1 / 49

Health Equity

Health Equity. March 21, 2016. What is health?. “Health is a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity.” World Health Organization 1948. Public Health.

barneyg
Download Presentation

Health Equity

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Health Equity March 21, 2016

  2. What is health? “Health is 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 health is 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 determine health Tarlov AR. Public policy frameworks for improving population health. Ann N Y AcadSci 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 of Health External environments and conditions that contribute to health or lack of health.

  7. Health Equity Attainment of the 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: Diabetes by Income Level, Minnesota 2010

  9. Health Inequity Health Inequity—Differences in 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: Diabetes by Income Level, Minnesota 2010 Source: CDC Behavioral Risk Factor Surveillance System Percentages are weighted to population characteristics.

  11. Structural inequities • Structures or 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 by structural 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 and structural 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 in Minnesota 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: Redlining and Infant Mortality in Minneapolis, MN

  16. Infant mortality rates in Minneapolis by neighborhood, 2001-2010

  17. Comparison: Redlining and Infant Mortality 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. 7% 7% Low Birth Weight (singletons) by Race, 2011Bloomington, Richfield White Black/African American White Black/African American Minnesota Department of Health Vital Records, 2010

  19. 6% Preterm Births (singletons) by Race, 2011Edina Minnesota Department of Health Vital Records, 2010

  20. What is Structural Inequity? • 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 on time?

  22. Structural Inequity

  23. Structural Inequity

  24. Structural Inequity

  25. Structural Inequity

  26. Structural Inequity

  27. Structural Inequity

  28. Structural Inequity Is this Systematic?

  29. Bloomington Unemployment American Community Survey: 2010-2014 (5-year estimates) Employment Status

  30. Edina Unemployment American Community Survey: 2010-2014 (5-year estimates) Employment Status

  31. Richfield Unemployment American Community Survey: 2010-2014 (5-year estimates) Employment Status

  32. How could education affect health? BravemanP, Gottlieb L. Public Health Rep. 2014 Jan-Feb;129 Suppl2:19-31. The social determinants of health: it's time to consider the causes of the causes.

  33. Lets look at obesity and health equity

  34. Overweight and Obesity Leads to… • Coronary Heart Disease • High Blood Pressure • Stroke • Type 2 Diabetes • Abnormal Body Fats • Metabolic Syndrome • Hold on there’s more…

  35. Overweight and Obesity Leads to… • 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 obese in Bloomington, Edina and Richfield?

  37. 18.3% Bloomington Overweight by Race/Ethnicity Dark bars differ significantly from White (p<0.05) Minnesota Student Survey, 2013

  38. EdinaOverweight by Race/Ethnicity 23.6% Dark bars differ significantly from White (p<0.05) Minnesota Student Survey, 2013

  39. Richfield Overweight by Race/Ethnicity 17.5% Dark bars differ significantly from White (p<0.05) Minnesota Student Survey, 2013

  40. 3.7% 6.5% Chronic Disease by Income AdultsBloomington, Edina, Richfield and Eden Prairie Dark bars and light bars differ significantly from each other (p<0.05) Hennepin County Adult SHAPE, 2010

  41. Interconnectedness If we are not all healthy together, none of us is as healthy as we could be.

  42. Public Health “Public health is 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: • Access to 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 to be 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 • Continue to 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. Questions

More Related