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Health Inequities in Spokane County Community Health Association of Spokane May 14, 2012

Health Inequities in Spokane County Community Health Association of Spokane May 14, 2012. Why Neighborhoods/Place?. What We Heard

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Health Inequities in Spokane County Community Health Association of Spokane May 14, 2012

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  1. Health Inequities in Spokane County Community Health Association of SpokaneMay 14, 2012

  2. Why Neighborhoods/Place? What We Heard “My neighborhood is better than it was when I was a kid. It’s been about six months since we’ve had a shooting within 5 blocks of my house. That’s a good distance between shootings. I remember being 2-3 years old watching out my window, watching people shoot at each other.” Focus Group Participant (income <35k)

  3. Ranking of Spokane Neighborhoods for Teenage Pregnancy

  4. Teenage Pregnancy (15 to 19 Years of Age), Spokane County Neighborhoods, 2005-2009 • Data Source: Community Health Assessment Tool (CHAT), Office of Financial Management, Washington State Department of Health, Birth Certificates ^Significantly higher than Spokane County *Significantly higher than Washington State +Significantly lower than Spokane County >Significantly lower than Washington State

  5. Ranking of Spokane Neighborhoods for Maternal Smoking

  6. Maternal Smoking, Spokane County Neighborhoods, 2005-2009 Data Source: Community Health Assessment Tool (CHAT), Office of Financial Management, Washington State Department of Health, Birth Certificates • ^Significantly higher than Spokane County • *Significantly higher than Washington State • +Significantly lower than Spokane County • >Significantly lower than Washington State

  7. Causes of Mortality (Age Adjusted Rate per 100,000) in Spokane County with Top Five Neighborhoods, ^Significantly higher than Spokane County

  8. Overall Age-Adjusted Mortality Rate (per 100,000), Spokane County Neighborhoods

  9. Overall Age-Adjusted Mortality Rate (per 100,000), Spokane County Neighborhoods, 2005-2009 Data Source: Washington State Department of Health, Death Certificates ^Significantly higher than Spokane County *Significantly higher than Washington State +Significantly lower than Spokane County >Significantly lower than Washington State

  10. Life Expectancy by Neighborhood, Spokane County – Comparison 90s vs. 00s

  11. Life Expectancy, Spokane County Neighborhood Comparison, 1990 to 1999 vs. 2000 to 2009 Data Source: Community Health Assessment Tool (CHAT), Office of Financial Management, Washington State Department of Health

  12. A Framework for Health Inequity Socio-Ecological Medical Model Individual Health Knowledge Genetics UpstreamDownstream • Race • Class • Gender • Immigration status • National Origin • Sexual orientation • Disability • Corporations & other businesses • Government agencies • Schools • Neighborhood conditions • Social • Physical • Residential segregation • Workplace conditions Social Inequities • Smoking • Nutrition • Physical activity • Violence • Chronic Stress • Infectious disease • Chronic disease • Injury (intentional / unintentional) • Infant mortality • Life expectancy Institutional Power Discriminatory Beliefs (ISMS) Risk Factors & Behaviors Disease & Injury Mortality Health Status Healthcare Access Social Factors

  13. Health is more than absence of disease; it is about economics, education, environment, empowerment, and community. The health and well being of the people is critically dependent upon the system that serves them. It must provide the best possible health with the least disparities and respond equally well to everyone." Joycelyn Elders U.S. Surgeon General 1993-1994

  14. Adrian E. Dominguez, M.S.EpidemiologistSpokane Regional Health DistrictDisease Prevention and ResponseCommunity Health Assessment, Planning , and Evaluationadominguez@spokanecounty.org509.324.1670

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