Local Public Health; Agents for Health Equity

1. Local Public Health; Agents for Health Equity Adewale Troutman,M.D., M.A., M.P.H. University of Louisville Louisville Department of Public Health and Wellness

2. Core Public Health Functions • Assessment • Assess the health needs of the community • Investigate the occurrence of health effects and health hazards in the community • Analyze the determinants of identified health needs • Policy development • Advocate for public health, build constituencies, and identify resources in the community • Set priorities among health needs • Develop plans and policies to address priority health needs • Assurance • Manage resources and develop organizational structures • Implement programs • Evaluate programs and provide quality assurance • Inform and educate the public

3. Monitor health status Diagnose and investigate health problems Inform and educate Mobilize communities to address health problems Develop policies and plans Enforce laws and regulations Link people to needed health services Assure a competent health services workforce Evaluate health services Conduct research for new innovations The Essential Public Health Services

4. Healthy People 2010 • Two Goals • Increase Quality and Years of Health Life • Eliminate Health Disparities

5. Health • “The presence of physical, psychological, social, economic and spiritual well being not merely the absence of disease or infirmity” • “The maintenance of a harmonious balance of mind, body and spirit” • Community and individual

6. Equity • Justice according to natural law or right • Freedom from bias or favoritism

7. Health Equity • “The absence of unfair and avoidable or remediable differences in health among social groups” ( The Commission ) • A value position supported by an evidence base • There is and will be political opposition to the core value of health equity

8. Health inequities are systemic, avoidable, unfair and unjust differences in health status and mortality rates and in the distribution of disease and illness across population groups. They are sustained over time and generations and beyond the control of individuals

9. “The time has come to herald human rights as both the foundation of public health and the compass of public policy”JAPHA 2000

10. Looking Upstream

11. Determinants of Health; A Holistic Approach • Social and Economic Environment • Physical Environment • Health Behaviors • Health Care Access • Policies & The Political Environment • The Balance of Power • Genetics/Biology

12. Why Social Determinants?

13. Socioeconomic Status • Occupation • Education • Income • Income gaps • Racism & discrimination • Housing • Political power

14. Social Determinants ( WHO ) • The Social Gradient • Stress • Early Life • Social Exclusion • Work • Unemployment • Social Support • Addiction • Food • Transport

15. Housing

16. Public Health and the Built Environment

17. Housing and Health • Lead • Indoor air quality • Unsafe environments • Obesity • Asthma • Stress

20. Cotter Lane

21. Park DuValle

22. Park DuValle

24. Center Activities

25. Center Activities • Staff Training on Community Organizing • Staff and Community Training on Capacity Building • Community Policy Mini-grants • Speakers series • On line learning in Health Equity for consumers and state employees in health • Training in policy development

26. Activities • Food Security Task Force • Community Visioning Process • Dialogue Process- Yale University • Framing Research followed by Social Marketing Strategy • Emergency Preparedness and Health Equity/Social Justice

27. Activities • School of Public Health and Information Sciences course development • “White Paper” on Health Equity and Social Justice • Implementation of focus on HIA’s • Office of Faith and Health ( Social Justice ) • Tommie Smith Youth Athletic Initiative • Undoing Racism workshops

29. Adewale Troutman, M.D.,M.P.H.The Troutman Group5109 Forrest Grove PlaceLouisville, Ky 40059denzibell@aol.comadedrum@aol.comwww.adewaletroutman.comwww.thetroutmangroup.org