Health Equity, WePLAN2020, & Community Health

Improvement Planning at the Cook County

Department of Public Health

Jim Bloyd, MPH, DrPH(c)Regional Health Officer

October 25, 2017PH370 Using the Public Health Toolbox

University of Illinois at Chicago School of Public Health

Cook County Department of Public Health

But stand up, you, stand up, but stand up with me and let us go off together to fight face to face against the devil’s webs, against the system that distributes hunger, against organized misery.

(Pablo Neruda, 1972, p. 99, cited by Pickett & Dorling, (2010).

Pero levántate, tú, levántate, pero conmigo levántate y salgamos reunidos a luchar cuerpo a cuerpo contra las telarañas del malvado, contra el sistema que reparte el hambre, contra la organización de la miseria.

(Pablo Neruda, 1972, p. 99, cited by Pickett & Dorling, (2010).

Source: http://www.poema-de-amor.com.ar/mostrar-poema.php?poema=13301

Cook County Department of Public Health

Our collaboration has yielded a plan that will guide the activities of both CCDPH and community partners - all of us who make up the local public health system - for the next five years. The information included here will help residents, institutions, and leaders of Cook County by informing their work to prevent illness and disease, improve population health, and move towards health equity.

Terry Mason, MDChief Operating Officer

Cook County Department of Public Health

Cook County Department of Public Health

WePLAN2020 p. 20

Cook County Department of Public Health

WePLAN2020 p.11

Cook County Department of Public Health

150 community participants

Cook County Department of Public Health

MAPP Assessment 1: Local Public Health System Assessment

• Comprehensive assessment of all of the organizations and entities that contribute to the public’s health

– What are the activities, competencies and capacities of our local public health system?

– How are the Essential Services being provided to our community?

Cook County Department of Public Health

MAPP Assessment 2: Community Health Status Assessment

• Identifies priority issues related to community health and quality of life

– How healthy are our residents?

– What does the health status of our community look like?

Cook County Department of Public Health

MAPP Assessment 3: Community Themes and Strengths

Assessment• Provides an

understanding of the issues residents think are important

– What is important to our community?

– How is quality of life perceived in our community?

– What assets do we have that can be used to improve community health?

Survey at http://ow.ly/RNBrE

Question 37

Cook County Department of Public Health

CCDPH @CookCoHealth

Tell us if housing, health svcs, jobs,

schools, transportation & recreation

support healthy living in your community.

http://ow.ly/RNBrE

Cook County Department of Public Health

MAPP Assessment 4: Forces of Change Assessment

• CCDPH Used the NACCHO’s MAPP Equity Supplement

• Identifies forces, such as legislation, technology and other issues that affect the context in which the community and its public health system operates

– What is occurring or might occur that affects the health of our community or the local public health system?

– What specific threats or opportunities are generated by these occurrences?

Questions to identify forces of change:

• What has occurred recently that may affect our local public health system or community?• What may occur in the

future?• What specific threats or

opportunities are generated by these occurrences?

• What patterns of decisions, policies, investments, rules, and laws affect the health of our community?• Who benefits from these

patterns?• Whom do these patterns

harm?• Who or what institutions have

the power to create, enforce, implement, and change these decisions, policies, investments, rules, and laws?• What interests support or

oppose actions that contribute to health inequity?

Forces of change: environmental forces – factors, trends, or events, that are or will affect the

community and the local public health system

Social determinants of health: resources necessary for social and physical environments for

good health for allHousing * Money * Wealth * Education * Transportation *

Health Care * Community Design * Food & Agriculture * Social Services * Employment * Working Conditions * Social Inclusion

vs. Exclusion * Public Safety* Daily Living Conditions

Health: a complete state of, physical, mental, and social well-being and not merely the

absence of disease or infirmity (WHO 1948)Health equity: the realization by all people of

the highest attainable level of health (Troutman)

A Forces of Change Assessment Framework Emphasizing the Social Determinants of Health

Cook County Department of Public Health

Cook County Department of Public Health

WePLAN2020

People without great wealth have power when they unite to advocate

for their interests. This happens through social movements, advocacy

of elected officials, and requires organizing.

Forces of Change Assessment page 1.

