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Policy Development to Tackle Structural Origins of Health Inequities: Thoughts on Best Practices
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Transcript of Policy Development to Tackle Structural Origins of Health Inequities: Thoughts on Best Practices
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PolicyDevelopmenttoTackleStructuralOriginsofHealthInequi=es:
ThoughtsOnBestPrac=ces
JimBloyd,MPHRegionalHealthOfficer,CookCounty
DepartmentofPublicHealthStrengtheningtheCapacityofPublicHealth
DepartmentstoAdvanceHealthEquityApril12,2016CDCTomHarkinGlobalCommunica=onsCenter,Atlanta,Georgia
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Outline
• CookCounty(Illinois)Context• Whatisourcausalframework:‘nothingasprac=calasagoodtheory….’
• ‘bestprac=ce’thoughtsonpolicytotacklehealthinequi=es
Cook County Department of Public Health 3
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USFederalGovernmentcreatedwealthforwhitepeople1930’s…
RecordsoftheFederalHomeLoanBankBoard[FHLBB].(n.d.).[Webpage].Retrievedfromh]p://www.archives.gov/research/guide-fed-records/groups/195.html#195.
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HomeequitystrippingofBlackandBrownneighborhoodstoday…
CookCountyDepartmentofPublicHealth 5
Source:CountyofCook,IllinoisvWellsFargoCaseNo:14-cv-9548(FiledNovember2014)
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MapofChildOpportunityinCookCounty(Source:Diversitydatakids.org)ChildreninCookCountygrowupinneighborhoodswithstark,unfairdifferencesinopportunityforhealthydevelopment.Na=onally,40%ofBlackand32%ofHispanicchildrenliveinverylow-opportunityneighborhoodscomparedto9%ofWhitechildren.(Acevedo-Garcia,etal2015)
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CookCountyDepartmentofPublicHealth 7Source:CenterforTaxandBudgetAccountability.(2015)h]p://bit.ly/1qB3qeA
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PoorBlackchildrenexposedtoneighborhoodpovertymetroChicago
CookCountyDepartmentofPublicHealth 8Source:ChildrenLeiBehind(2007)h]p://diversitydata.sph.harvard.edu
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PoorLa=nochildrenexposedtoneighborhoodpovertymetroChicago
CookCountyDepartmentofPublicHealth 9Source:ChildrenLeiBehind(2007)h]p://diversitydata.sph.harvard.edu
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#16Shots#LaQuanMcDonald
CookCountyDepartmentofPublicHealth 10
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CookCountyDepartmentofPublicHealth 11
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12.24.2016#BlackChristmasMagMileChicagoProtest
CookCountyDepartmentofPublicHealth 12
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Ourviewsinformpolicyandstrategy:Graham’ssimplifiedmodel
CookCountyDepartmentofPublicHealth 13
Source:Graham,H.(2007)Unequallives:HealthandsocioeconomicinequaliHes.
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We have repeatedly referred to Hilary Graham’s warning about the tendency to conflate the social determinants of health and the social processes that shape these
determinants’ unequal distribution, by lumping the two phenomena together under a single label. Maintaining the distinction is
more than a matter of precision in language. As Graham argues, blurring these concepts
may lead to seriously misguided policy choices.
[emphasisadded]Source:Solar&Irwin(2010)p.47
CookCountyDepartmentofPublicHealth 14
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Ourviewsinformpolicyandstrategy:WHOConceptualFramework
CookCountyDepartmentofPublicHealth 15
Source:Solar&Irwin(2010)AconceptualframeworkforacHononthesocialdeterminantsofhealth..
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Publichealthvaluesðicsshouldguidepolicydevelopment
• SocialJus=ce• HealthisaHumanRight&“humanshavearighttotheresourcesnecessaryforhealth”(p2PrinciplesoftheEthicalPracHceofPublicHealth)
• Addressingfundamental&systemiccausesofhealth“ismoretrulypreven=ve”(PHLeadershipSociety2002p6)
• CCDPHMission:“…toachieveheathequity”• CCDPHWePLAN2020priority-Healthinequity
CookCountyDepartmentofPublicHealth 16
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StructuralRacism:WePLAN2020Priority
CookCountyDepartmentofPublicHealth 17
www.cookcountypublichealth.orgh]p://www.cookcountypublichealth.org/about/weplan-feedbackWePLAN2020ForcesofChangeAssessmenth]p://bit.ly/1V5sKWRHealthIssuePriori=za=onProcessSummaryh]p://bit.ly/1VEKWF6
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CCDPH @CookCoHealth Tell us if housing, health svcs, jobs, schools, transportation & recreation support healthy living in your community. http://ow.ly/RNBrE
June-October,2015:ForcesofChangeAssessmentJune-October:CommunityThemes&StrengthsAssessmentSeptember1:LocalPublicHealthSystemAssessmentMee=ngJune-October:CommunityHealthStatusAssessmentOctober2015-January2016:CommunityPartner&StrategyMee=ngs
CookCountyDepartmentofPublicHealth 18
4MAPPassessmentsplannedbyCCDPHstaffcommi]ees
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FrameworkusedintheCCDPHForcesofChangeFocusGroups
CookCountyDepartmentofPublicHealth 19
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CookCountyDPHjurisdic=onisfourDistricts4Focusgroups/loca=ons26people/mul=-sectorCityofChicago-(Grey)
CookCountyDepartmentofPublicHealth 20
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Ques=onsusedinthe
CCDPHForcesofChange
FocusGroups
CookCountyDepartmentofPublicHealth 21
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CookCountyDepartmentofPublicHealth 22
‘Pa]erns’Results
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CookCountyDepartmentofPublicHealth 23
‘Power/Interests’Results
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Iden=fy&confrontsystemsofprivilege,dominance
You don't even have to be aware of it to receive
the benefit. And the thing that's really slick
about whiteness, if you will, is that most of the
benefits can be obtained without ever doing
anything personally.
john powell Source: Interviewwithjohna.powelleditedtranscript(2003)CaliforniaNewsreel
CookCountyDepartmentofPublicHealth 24
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CookCountyDepartmentofPublicHealth 25
CHECookCounty.org@CHECookCounty
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Power, after all, is the heart of the matter—and
the science of health inequities can no more
shy away from this question than can physicists
ignore gravity or physicians ignore pain. Jason Beckfield & Nancy Krieger
Source: EpidemiologicReviews,31,152-77(2009) p. 169
CookCountyDepartmentofPublicHealth 26
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Thankyou
CookCountyDepartmentofPublicHealth 27
JimBloyd,MPHRegionalHealthOfficerCookCountyDepartmentofPublicHealth15900S.CiceroAvenueOakForest,[email protected]
Acknowledgements:• FocusGroupPar=cipants• DeyaGreer,MA,Na=onalAssocia=onof
County&CityHealthOfficials• TiffanyHuang,MPH,Na=onalAssocia=onof
County&CityHealthOfficials• JosephZanoni,PhD,UniversityofIllinoisat
Chicago,SchoolofPublicHealth