Source: Dying young Apr 25th 2012, 13:45 by The Economist online http://www.economist.com/blogs/graphicdetail/2012/04/daily-chart-14
ADOLESCENCE can be tedious all over the world. But in some countries it is dangerous too. Even within the rich world mortality rates for young people vary widely, as do the factors explaining these rates, according to data collected by George Patton of the University of Melbourne for an article published in the Lancet on April 25th. In Greece, suicides are rare but car accidents are common. In Finland it is the other way round. America stands out for having the highest mortality rate. It has a particularly high rate of traffic deaths, despite laws that ban drinking until 21. Where America is truly exceptional, however, is in its violence. At 8.9 per 100,000 population, the rate of violent death (such as from homicide or accidental shooting) is 18 times higher than in Britain. For young American men the risk is much higher. The death rate from homicide for 20-24 year olds is a staggering 28 per 100,000 population. Patton, G. C., C. Coffey, et al. (2012). "Health of the world's adolescents: a synthesis of internationally comparable data." The Lancet 379(9826): 1665-1675.
  • Godson, S. L. (2006). "The third world health status of black American males." Journal of the National Medical Association 98(4): 488-491.
  • The California Pregnancy-Associated Mortality Review (2011). THE CALIFORNIA PREGNANCY-ASSOCIATED MORTALITY REVIEW: Report from 2002 and 2003 Maternal Death Reviews. Sacramento, Department of Public Health, Maternal Child and Adolescent Health Division.
  • http://www.youtube.com/watch?v=WG7U1QsUd1g Bergner, G. (2009). "Black Children, White Preference: Brown v. Board, the Doll Tests, and the Politics of Self-Esteem." American Quarterly 61(2): 299-332.
  • De la Fuenta 1995 Table 5
  • Downloaded from http://www.kingcounty.gov/healthservices/health/healthofficer/presentations.aspx Saved as FlemingHealthOfKingCounty2012.pdf
  • Agrawal, J. R., J. Huebner, et al. (2005). "Medical students' knowledge of the U.S. health care system and their preferences for curricular change: a national survey." Acad Med 80(5): 484-8.
  • Halley Brunsteter
  • RGW Figure 1.3 2009
  • Kondo, N., G. Sembajwe, et al. (2009). "Income inequality, mortality, and self rated health: meta-analysis of multilevel studies." BMJ 339(nov10_2): b4471-.
  • Galilleo drawing
  • http://www.bphc.org/CHESJ/Pages/default.aspx
  • Bezruchka scoreboard

    1. 1. FALLING BEHIND USA Playing the Game of HealthWithout a Scoreboard Stephen Bezruchka MD, MPHDepartments of Global Health & Health Services School of Public Health University of Washington
    2. 2. AgendaPopulation Health QuizHealth OlympicsDeterminants of health –Economic Inequality & First 1000 daysWhat needs to be done
    3. 3. Health QUIZ True FalseA 15 year old girl in the US has asmaller chance of dying before reachingage 60 than a similarly aged girl in SriLanka.During the period of 1987 to 2007 lifeexpectancy for women declined in about30% of US counties (which was not sofor the previous 20 years).Maternal mortality in the US hasincreased 50% over the last 15 years.
    4. 4. Sri Lanka USAdult Female Mortality 1970-2010
    5. 5. Health QUIZ True FalseA 15 year old girl in the US a smallerchance of dying before reaching age 60than a similarly aged girl in Sri Lanka.During the period of 1987 to 2007 lifeexpectancy for women declined inalmost 30% of US counties (which wasnot so for the previous 20 years).Maternal mortality in the US hasincreased 50% over the last 15 years.
    6. 6. US County Life Expectancy Trends 1987-2007 Female Male Ezzati et. al 2008
    7. 7. Health QUIZ True FalseA 15 year old girl in the US a smallerchance of dying before reaching age 60than a similarly aged girl in Sri Lanka.During the period of 1987 to 2007 lifeexpectancy for women declined in about30% of US counties (which was not sofor the previous 20 years).Maternal mortality in the US hasincreased 50% over the last 15 years.
