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The Doctor is Out: HEALTH HAPPENS WHERE YOU LIVE, LEARN, WORK & PLAY Douglas Jutte, MD, MPH Arizona Healthy Communities Conference March 19, 2014

The Doctor is out: Health Starts where you live, learn

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Page 1: The Doctor is out: Health Starts where you live, learn

The Doctor is Out: HEALTH HAPPENS

WHERE YOU LIVE, LEARN, WORK & PLAY

Douglas Jutte, MD, MPH

Arizona Healthy Communities ConferenceMarch 19, 2014

Page 2: The Doctor is out: Health Starts where you live, learn
Page 3: The Doctor is out: Health Starts where you live, learn

DEFININGHEALTH

Health

Health Care

Page 4: The Doctor is out: Health Starts where you live, learn

DEFININGHEALTH

Health

Health Care

Medical Care

Page 5: The Doctor is out: Health Starts where you live, learn

CONTRIBUTIONSTO PREMATUREDEATH

BehavioralPatterns

40%

Genetic Predisposition

30%

Environmental Exposure

5%

Social Circumstances

15%

Health Care

10%

Page 6: The Doctor is out: Health Starts where you live, learn

DEFININGHEALTH

“Health is a state of complete physical, mental

and social well-beingand not merely the absence

of disease or infirmity” – Preamble to the Constitution of the World Health Organization, June 1946

Page 7: The Doctor is out: Health Starts where you live, learn

9.9.13HEALTH AND COMMUNITY DEVELOPMENT

Page 8: The Doctor is out: Health Starts where you live, learn

SOCIAL DETERMINANTS OF HEALTH

Source: www.smartcitymemphis.com/cartoon/toxic-stress/

Page 9: The Doctor is out: Health Starts where you live, learn

TOXIC STRESS & NEURO-DEVELOPMENT

Page 10: The Doctor is out: Health Starts where you live, learn

SOCIOECONOMICGRADIENT IN HEALTH

4.7

7.3

12.4

17.6

0

5

10

15

20

ADMINISTRATIVE PROFESSIONAL AND EXECUTIVE

CLERICAL SEMI-SKILLED AND UNSKILLED

MO

RT

AL

ITY

RA

TE

PE

R 1

,00

0

BRITISH CIVIL CLASS

Mortality rate per 1,000, ages 40 to 64 years

Page 11: The Doctor is out: Health Starts where you live, learn

SOCIOECONOMIC GRADIENTCROSSES RACIAL/ETHNIC LINES

23.9

19.2

20.9

18.3

15.614.8

11.210.3

7.76.8 6.4

4

0

5

10

15

20

25

30

BLACK, NON-HISPANIC HISPANIC WHITE, NON-HISPANIC

PE

RC

EN

T O

F P

ER

SO

NS

WIT

H P

OO

R/

FAIR

HE

ALT

H

<100%

100–199%

200–399%

400%

Page 12: The Doctor is out: Health Starts where you live, learn

HEALTH DISPARITIESGLOBAL LIFE EXPECTANCIES

Page 13: The Doctor is out: Health Starts where you live, learn

HEALTH DISPARITIESSHORT DISTANCES:LARGEDIFFERENCES

WASHINGTON,DC

Source: Robert Wood Johnson Foundation, Commission to Build a Healthier America

Page 14: The Doctor is out: Health Starts where you live, learn

HEALTH DISPARITIESSHORT DISTANCES:LARGEDIFFERENCES

NEW ORLEANS

Source: Robert Wood Johnson Foundation, Commission to Build a Healthier America

Page 15: The Doctor is out: Health Starts where you live, learn

HEALTH DISPARITIESSHORT DISTANCES:LARGEDIFFERENCES

MINNEAPOLIS –ST. PAUL

Source: Robert Wood Johnson Foundation, Commission to Build a Healthier America

Page 16: The Doctor is out: Health Starts where you live, learn

IN DETERMININGYOUR HEALTH…

85201

Page 17: The Doctor is out: Health Starts where you live, learn

COMMUNITY DEVELOPMENT IS IN THEZIP CODE IMPROVEMENT BUSINESS

Page 18: The Doctor is out: Health Starts where you live, learn

AFFORDABLE HOUSING &SUPPORTIVE HOUSING

Page 19: The Doctor is out: Health Starts where you live, learn

SMALL BUSINESS& COMMUNITY INFRASTRUCTURE

Page 20: The Doctor is out: Health Starts where you live, learn

COMMUNITY DEVELOPMENT ATTACKS THE CORROSIVE EFFECTS

OF POVERTY THAT LEAD TO POOR HEALTH & REDUCED LIFE

CHANCES

Page 21: The Doctor is out: Health Starts where you live, learn

WHY WE SHOULD ALL CARE

$2.9 TRILLION

Page 22: The Doctor is out: Health Starts where you live, learn

WHY WE SHOULD ALL CARE

The U.S. Is Not Getting Good Value for its Health Dollar

Page 23: The Doctor is out: Health Starts where you live, learn

Number of people age 65 and over: 1900–2000 and projected 2010–2050

WHY WE SHOULD ALL CARE

Page 24: The Doctor is out: Health Starts where you live, learn

WHY WE SHOULD ALL CARE

“Every child

is precious”

Page 25: The Doctor is out: Health Starts where you live, learn

THE STATUS QUO ISSTUPID AND EXPENSIVE

WE SPEND MONEY ON THE WRONG THINGS

vsPRISON PRESCHOOL

vsSPECIAL EDUCATION TUTORS

vsEMERGENCY ROOM VISITS SUMMER CAMPS

vsPOLICE JOB TRAINING

Page 26: The Doctor is out: Health Starts where you live, learn

COMMUNITY DEVELOPMENT AND HEALTHWORK SIDE-BY-SIDE

Page 27: The Doctor is out: Health Starts where you live, learn

COMMUNITY DEVELOPMENT AND HEALTH COULD BE A POWERFUL TEAM…

COMMUNITY

DEVELOPMENTHEALTH

Page 28: The Doctor is out: Health Starts where you live, learn

…BUT WE NEED MORECOORDINATION & INTEGRATION

COMMUNITY

DEVELOPMENTHEALTH

Page 29: The Doctor is out: Health Starts where you live, learn

AND WE NEEDMORE PARTNERS

COMMUNITY

DEVELOPMENTHEALTH

EDUCATIONPUBLIC

SAFETY

ECONOMIC

DEVELOPMENT

COMMUNITY

EMPOWERMENT

Page 30: The Doctor is out: Health Starts where you live, learn

IT REQUIRESALL HANDS ON DECK

COMMUNITY

DEVELOPMENTHEALTH

EDUCATIONPUBLIC

SAFETY

ECONOMIC

DEVELOPMENT

COMMUNITY

EMPOWERMENT

Page 31: The Doctor is out: Health Starts where you live, learn

NATIONAL PARTNERSHIP FOR COMMUNITY DEVELOPMENT & HEALTHBUILDHEALTHYPLACES.ORG

Page 32: The Doctor is out: Health Starts where you live, learn

BRIGHT EYES

Page 33: The Doctor is out: Health Starts where you live, learn

THE DOCTOR IS OUT: HEALTH HAPPENS WHERE YOU LIVE, LEARN, WORK & PLAY

Douglas Jutte, MD, MPHSchool of Public Health, University of California, Berkeley

[email protected]

www.buildhealthyplaces.org