Panel presentation May 12, 2017 by Jim Bloyd, MPH, Regional Health Officer, Cook County Department of Public Health at the Chicago Metropolitan Fair Housing Convening: Advancing Regional Prosperity, taking place at the Federal Reserve Bank of Chicago, 230 South LaSalle Street, Chicago, Illinois, 60604.

1. Affirma&vely Furthering Fair Housing:
A pla8orm for health equity advocates
Jim Bloyd, MPH
Regional Health Officer, Cook County Department of Public Health
Chicago Metropolitan Fair Housing Convening May 12, 2017
Federal Reserve Bank of Chicago
Chicago, Illinois

2. WePLAN2020
• Health Equity
• Chronic Disease
• Behavioral Health
www.cookcountypublichealth.org
@CookCoHealth
• The Collabora&ve for Health Equity Cook
County (CHE) is a source of leadership and
strategic guidance in implemen&ng strategies
described in this plan.
www.checookcounty.org @CHECookCounty

3. Residential segregation
by race/ethnicity and
socioeconomic position
Inequalities in
Resource distribution
Neighborhood physical environments
Environmental exposures
Food and recreational resources
Built environment
Aesthetic quality/natural spaces
Services
Quality of housing
Neighborhood social environments
Safety/violence
Social connections/ cohesion
Local institutions
Norms
Behavioral
mediators
Stress
Health
Personal characteristics
Material resources
Psychosocial resources
Biological attributes
Source: Diez Roux, A. V., & Mair, C. (2010).
Neighborhoods and health. Annals of the New York
Academy of Sciences, 1186(1), 125-145.

4. Segrega&on is associated with
inequi&es in…
• Premature death/ life expectancy
• Sexual health status
• Violence
• Asthma
• Poor self-reported health
• Infant mortality
• Diabetes
• Obesity, ….

5. Average Life Expectancy (2003-2007) by Median
Income of Census Tract/Municipality (2009),
Cook County
73.2
78.8
79.9 79.9
87.0
65
70
75
80
85
90
Less than 25k 25k - 35k 35k - 44k 44k - 53k Greater than
53k
Lifeexpectancyatbirthinyears
Median Income
Source: Life expectancy calculated by the VCU Center on Human Needs from 2003-2007 data provided by Cook County Health
Department: Median Income from 2009 Geolytics Premium Estimates.
13.8
Years
8.2 7.1 7.1
5

6. Social Gradient Example: health by
family income and race RWJF cited by Marmot and Bell (2011)

7. Reducing the Black-White Infant
mortality gap (Brown Speights 2017)
• 4,080 Black infant lives saved if Black IMR =
White IMR
• IL 17th of 35 states in reducing Black IMR
1999-2013
• IL 34th of 35 states in equitable improvement of
IM rate dispari&es 1999-2013
• Year IL would achieve IM rate equality on current
trend: 2030

8. Racial
segrega&on
exposes poor
Black children
to high poverty
neighborhoods
but not poor
white children
Divesitydata.org “Children Lee Behind:
How Metropolitan Areas Are Failing
America’s Children Chartbook”

9. Racial segrega&on
exposes more
poor La&no
children to high
poverty
neighborhoods but
not poor white
children
Divesitydata.org “Children Lee Behind: How
Metropolitan Areas Are Failing America’s Children
Chartbook”

10. Most Black children in Cook County live in
neighborhoods of Very Low Child Opportunity
54%
28%
10%
5% 4% 2%
10%
22%
26%
39%
-10%
0%
10%
20%
30%
40%
50%
60%
Very Low Low Moderate High Very high
Black White Linear (Black ) Linear (White )

11. Most La&no children in Cook County live in
neighborhoods of Low/Very Low Child Opportunity
32%
36%
19%
8%
5%
2%
10%
22%
26%
39%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Very Low Low Moderate High Very high
Hipanic /La&no White Linear (Hipanic /La&no ) Linear (White )

12. “In metropolitan
Chicago, Blacks and
La&nos pay rela&vely
more, in terms of
housing and
transporta&on costs, to
live in neighborhoods
with opportuni&es for
children.” Source: Diversitydatakids.org hjp://
www.arcgis.com/apps/MapSeries/index.html?appid=13492fdd497c47a4bd14883ee78151e5

13. Neighborhood opportunity levels &
cost levels by race
Source: Diversitydatakids.org hjp://www.arcgis.com/apps/MapSeries/index.html?
appid=13492fdd497c47a4bd14883ee78151e5

14. “By failing to curb
discrimina&on that its own
data disclosed, the Federal
Reserve violated African
Americans’ legal and
cons&tu&onal rights.”
Rothstein, R. (2017) p.111