    8. 8. Australia, Canada, Japan, Sweden US Maternal Mortality 1970-2010
    9. 9. 790.5 6672406 702.5 Time magazine July 30, 2012 + web update
    10. 10. How healthy is the US? Health OlympicsNumber one Gold 16-20 _______1-5 _______ 21-25 _______6-10 _______ 26-30 _______11-15 _______ 31+ _______
    11. 11. HEALTH OLYMPICS 2011 5expectancy Life 10 15 20 25 30United Nations Human Development Report 2011
    12. 12. Economist April 25, 2012
    13. 13. African AmericanHarlem Mortality cf. Bangladesh
    14. 14. Male Life Expectancies early 2000s United States (white) 74.6 Sri Lanka 71.5Journal of the National MedicalAssociation 98(4): 488-491 Ecuador 71.4 Malaysia 70.9 Occupied Palestinian territories 70.9 Iran 69.0 Colombia 69.3 United States (black) 68.8 Viet Nam 68.6 El Salvador 67.8 Iraq* 67.5 Nicaragua 67.3
    15. 15. Maternal Mortality Rates by Race/Ethnicity, California Residents; 1999-2008 California Pregnancy-Associated Mortality Review (2011
    16. 16. Country without Black – Whitehealth inequities?
    17. 17. Life Expectancy Race, Cuba, Brazil USCountry Whites Blacks W-BCuba (1981) 71.2 70.2 1.0Brazil (1980) 66.1 59.4 6.7USA (1980) 74.4 68.1 6.3 de la Fuente(1995): Race and Inequality in Cuba, 1899-1981
    18. 18. WHERE IS PACIFIC NW HEALTH?
    19. 19. Cascadia2002NW Env Wa
    20. 20. CLOSER TO HOME Life Expectancy
    21. 21. Killer Facts
    22. 22. How healthy is the US? Health OlympicsNumber one Gold 16-20 _______1-5 _______ 21-25 _______6-10 _______ 26-30 _______11-15 _______ 31+ _______
    23. 23. 1st & 4th yr US medical student knowledge of Population Health (2002)Question INCORRECTUS has higher life expectancy 32%than any other nation?US has lower infant mortality 34%than any other nation? Agrawal, J. R., J. Huebner, et al. (2005). "Medical students knowledge of the U.S. health care system and their preferences for curricular change: a national survey." Acad Med 80(5): 484-8.
    24. 24. Playing Game of Healthwithout a scoreboard
    25. 25. POPULATION HEALTHHealth Inequalities (poorer people have poorer health)Early Life: critical for adult health
    26. 26. Harvey 2005
    27. 27. US MORTALITY RATES BY ZIP CODE INCOME Wilkinson & Pickett 2009 Spirit Level
    28. 28. Health and Social Problems are Worse in More Unequal Countries Index of: • Life expectancy • Math & Literacy • Infant mortality • Homicides • Imprisonment • Teenage births • Trust • Obesity • Mental illness – incl. drug & alcohol addiction • Social mobilitySource: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    29. 29. People who create INEQUALITY KILL
    30. 30. Deaths attributable toexcess income inequality 1/3 Kondo et al. 2009
    31. 31. Early life lasts a lifetime
    32. 32. Womb to TombFirst 1000 days9 months –maternal grandmotherFirst two years outsideHALF of adult health programmed
    33. 33. SONGI want to be aBILLIONAIRE
    34. 34. When YOUR BELIEFS were SHATTERED
    35. 35. NYT 050515
    36. 36. "This is our generations Sputnik moment," State of the Union Jan 25, 2011
    37. 37. Stephen Bezruchka sabez@uw.eduResources: readings, talks other materialhttp://depts.washington.edu/eqhlth/pages/resources.html

    ×