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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

slide4
Sri Lanka US

Adult Female Mortality 1970-2010

slide7
US County Life Expectancy Trends 1987-2007

Female

Male

Ezzati et. al 2008

slide10
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.

how healthy is the us health olympics
How healthy is the US?Health Olympics

Number one Gold

1-5 _______

6-10 _______

11-15 _______

16-20 _______

21-25 _______

26-30 _______

31+ _______

slide24
HEALTH OLYMPICS 2011

5

Life

expectancy

10

15

20

25

30

United Nations Human Development Report 2011

slide25
US County Life Expectancy Trends 1961-1983

Male

Female

Ezzati et. al 2008

slide26
US County Life Expectancy Trends 1987-2007

Female

Male

Ezzati et. al 2008

slide28
In Phillips County,Arkansas,

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

slide29
Youth violence Olympics—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 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 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
slide32
US MORTALITY RATES BY ZIP CODE INCOME

Wilkinson & Pickett 2009 Spirit Level

health and social problems are worse in more unequal countries
www.equalitytrust.org.ukHealth 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)

slide36
"more egalitarian societies (i.e., those with a less steep differential between the richest and the poorest) have better average health" pg. 59
slide37
Deaths attributable to

excess income inequality

1 / 3

Kondo et al. 2009

health and education
Health and Education
  • 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
slide39
BETTER HEALTH

World Bank WDR 2006

Data are for 2000 and line tracks changes 1985-2000

slide40
BETTER HEALTH

World Bank WDR 2006

Data are for 2000 and line tracks changes 1985-2000

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