Download to read offline
BloomingtonPHABERHealthEquity.pptx
- 1.
- 2. What is health? “Healthis a state of complete physical, social and mental well- being, and not merely the absence of disease or infirmity.” World Health Organization 1948
- 3. Public Health “Public healthis what we, as a society, do collectively to assure the conditions in which (all) people can be healthy.” Institute of Medicine (1988), Future of Public Health
- 4. Factors that determinehealth Tarlov AR. Public policy frameworks for improving population health. Ann N Y Acad Sci 1999; 896: 281-93.
- 5. Necessary conditions for health •Peace • Shelter • Education • Food • Income • Stable eco-system • Sustainable resources • Social justice and equity World Health Organization. Ottawa charter for health promotion. International Conference on Health Promotion: The Move Towards a New Public Health, November 17-21, 1986 Ottawa, Ontario, Canada, 1986. Accessed July 12, 2002 at <http://www.who.int/hpr/archive/docs/ottawa.html>.
- 6. Social Determinants ofHealth External environments and conditions that contribute to health or lack of health.
- 7. Health Equity Attainment ofthe highest level of health possible for all people. Achieving health equity requires valuing everyone with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health disparities and health care disparities
- 8. Health Equity: Diabetesby Income Level, Minnesota 2010 4.4 4.4 4.4 4.4 4.4 0 5 10 15 20 25 Less than $15,000 $15,000- 24,999 $25,000- 34,999 $35,000- 49,999 $50,000+ Percent Income Category Have you ever been told by a doctor that you have diabetes?
- 9. Health Inequity Health Inequity—Differencesin health status between more and less socially and economically advantaged groups, caused by systematic differences in social conditions and processes that effectively determine health. Health inequities are avoidable, unjust, and therefore actionable.
- 10. Health Equity: Diabetesby Income Level, Minnesota 2010 19.1 9.4 8.2 6.7 4.4 0 5 10 15 20 25 Less than $15,000 $15,000- 24,999 $25,000- 34,999 $35,000- 49,999 $50,000+ Percent Income Category Have you ever been told by a doctor that you have diabetes? Source: CDC Behavioral Risk Factor Surveillance System Percentages are weighted to population characteristics.
- 11. Structural inequities • Structuresor systems of society — such as finance, housing, transportation, education, social opportunities, etc. — that are structured in such a way that they benefit one population unfairly (whether intended or not).
- 12. Who’s affected bystructural inequities in Minnesota? • American Indians • African Americans • Children • Persons with mental health challenges • LGBTQ • Immigrants • Refugees • Asian-Pacific Islanders • Hispanics/Latinos • Rural Minnesotans • Women • Older Minnesotans • Persons with disabilities • And more…
- 13. Health equity andstructural racism: • Structural racism is the normalization of an array of dynamics — historical, cultural, institutional and interpersonal — that routinely advantage white people while producing cumulative and chronic adverse outcomes for people of color and American Indians.
- 14. Health inequities inMinnesota are significant and persistent, especially by race: In Minnesota, an African American or Native American infant has more than twice the chance of dying in the first year of life as a white baby.
- 15. Appendix D: Redliningand Infant Mortality in Minneapolis, MN
- 16. Infant mortality ratesin Minneapolis by neighborhood, 2001-2010
- 17. Comparison: Redlining and InfantMortality in Minneapolis “Color-coded maps indicated which neighborhoods were considered lesser (green=best; blue=still desirable) or greater (yellow=declining; and red=hazardous), investment risks,…”
- 18. Low Birth Weight(singletons)by Race,2011 Bloomington,Richfield 3% 5% 10% 12% -1% 1% 3% 5% 7% 9% 11% 13% 15% Bloomington Richfield 7% 7% Minnesota Department of Health Vital Records, 2010 White Black/African American White Black/African American
- 19. PretermBirths (singletons) byRace,2011 Edina 5% 11% -1% 1% 3% 5% 7% 9% 11% 13% 15% White Person of Color 6% Minnesota Department of Health Vital Records, 2010
- 20. What is StructuralInequity? • Systematic or Structural elements of society that benefit one population unfairly. • Finance • Housing • Transportation • Education • Social Opportunities • ETC… From Minnesota Department of Health Office of Health Statistics, Advancing Health Equity in Minnesota, 2014
- 21. Who graduates ontime?
- 22. Structural Inequity Employment Financial Security Ability to payhigh property tax Access to Quality School System Education
- 23. Structural Inequity Employment Financial Security Ability to payhigh property tax Access to Quality School System Lower Education
- 24. Structural Inequity Unemployment Financial Security Ability to payhigh property tax Access to Quality School System Lower Education
- 25. Structural Inequity Unemployment Financial Insecurity Ability to payhigh property tax Access to Quality School System Lower Education
- 26. Structural Inequity Unemployment Financial Insecurity Inability to payhigh property tax Access to Quality School System Lower Education
- 27. Structural Inequity Unemployment Financial Insecurity Inability to payhigh property tax Lack of Access to Quality School System Lower Education
- 28. Structural Inequity Unemployment Financial Insecurity Inability to payhigh property tax Lack of Access to Quality School System Lower Education Is this Systematic?
