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PolicyDevelopmenttoTackleStructuralOriginsofHealthInequi=es:
ThoughtsOnBestPrac=ces
JimBloyd,MPHRegionalHealthOfficer,CookCounty
DepartmentofPublicHealthStrengtheningtheCapacityofPublicHealth
DepartmentstoAdvanceHealthEquityApril12,2016CDCTomHarkinGlobalCommunica=onsCenter,Atlanta,Georgia
Outline
• CookCounty(Illinois)Context• Whatisourcausalframework:‘nothingasprac=calasagoodtheory….’
• ‘bestprac=ce’thoughtsonpolicytotacklehealthinequi=es
Cook County Department of Public Health 3
USFederalGovernmentcreatedwealthforwhitepeople1930’s…
RecordsoftheFederalHomeLoanBankBoard[FHLBB].(n.d.).[Webpage].Retrievedfromh]p://www.archives.gov/research/guide-fed-records/groups/195.html#195.
HomeequitystrippingofBlackandBrownneighborhoodstoday…
CookCountyDepartmentofPublicHealth 5
Source:CountyofCook,IllinoisvWellsFargoCaseNo:14-cv-9548(FiledNovember2014)
6
MapofChildOpportunityinCookCounty(Source:Diversitydatakids.org)ChildreninCookCountygrowupinneighborhoodswithstark,unfairdifferencesinopportunityforhealthydevelopment.Na=onally,40%ofBlackand32%ofHispanicchildrenliveinverylow-opportunityneighborhoodscomparedto9%ofWhitechildren.(Acevedo-Garcia,etal2015)
CookCountyDepartmentofPublicHealth 7Source:CenterforTaxandBudgetAccountability.(2015)h]p://bit.ly/1qB3qeA
PoorBlackchildrenexposedtoneighborhoodpovertymetroChicago
CookCountyDepartmentofPublicHealth 8Source:ChildrenLeiBehind(2007)h]p://diversitydata.sph.harvard.edu
PoorLa=nochildrenexposedtoneighborhoodpovertymetroChicago
CookCountyDepartmentofPublicHealth 9Source:ChildrenLeiBehind(2007)h]p://diversitydata.sph.harvard.edu
#16Shots#LaQuanMcDonald
CookCountyDepartmentofPublicHealth 10
CookCountyDepartmentofPublicHealth 11
12.24.2016#BlackChristmasMagMileChicagoProtest
CookCountyDepartmentofPublicHealth 12
Ourviewsinformpolicyandstrategy:Graham’ssimplifiedmodel
CookCountyDepartmentofPublicHealth 13
Source:Graham,H.(2007)Unequallives:HealthandsocioeconomicinequaliHes.
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
Ourviewsinformpolicyandstrategy:WHOConceptualFramework
CookCountyDepartmentofPublicHealth 15
Source:Solar&Irwin(2010)AconceptualframeworkforacHononthesocialdeterminantsofhealth..
Publichealthvaluesðicsshouldguidepolicydevelopment
• SocialJus=ce• HealthisaHumanRight&“humanshavearighttotheresourcesnecessaryforhealth”(p2PrinciplesoftheEthicalPracHceofPublicHealth)
• Addressingfundamental&systemiccausesofhealth“ismoretrulypreven=ve”(PHLeadershipSociety2002p6)
• CCDPHMission:“…toachieveheathequity”• CCDPHWePLAN2020priority-Healthinequity
CookCountyDepartmentofPublicHealth 16
StructuralRacism:WePLAN2020Priority
CookCountyDepartmentofPublicHealth 17
www.cookcountypublichealth.orgh]p://www.cookcountypublichealth.org/about/weplan-feedbackWePLAN2020ForcesofChangeAssessmenth]p://bit.ly/1V5sKWRHealthIssuePriori=za=onProcessSummaryh]p://bit.ly/1VEKWF6
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
FrameworkusedintheCCDPHForcesofChangeFocusGroups
CookCountyDepartmentofPublicHealth 19
CookCountyDPHjurisdic=onisfourDistricts4Focusgroups/loca=ons26people/mul=-sectorCityofChicago-(Grey)
CookCountyDepartmentofPublicHealth 20
Ques=onsusedinthe
CCDPHForcesofChange
FocusGroups
CookCountyDepartmentofPublicHealth 21
CookCountyDepartmentofPublicHealth 22
‘Pa]erns’Results
CookCountyDepartmentofPublicHealth 23
‘Power/Interests’Results
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
CookCountyDepartmentofPublicHealth 25
CHECookCounty.org@CHECookCounty
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
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