15. References
• Bassej, M. (2016). Public health meets the "problem of the color line" speech by dr. Mary bassej. Retrieved from hjp://www.huffingtonpost.com/
entry/racism-as-cause-of-poor- health_us_581a1376e4b01a82df6406d6
• Brown Speights, J. S. (2017). State-level progress in reducing the black-white infant mortality gap. American Journal of Public Health, 107(5), 775-782.
• Buffardi, A. L., Thomas, K. K., Holmes, K. K., & Manhart, L. E. (2008). Moving upstream: Ecosocial and psychosocial correlates of sexually transmijed
infec&ons among young adults in the united states. American Journal of Public Health, 98(6), 1128-36. doi:10.2105/AJPH. 2007.120451
• Cook County Department of Public Health. (2016a). WePLAN 2020 forces of change assessment. Cook County Department of Public Health. (2016b).
WePLAN2020 improving community health and health equity for suburban cook county . Oak Forest, Illinois.
• Diez Roux , A. V., & Mair, C. (2010). Neighborhoods and health. Annals of the New York Academy of Sciences, (1186), 125-145. doi:10.1111/j.
1749-6632.2009.05333.x
• diversitydata.org. (2007). Children leJ behind: How metropolitan areas are failing america's children chartbook. Diversitydata.org. Retrieved from
hjp://diversitydata.sph.harvard.edu/Publica&ons/children_lee_behind_chartbook.pdf
• Diversitydatakids.org. (2017). The how affordable is opportunity? Tool. [Pamphlet] Retrieved from
hjp://www.diversitydatakids.org/files/Images/StoryMaps/How%20Afford%20is%20Opp%20Learn%20More_Final.pdf
• Diversitydatakids.org, & Kirwan Ins&tute. (2014). How to use and interpret the child opporunity index maps. Retrieved from
hjp://www.diversitydatakids.org/files/CHILDOI/DOCS/DDK_KIRWAN_HOW_TO_USE_CHILDOI.pdf
• Freudenberg, N., Franzosa, E., Chisholm, J., & Libman, K. (2015). New approaches for moving upstream: How state and local health departments can
transform prac&ce to reduce health inequi&es. Health EducaQon & Behavior, 42(1S), 46S-56S. doi:10.1177/1090198114568304 Himmelman, A. T.,
• Berkowitz, B., Christens, B. D., Bujerfoss, F. D., Lee, K. S., Bowen, L., . . . Francisco, V. T. (2017). Collabora&ng for equity and jus&ce: Moving beyond
collec&ve impact. Non Profit Quarterly. Retrieved from hjps://nonprofitquarterly.org/2017/01/09/ collabora&ng-equity-jus&ce-moving-beyond-
collec&ve-impact/? utm_source=Daily+Newswire&utm_campaign=bd6ae96ea8-
EMAIL_CAMPAIGN_2017_01_09&utm_medium=email&utm_term=0_94063a1d17- bd6ae96ea8-12567505

16. References • Jones, K. (2016). Asthma and injus&ce on chicago's southeast side. Health Affairs, 35(5), 928-931. doi:10.1377/hlthaff.
2015.0117
• Krieger, N. (2016). Living and dying at the crossroads: Racism, embodiment, and why theory is essen&al for a public health
of consequence. American Journal of Public Health, 106(5), 832-3. doi:10.2105/AJPH.2016.303100
• McElwee, S. (2016). How chicago's white donor class distorts city policy. Retrieved from hjp:// www.demos.org/
publica&on/how-chicagos-white-donor-class-distorts-city-policy
• NACCHO. (2016). Health inequity: A charge for public health. Washington, DC: Na&onal Associa&on of County and City
Health Officials.
• Na&onal Research Council and Ins&tute of Medicine, Woolf, S., & Aron, L. (2013). U.S. Health in internaQonal perspecQve:
Shorter lives, poorer health . Washington, DC: The Na&onal Academies Press. Retrieved from hjp://www.nap.edu/
openbook.php?record_id=13497
• Rothstein, R. (2017). The color of law: A forgoen history of how our government segregated america. New York: Liveright
Publishing Corp
• Rothstein, R. (2012). A COMMENT ON BANK OF AMERICA/ COUNTRYWIDE’S DISCRIMINATORY MORTGAGE LENDING AND
ITS IMPLICATIONS FOR RACIAL SEGREGATION . EPI Briefing Paper.
• Sampson, R. J., Morenoff, J. D., & Raudenbush, S. (2005). Social anatomy of racial and ethnic dispari&es in violence.
American Journal of Public Health, 95(2), 224-32
• Smedley, B. (2012). The lived experience of race and its health consequences. American Journal of Public Health, 102(5),
933-935. doi:10.2105/AJPH.2011.300643
• Smedley, B., & Tegeler, P. (2016). "Affirma&vely furthering fair housing": A pla8orm for public health advocates. American
Journal of Public Health, 106(6), 1013-1014. doi:10.2105/AJPH.2016.303175

17. Thank you
Jim Bloyd, MPH
Regional Health Officer
Cook County Department of Public Health
15900 S. Cicero Avenue
Oak Forest, Illinois 60452
708-633-8314
jbloyd@cookcountyhhs.org