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Reclaiming the Commons:  Our Health and Our Education. Stephen Bezruchka, MD, MPH Departments of Global Health & Health Services School of Public Health University of Washington. POP HEALTH QUIZ. POP HEALTH QUIZ. Sri Lanka US Adult Female Mortality 1970-2010. POP HEALTH QUIZ.

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Reclaiming the commons our health and our education

Reclaiming the Commons:  Our Health and Our Education

Stephen Bezruchka, MD, MPH

Departments of Global Health & Health Services

School of Public Health

University of Washington




Sri Lanka US

Adult Female Mortality 1970-2010




US County Life Expectancy Trends 1987-2007

Female

Male

Ezzati et. al 2008




Australia, Canada, Japan, Sweden

US Maternal Mortality 1970-2010






1st 4th yr us medical student knowledge of population health 2002
1st & 4th yr US medical student knowledge of Population Health (2002)

Agrawal, J. R., J. Huebner, et al. (2005). "Medical students' knowledge of the U.S. health care system and their preferences for curricular change: a national survey." Acad Med 80(5): 484-8.


Pop health quiz10
POP HEALTH QUIZ Health (2002)


Pop health quiz11
POP HEALTH QUIZ Health (2002)


Playing game of health without a scoreboard

Playing Game of Health Health (2002)without a scoreboard



How healthy is the us health olympics
How healthy is the US? Health (2002)Health Olympics

Number one Gold

1-5 _______

6-10 _______

11-15 _______

16-20 _______

21-25 _______

26-30 _______

31+ _______


HEALTH OLYMPICS 2011 Health (2002)

5

Life

expectancy

10

15

20

25

30

United Nations Human Development Report 2011


US County Life Expectancy Trends 1961-1983 Health (2002)

Male

Female

Ezzati et. al 2008


US County Life Expectancy Trends 1987-2007 Health (2002)

Female

Male

Ezzati et. al 2008



In Phillips County,Arkansas, Health (2002)

the birth rate among teenage girls

in 2000 was 127 births per 1,000 w

omen aged 15 to 19

- a rate higher than in 94 developing countries.

A fifth of 20-yr old women

in the US gave birth in their teens

SCF State of the World's Mothers 2004


Youth violence Olympics Health (2002)—Homicide rates among youth aged 10-29 (most recent year available) from the World Health Organizations’ World Report on Violence and Health, 2002*

*Austria, Finland, Ireland, Norway, Sweden and Switzerland had fewer than 20 deaths reported and therefore rates were not calculated.

checking indicators


Population health concepts
Population Health Concepts Health (2002)

  • Health has been improving most of the last century

  • Health improvements are not shared equally

  • Poorer people have poorer health

  • Early life is most critical period for health


Population health concepts1
Population Health Concepts Health (2002)

  • Health has been improving most of the last century

  • Health improvements are not shared equally

  • Poorer people have poorer health

  • Early life is most critical period for health


US MORTALITY RATES BY ZIP CODE INCOME Health (2002)

Wilkinson & Pickett 2009 Spirit Level


Survival Rate on the Titanic Health (2002)

60 %

40 %

25 %

24 %


Health and social problems are worse in more unequal countries

www.equalitytrust.org.uk Health (2002)

Health and Social Problems are Worse in More Unequal Countries

  • Index of:

  • Life expectancy

  • Math & Literacy

  • Infant mortality

  • Homicides

  • Imprisonment

  • Teenage births

  • Trust

  • Obesity

  • Mental illness – incl. drug & alcohol addiction

  • Social mobility

Source: Wilkinson & Pickett, The Spirit Level (2009)


"more egalitarian societies (i.e., those with a less steep differential between the richest and the poorest) have better average health" pg. 59


Deaths attributable to differential between the richest and the poorest) have better average health" pg. 59

excess income inequality

1 / 3

Kondo et al. 2009


Health and education
Health and Education differential between the richest and the poorest) have better average health" pg. 59

  • Education

    • an epiphenomenon, not root cause

    • (we have most education of all countries)

    • Marsh, J. (2011). Class dismissed : why we cannot teach or learn our way out of inequality. New York, N.Y., Monthly Review Press. Introduction Unintended Consequences: 9-23


BETTER HEALTH differential between the richest and the poorest) have better average health" pg. 59

World Bank WDR 2006

Data are for 2000 and line tracks changes 1985-2000


BETTER HEALTH differential between the richest and the poorest) have better average health" pg. 59

World Bank WDR 2006

Data are for 2000 and line tracks changes 1985-2000


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