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A Health Equity Focused Model For Building Healthy Communities

A Health Equity Focused Model For Building Healthy Communities. Urban Habitat January 12, 2011 Tony Iton , M.D., J.D., MPH Senior Vice President The California Endowment. Health ≠ Health care. Where You Live Matters. It Matters A LOT!. Life Expectancy by Poverty Group 2000-2003.

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A Health Equity Focused Model For Building Healthy Communities

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  1. A Health Equity Focused Model For Building Healthy Communities Urban Habitat January 12, 2011 Tony Iton, M.D., J.D., MPH Senior Vice President The California Endowment

  2. Health ≠ Health care Where You Live Matters It Matters A LOT!

  3. Life Expectancy by Poverty Group 2000-2003

  4. Tract Poverty vs. Life Expectancy

  5. Bay Area Poverty vs. Life Expectancy

  6. California Poverty vs. Life Expectancy

  7. Cost of Poverty in San Francisco Bay Area • Every additional $12,500 in household income buys one year of life expectancy • (Benefit appears to plateau at household incomes above $150,000) • Similar gradients in Baltimore, NYC, Philadelphia, Hennepin County (Minneapolis-St. Paul), Colorado, California, AND Cuyahoga County ($6304/year of life)

  8. A 30 year longitudinal study of nearly 7000 Alameda County residents from 1965 forward. Those residents with household income 1 SD above mean were 25% less likely to die prematurely, 1 SD below mean were 35% more likely to die early.

  9. Health Inequities Health Disparities Family & Culture

  10. Family & Culture Values Policy Place

  11. Building Healthy Communities

  12. Human Capital: Our Greatest Resource

  13. 10 Outcomes All children have health coverage Families have improved access to a “health home” that supports healthy behaviors Health and family-focused human services shift resources toward prevention Residents live in communities with health-promoting land-use, transportation and community development Children and their families are safe from violence in their homes and neighborhoods Communities support healthy youth development Neighborhood and school environments support improved health and healthy behaviors Community health improvements are linked to economic development Health gaps for boys and young men of color are narrowed California has a shared vision of community health

  14. Affordable Care Act?? 4. Land use 5. Neighborhoodsafety 8. Economic development

  15. “Strategic Opportunism”

  16. 10 Outcomes All children have health coverage Families have improved access to a “health home” that supports healthy behaviors Health and family-focused human services shift resources toward prevention Residents live in communities with health-promoting land-use, transportation and community development Children and their families are safe from violence in their homes and neighborhoods Communities support healthy youth development Neighborhood and school environments support improved health and healthy behaviors Community health improvements are linked to economic development Health gaps for boys and young men of color are narrowed California has a shared vision of community health

  17. The WHAT: Clustering Outcomes into Domains 10 BHC Outcomes 3 Primary Domains of Work Health home/coverage/ACA Safety/violence prevention/youth development Land use/community development/school environments/HIAP Two Overarching Themes: Economic Development Structural Racialization BMoC Immigration • All Children Have Health Coverage • Access to a Health Home • Health Services Shift Resources Toward Prevention • Health-Promoting Land-Use • Neighborhoods Safe from Violence • Communities Support Healthy Youth Development • Healthy Neighborhood & School Environments • Health Improvements Linked to Economic Development • Narrowing Health Gaps for BMOC • Shared Vision of Community Health Social Norms Change

  18. 4 Systems/Institutional Targets

  19. Current Political & Economic Landscape • Economic downturn/structural adjustment • Government contraction (devolution of programs to local level) • Assault on government • Polarized political climate • California out of step with nation • Suspicious electorate

  20. What Is Needed • Build a pan-ethnic coalition • Develop clear & galvanizing theme(s) • Cross-sectoral collaboration-radical redefinition of agency purpose (e.g. “Corrections”) • Structural analysis & “catalytic interventions” • Deepening commitment to optimizing our democratic and participatory processes

  21. Contact Information Tony Iton, MD, JD, MPH Senior Vice President The California Endowment aiton@calendow.org 510 271-4310

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