Tulsa Children’s Project: Addressing the social determinants of health. Jennifer Hays-Grudo, PhD George Kaiser Family Foundation Chair in Community Medicine School of Community Medicine, OU-Tulsa Principal Investigator, Tulsa Children’s Project. Tulsa Children’s Project.
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Tulsa Children’s Project: Addressing the social determinants of health
Jennifer Hays-Grudo, PhD
George Kaiser Family Foundation Chair in Community Medicine
School of Community Medicine, OU-Tulsa
Principal Investigator,Tulsa Children’s Project
Caren Calhoun, Vicki Wolfe
School of Community Medicine: Jennifer Hays-Grudo, Jerry Root
School of Social Work: Julie Miller-Cribbs, graduate assistants
College of Education: Diane Horm
Family and Children’s Services
Educare mental health & family support specialists
Center on the Developing Child: Jack Shonkoff
Graduate School of Education: Catherine Snow, Hiro Yoshikawa
Boston Children’s Hospital: William Beardslee
U of Texas, Ray Marshall School of Public Policy
Chris King, Bob Glover
George Kaiser Family Foundation (GKFF)
Annie Van Henken and Monica Basu, project officers
Children prepared to succeed in school (foundation for life-long success)
Children (birth-5) enrolled in Tulsa Educare
Early Childhood Education
Healthy Competent Children in Healthy Competent Families
Social- Emotional Health
EduCareers: Adult Education Workforce Training
Parents actively improving their own & their children’s life circumstances
Reduction in inter-generational poverty
Focus on high demand occupation: Nursing (CNA, LPN, RN)
Team-based college education (TCC, TTC)
Weekly partner support meetings
Limited slots: 10 currently enrolled
GED (Union PS)
ESL (Union PSon-site at Educare
Civic and Work Readiness
Biweekly partner support meetings
GED: 10 enrolled
ESL: 30 enrolled
One-on-one coaching through Workforce Tulsa
Enhanced Employment Planning (EEP) process
Biweekly partner support meetings
Limited seats: 4 enrolled
Socioeconomically determined factors
Social circumstances 15%
Environmental exposure 5%
Behavioral patterns 40%
Health care access 5-10%
*and their contributions to premature mortality; Schroeder, NEJM, 2007
The World Health Organization Commission defined social determinants of health as the conditions in which people are born, grow, live, work and age, including the health system.”
“The structural determinants and conditions of daily life constitute the social determinants of health and are responsible for a major part of health inequities between and within countries”
(WHO Commission on Social Determinants of Health, Final Report, 2008).
WHO Commission on Social Determinants of Health, final report, 2008.
WHO Commission on SDH (2008)
What have we been doing? (where did it get us?)
What do we see that could be done?
What do we sense from the community?
What is our deepest purpose?
What is possible? What can we begin to do?
Interventions to address SDH
Possible Disciplines Clinical medicine Behavioral science Public health Nursing Education Social work Public policy Economics Law Architecture Urban design Marketing Media Nutrition Exercise science
Public opinion/messaging research, funded by Robert Wood Johnson Foundation
Political difference on issue of imbalance:
Democrats see it as unnatural, cause for anger
Republicans see it as natural, fear effort to redistribute resources
But agree on importance of fairness and personal responsibility
The conditions in which we live and work have an enormous impact on our health, long before we ever see a doctor (social determinants of health).
It’s time we expand the way we think about health to include how to keep it, not just how to get it back (prevention).
The more we see the problem of health this way, the more opportunities we have to improve it, individually and as a society.