Reclaiming the Commons: Our Health and Our Education

1. Reclaiming the Commons:  Our Health and Our Education Stephen Bezruchka, MD, MPH Departments of Global Health & Health Services School of Public Health University of Washington

2. POP HEALTH QUIZ

3. POP HEALTH QUIZ

4. Sri Lanka US Adult Female Mortality 1970-2010

5. POP HEALTH QUIZ

6. POP HEALTH QUIZ

7. US County Life Expectancy Trends 1987-2007 Female Male Ezzati et. al 2008

8. POP HEALTH QUIZ

9. POP HEALTH QUIZ

10. Australia, Canada, Japan, Sweden US Maternal Mortality 1970-2010

11. POP HEALTH QUIZ

12. POP HEALTH QUIZ

14. POP HEALTH QUIZ

15. POP HEALTH QUIZ

16. 1st & 4th yr US medical student knowledge of Population Health (2002) 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.

17. POP HEALTH QUIZ

18. POP HEALTH QUIZ

19. Playing Game of Healthwithout a scoreboard

22. Measures of health of populations?

23. How healthy is the US?Health Olympics Number one Gold 1-5 _______ 6-10 _______ 11-15 _______ 16-20 _______ 21-25 _______ 26-30 _______ 31+ _______

24. HEALTH OLYMPICS 2011 5 Life expectancy 10 15 20 25 30 United Nations Human Development Report 2011

25. US County Life Expectancy Trends 1961-1983 Male Female Ezzati et. al 2008

26. US County Life Expectancy Trends 1987-2007 Female Male Ezzati et. al 2008

27. Trends FEMALE life expectancy age 50 from 1955-2007 Glei et al. 2010

28. In Phillips County,Arkansas, the birth rate among teenage girls in 2000 was 127 births per 1,000 w omen aged 15 to 19 - a rate higher than in 94 developing countries. A fifth of 20-yr old women in the US gave birth in their teens SCF State of the World's Mothers 2004

29. Youth violence Olympics—Homicide rates among youth aged 10-29 (most recent year available) from the World Health Organizations’ World Report on Violence and Health, 2002* *Austria, Finland, Ireland, Norway, Sweden and Switzerland had fewer than 20 deaths reported and therefore rates were not calculated. checking indicators

30. Population Health Concepts • Health has been improving most of the last century • Health improvements are not shared equally • Poorer people have poorer health • Early life is most critical period for health

31. Population Health Concepts • Health has been improving most of the last century • Health improvements are not shared equally • Poorer people have poorer health • Early life is most critical period for health

32. US MORTALITY RATES BY ZIP CODE INCOME Wilkinson & Pickett 2009 Spirit Level

33. Survival Rate on the Titanic 60 % 40 % 25 % 24 %

35. www.equalitytrust.org.uk 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 mobility Source: Wilkinson & Pickett, The Spirit Level (2009)

36. "more egalitarian societies (i.e., those with a less steep differential between the richest and the poorest) have better average health" pg. 59

37. Deaths attributable to excess income inequality 1 / 3 Kondo et al. 2009

38. Health and Education • Education • an epiphenomenon, not root cause • (we have most education of all countries) • Marsh, J. (2011). Class dismissed : why we cannot teach or learn our way out of inequality. New York, N.Y., Monthly Review Press. Introduction Unintended Consequences: 9-23

39. BETTER HEALTH World Bank WDR 2006 Data are for 2000 and line tracks changes 1985-2000

40. BETTER HEALTH World Bank WDR 2006 Data are for 2000 and line tracks changes 1985-2000