Cook County Department of Public Health

Healthy weight & household income< 25th percentile

Extremely obese & household income > 75th percentile

Healthy weight & household income > 75th percentile

Adapted from Vega & Sribney 2017 Fig 1:Association of Body Mass Index With Age of First Onset of Functional Limitations, by Income Group: Health and Retirement Survey, United States, 2015

Cook County Department of Public Health

Association of Body Mass Index With Age of First Onset of Functional Limitations, by Income Group: Health and Retirement Survey,

United States, 2015 (Vega & Sribney 2017)

Cook County Department of Public Health

References/Resources1. Chaufan, C., Yeh, J., Ross, L., & Fox, P. (2014). You can’t walk or bike yourself out of the health effects of poverty: Active school

transport, child obesity, and blind spots in the public health literature. Critical Public Health. doi:10.1080/09581596.2014.920078

1. Collaborative for Health Equity Cook County www.CHECookCounty.org info@checookcounty.org twitter: @CHECookCounty

1. Cook County Department of Public Health. (2016). WePLAN 2020 forces of change assessment. Retrieved from https://docs.wixstatic.com/ugd/5dd873_a66a75b7c9024166a7c7dfdfcb39c567.pdf

2. Cook County Department of Public Health. (2016). WePLAN2020 improving community health and health equity for suburban cook county . Oak Forest, Illinois. Retrieved from http://cookcountypublichealth.org/files/pdf/weplan/weplan2020-report-111416-final-lr-for-viewing-online.pdf

3. Grotto, J. (2017). Tribune watch dog the tax divide. Chicago Tribune. Retrieved from http://apps.chicagotribune.com/news/watchdog/cook-county-property-tax-divide

4. Human Impact Partners (2017). HealthEquityGuide.org A Human Impact Partners Project. Local health departments are building power for health equity.

5. ILGA.Gov. SECTION 600.410 REQUIREMENTS FOR IPLAN OR AN EQUIVALENT PLANNING PROCESS Joint Committee on Administrative Rules Administrative Code. (2017). Retrieved from http://www.ilga.gov/commission/jcar/admincode/077/077006000D04100R.htm

6. Medvedyuk, S., Ali, A., & Raphael, D. (2017). Ideology, obesity and the social determinants of health: A critical analysis of the obesityand health relationship. Critical Public Health, 1-13. doi:10.1080/09581596.2017.1356910

7. Muntaner, C., Sridharan, S., Solar, O., & Benach, J. (2009). Commentary: Against unjust global distribution of power and money: The report of the who commission on the social determinants of health: Global inequality and the future of public health policy. Journal of Public Health Policy, 30(2), 163-175. doi:10.2307/40207234

8. National Association of County & City Health Officials. (2014) Mobilizing and Organizing Partners To Achieve Health Equity (Equity Supplement). NACCHO: Washington, DC.

9. Pickett, K. E., & Dorling, D. (2010). Against the organization of misery? The marmot review of health inequalities. Social Science & Medicine (1982), 71(7), 1231-3; discussion 1254-8. doi:10.1016/j.socscimed.2010.07.013

10. Public Health Leadership Society. (2002). Principles of the ethical practice of public health. [Pamphlet] Retrieved from http://www.apha.org/NR/rdonlyres/1CED3CEA-287E-4185-9CBD-BD405FC60856/0/ethicsbrochure.pdf

1. Solar, O., & Irwin, A. (2010). A conceptual framework for action on the social determinants of health. Social determinants of health discussion paper 2 (policy and practice) [The Series: The Discussion Paper Series on Social Determinants of Health provides a forum for sharing knowledge on how to tackle the social determinants of health to improve health equity. Geneva: World Health Organization. http://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf

Cook County Department of Public Health

CCDPH serves suburban Cook County

• 125 municipalities, 30 townships, 1000+ schools

• Inequities: Wealthiest and poorest populations

• One of 6 certified health departments in the County

• Jurisdiction: suburban Cook County not served by a municipal certified public health department

• Question: Who governs CCDPH?

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Map: Cook County, IL with 4 Forces of Change Assessment Focus Group Locations

Cook County Department of Public Health

Contact Information

Jim Bloyd, MPH, DrPH(c)

Regional Health Officer

Community Epidemiology and Health Planning

708-633-8314

Jbloyd@cookcountyhhs.org

cookcountypublichealth.org