- 29. Bloomington Unemployment 6.70% 15.60% 26.80% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% Unemployment rateLess than high school graduate Below poverty level Bloomington Unemployment Rate by Education and Poverty Level American Community Survey: 2010-2014 (5-year estimates) Employment Status
- 30. Edina Unemployment 5.10% 8.80% 28.40% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% Unemployment rateLess than high school graduate Below poverty level Edina Unemployment Rate by Education and Poverty Level American Community Survey: 2010-2014 (5-year estimates) Employment Status
- 31. Richfield Unemployment 7.70% 7.70% 27.70% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% Unemploymentrate Less than high school graduate Below poverty level Richfield Unemployment Rate by Education and Poverty Level American Community Survey: 2010-2014 (5-year estimates) Employment Status
- 32. How could educationaffect health? Braveman P, Gottlieb L. Public Health Rep. 2014 Jan-Feb;129 Suppl 2:19-31. The social determinants of health: it's time to consider the causes of the causes.
- 33. Lets look atobesity and health equity
- 34. Overweight and Obesity Leadsto… • Coronary Heart Disease • High Blood Pressure • Stroke • Type 2 Diabetes • Abnormal Body Fats • Metabolic Syndrome • Hold on there’s more…
- 35. Overweight and Obesity Leadsto… • Cancer • Osteoarthritis • Sleep Apnea • Obesity Hypoventilation Syndrome • Reproductive problems • Gallstones • Overweight and Obese children are more likely to be so as adults
- 36. Ok, who’s obesein Bloomington, Edina and Richfield?
- 37. Bloomington Overweightby Race/Ethnicity 18.3% 18.2% 25.8% 17.4% 36.5% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% White AfricanAmerican Asian Hispanic or Latino Overweight or Obese by race/ethnicity 8th, 9th and 11th grades 2013 Minnesota Student Survey, 2013 Dark bars differ significantly from White (p<0.05)
- 38. Edina Overweightby Race/Ethnicity 23.6% 10.5% 34.1% 13.1% 12.5% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% WhiteAfrican American Asian Hispanic or Latino Overweight or Obese by race/ethnicity 8th, 9th and 11th grades 2013 Minnesota Student Survey, 2013 Dark bars differ significantly from White (p<0.05)
- 39. Richfield Overweightby Race/Ethnicity 17.5% 18.2% 30.60% 35.7% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% White AfricanAmerican Hispanic or Latino Overweight or Obese by race/ethnicity 8th, 9th and 11th grades 2013 Minnesota Student Survey, 2013 Dark bars differ significantly from White (p<0.05)
- 40. Chronic Diseaseby IncomeAdults Bloomington,Edina, Richfield and Eden Prairie 12.4% 6.5% 38.1% 5.9% 2.8% 26.2% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% Diabetes Heart Attack Hypertension diagnosis Adults - Ever told by a doctor you had… <200% poverty 200%+ poverty 11.9% Hennepin County Adult SHAPE, 2010 Dark bars and light bars differ significantly from each other (p<0.05) 3.7% 6.5%
- 41. Interconnectedness If we arenot all healthy together, none of us is as healthy as we could be.
- 42. Public Health “Public healthis what we, as a society, do collectively to assure the conditions in which (all) people can be healthy.” Institute of Medicine (1988), Future of Public Health
- 43. A community effort •Health– and health equity - are created in the community by people working together to create just economic, social and environmental conditions that promote health.
- 44. Everyone needs: • Accessto economic and educational opportunities (high school graduation, access to jobs, transportation, etc.)… • The capacity to make decisions and effect change for ourselves, our families and our communities (empowerment of women, community self- governance, opportunities for civic participation, etc.)…
- 45. Everyone needs (cont’d)… •Social and environmental safety in the places we live, learn, work, worship and play (housing conditions, crime rates, school climate, social norms and attitudes, etc.) and • Culturally-competent and appropriate services when the need arises (access to health care, mental health care, financial assistance, etc.)
- 46. What needs tobe done • Achieving health equity and eliminating health disparities requires valuing everyone and making intentional, consistent efforts to address avoidable systematic inequalities, historical and contemporary injustices.
- 47. To create change •Public understanding – of what creates health • Public agenda – create expectation that we can and will address these conditions • Public/political will – to make tough choices- accountability for policies, programs
- 48. Our Approach • Continueto support BER’s work to factor in health in all policies • Building the capacity of our staff to understand and address health equity • Management team taking the Intercultural Development Inventory • Breaking down silos and asking questions • Thinking creatively on funding • Health equity work does not fit the traditional public health funding model • Collaborating • Expanding our collaborative work within BER to address health equity • Developing new relationship in the community • Strengthening existing relationships • Sharing data on health equity • Acknowledging solution will be collaboratively developed and implemented • Being patient Source: Advancing health equity: Case studies of health equity practice in four award-winning California health departments.
- 49.