Dr. Kinney reviews where we stand in health care, how it relates to the underserved, and what we can do to change it!

1. START YOUR PRE-TEST THANK YOU! SERVING THE UNDERSERVED POPULATIONS OF IL: FACING FAILURE AND CHOOSING CHANGE Deleshia “Dyi” Kinney, M.D., M.A.T. Health Care Advocate www.drkinney.webnode.com

2. START YOUR PRE-TEST THANK YOU! ACKNOWLEDGEMENTS 2008 IL WOMEN'S HEALTH CONFERENCE IL Dept. of Public Health Special Thanks to: Brenda Blasko Marbella Marsh IL Dept. of Public Health Ann Locke & Sandra Woods Springfield Urban League Health Initiative

5. START YOUR PRE-TEST THANK YOU! WHERE WE STAND The Common Wealth Fund: The National Scorecard The Agency for Health care Research & Quality (AHRQ): National Healthcare Disparities Report

6. START YOUR PRE-TEST THANK YOU! National Scorecard DIMENSIONS OF HIGH PERFORMANCE HEALTH SYSTEM (2006 – 2008)‏

7. START YOUR PRE-TEST THANK YOU! National Scorecard 67 65 2006 2008 OVERALL

8. START YOUR PRE-TEST THANK YOU! National Scorecard 70 71 2006 2008 EQUITY

10. START YOUR PRE-TEST THANK YOU! AHRQ 2.3% 1.5% 1994-2005 1999 - 2005 OVERALL RATE OF IMPROVEMENT

13. START YOUR PRE-TEST THANK YOU! Public Health “ ... the combination of science, practical skills, and values directed to the maintenance and improvement of the health of all the people. It is a set of efforts organised by society to protect, promote, and restore the people's health through collective and social action. ...but the goal remains the same - to reduce the amount of disease, premature death, and disease-produced discomfort and disability in the populations.”

14. START YOUR PRE-TEST THANK YOU! CONCLUSION SYSTEM IS BROKEN

19. START YOUR PRE-TEST THANK YOU! HEALTH INEQUALITY “… is the generic term used to designate differences, variations, and disparities in the health achievements and risk factors of individuals and groups…that need not imply moral judgment… Refer to measurable differences in outcomes.

20. START YOUR PRE-TEST THANK YOU! HEALTH INEQUITY “ ... health equity concerns those differences in population health that can be traced to unequal economic and social conditions and are systemic and avoidable – and thus inherently unjust and unfair.” Refers to stronger view that unfair differences could be changed if willing

25. START YOUR PRE-TEST THANK YOU! SOCIAL DETERMINANTS OF HEALTH HEALTH POLITICAL POLICY SOCIETY CHRONIC STRESS INEQUALITY CHOICES CONTROL RACISM CONTROL

27. RESPONSIBILITY VS .

30. START YOUR PRE-TEST THANK YOU! CHANGE APPROACH Conventional question: How can we promote healthy behavior? Health equity question: How can we target dangerous conditions and reorganize land use and transportation policies to ensure healthy spaces and places? Conventional: How can we reduce disparities in the distribution of disease and illness? Health equity: How can we eliminate inequities in the distribution of resources and power that shape health outcomes? Conventional: How can individuals protect themselves against health disparities? Health equity: What kinds of community organizing and alliance building are necessary to protect communities?

32. CHANGE SOCIAL POLICY HEALTH POLICY

35. WHERE TO START CHANGE Encourage Civic Engagement Stay connected! Realize change isn't easy but NOT impossible .

39. WHERE TO START CHANGE: you!!!! THANK YOU !!! .