Life & Death From Unnatural Causes: Does The American Approach to Health Make Sense? Beyond Health...
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Life & Death From Unnatural Life & Death From Unnatural Causes: Causes: Does The American Does The American Approach to Health Make Sense? Approach to Health Make Sense? Beyond Health Care Coverage: Major Beyond Health Care Coverage: Major Policy Forum To Address Inequality Policy Forum To Address Inequality and Health Disparities in America and Health Disparities in America February 23, 2009 February 23, 2009 Commonwealth Club Commonwealth Club Tony Iton, M.D., J.D., MPH Tony Iton, M.D., J.D., MPH Director Alameda County Public Health Department Director Alameda County Public Health Department
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Transcript of Life & Death From Unnatural Causes: Does The American Approach to Health Make Sense? Beyond Health...
Life & Death From Unnatural Life & Death From Unnatural Causes:Causes: Does The American Does The American
Approach to Health Make Approach to Health Make Sense?Sense?
Beyond Health Care Coverage: Major Beyond Health Care Coverage: Major Policy Forum To Address Inequality and Policy Forum To Address Inequality and
Health Disparities in AmericaHealth Disparities in America
February 23, 2009February 23, 2009Commonwealth ClubCommonwealth Club
Tony Iton, M.D., J.D., MPHTony Iton, M.D., J.D., MPHDirector Alameda County Public Health DepartmentDirector Alameda County Public Health Department
Health Health ≠≠ Health care Health care
Health Disparities Health Disparities ≠ ≠
Health Care Health Care DisparitiesDisparities
Race and Racism Matters: Race and Racism Matters: Health Inequities by Race/EthnicityHealth Inequities by Race/Ethnicity
2.3 years4.9 years
7.8 years
Life Expectancy by Poverty Group 2000-2003Life Expectancy by Poverty Group 2000-2003
Alameda County
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
Lif
e E
xp
ecta
ncy (
Years
)
Alameda County
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
Lif
e E
xp
ecta
ncy (
Years
)
San Francisco County
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
Lif
e E
xp
ecta
ncy (
Years
)
Contra Costa County
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
Lif
e E
xpect
an
cy (
Years
)
Tract Poverty vs. Life Expectancy
BARHII Life Expectancy and Poverty by Tract
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
Lif
e E
xp
ecta
ncy (
Years
)
Bay Area Poverty vs. Life Expectancy
Cost of Poverty in San Cost of Poverty in San Francisco Bay AreaFrancisco Bay Area
Every additional $12,500 in Every additional $12,500 in household income buys one year household income buys one year of life expectancyof life expectancy
(Benefit appears to plateau at household (Benefit appears to plateau at household incomes above $150,000)incomes above $150,000)
Similar gradients in Baltimore, NYC, Similar gradients in Baltimore, NYC, Philadelphia, Hennepin County, Colorado, Philadelphia, Hennepin County, Colorado, CaliforniaCalifornia
Alameda County Alameda County Public Health DepartmentPublic Health Department
Community Capacity Building
Internal Capacity Building
Local Policy Agenda
HEALTH EQUITY
http://www.acphd.org/healthequity
Alameda County Alameda County Public Health DepartmentPublic Health Department
Community Capacity Building
Internal Capacity Building
Local Policy Agenda
HEALTH EQUITY
http://www.acphd.org/healthequity
West Oakland Beat 6X
743 Households41% Poverty
71% African-Am.
Sobrante Park
Beat 31Z
837 Households21% Poverty Rate57% African-Am.
34% Latino
Project DescriptionProject DescriptionBuilding social, political and economic Building social, political and economic
power in low-income communities of power in low-income communities of colorcolor
Civic ParticipationCivic Participation Increased in Increased in Sobrante Park Between ’04 Sobrante Park Between ’04
and ’07and ’07
24%29% 29%
44%
38%35%
0%
10%
20%
30%
40%
50%
*Attended a BBQ orblock party
*Met with Neighbors todo something about SP
Voiced opinon about anissue
2004 2007
Alameda County Alameda County Public Health DepartmentPublic Health Department
Community Capacity Building
Internal Capacity Building
Local Policy Agenda
HEALTH EQUITY
http://www.acphd.org/healthequity
Why We Did the Report Health and social inequities have Health and social inequities have
an overwhelming negative impact an overwhelming negative impact on Alameda County residentson Alameda County residents
Alameda County Public Health Alameda County Public Health Department is focused on Department is focused on addressing health and social addressing health and social inequities through multiple inequities through multiple methodsmethods
The release of The release of Unnatural Causes Unnatural Causes series and the report provide an series and the report provide an opportunity for working across opportunity for working across multiple sectors to achieve health multiple sectors to achieve health equity.equity.
Report Chapters
• Executive Summary• Introduction• Part One: Health Inequities• Part Two: Social Inequities
• Historical Overview• What Research Tells Us• A Look at Alameda
County• Data to Action: Policy
Implications
• Social Inequities: Root Causes of Health Inequities• Segregation• Income & Employment• Education• Housing• Transportation• Air Quality• Food Access & Liquor Stores• Physical Activity & Neighborhood Conditions• Criminal Justice• Access to Health Care• Social Relationships & Community Capacity
Income & Employment:Income & Employment:Paid Sick DaysPaid Sick Days
40% California workers do not receive a single 40% California workers do not receive a single paid sick day. paid sick day.
Low wage workers most in need of paid sick Low wage workers most in need of paid sick days are the least likely to receive it.days are the least likely to receive it.
HIA:HIA: Reduce flu spreadReduce flu spread Reduce food borne disease, and nursing home Reduce food borne disease, and nursing home
and school communicable disease spreadand school communicable disease spread
Looking At OurselvesLooking At Ourselves
Internal Capacity BuildingInternal Capacity Building
Alameda County Alameda County Public Health DepartmentPublic Health Department
Community Capacity Building
Internal Capacity Building
Local Policy Agenda
HEALTH EQUITY
http://www.acphd.org/healthequity
Internal Capacity Building ActivitiesSharing the visionLeadership and Professional Development ProgramsPH 101 staff training Institutional Racism discussions
Strategic Plan focused on Social Justice
Public Health 101Public Health 101
Module 1: PH History; Public Health SystemCore Functions & 10 Essential ServicesModule 2:
Cultural Competency and Cultural Humility
Module 3: Undoing Racism
Module 4: Health Status/InequitiesSocial Determinants of Health
Module 5: Community Capacity Building
DiseaseBehaviorCommunity
Death
Diseased SocietalDecision
Processes
DeathBiased
Behaviors(Isms)
Medical Model (individuals)Socio-Ecological (society)
Emergency Rooms
ClinicsHealth Education
Comm.CapacityBuilding
Policy Advocacy
??????
Contact InformationContact Information
Tony Iton, MD, JD, MPHTony Iton, MD, JD, MPHDirector and Health OfficerDirector and Health OfficerAlameda County Public Health Alameda County Public Health DepartmentDepartment
[email protected] (510) 267-8019(510) 267-8019
