prevention institute - manal oboeleta
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@preventioninst
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Antelope Valley Partners for Health Fall Wellness Summit
October 29, 2015
Photo by Rudy Espinoza
Prevention Institute
A Coordinated, Community Approach to Advancing Health, Safety, and Equity
Photo by Rudy Espinoza
Photo from glenarborsun.com
Manal Aboelata, MPH Managing Director
Maureen Silva, MPHProgram Coordinator
Julie Leung, MURP, MPHProgram Coordinator
Deepen understanding of a prevention-based community health approach to health inequities
Demonstrate knowledge of successful examples – locally and nationally – that connect community efforts to changing environments, policy, and practices
Increase capacity to prioritize community level factors that are linked to chronic disease in the Antelope Valley
Keynote Objectives
a systematic process that reduces the frequency and/or severity of illness or injury.
Promotes healthy environments and behaviors to prevent problems from occurring before the onset of symptoms
HEALTH & SAFETYBEHAVIORBEHAVIOR
ENVIRONMENT
What’s Health and Equity Got To Do
With It?
Photo Courtesy of Health and Human Services
Photo courtesy of http://spacedust.atspace.com/soccer_archery.html
Photo courtesy of Latino Health Access
It is unreasonable to expect that people will change their
behavior easily when so many forces in the social, cultural, and physical environment
conspire against such change.
“
”Institute of Medicine
Source: Institute of Medicine. (2000). Promoting health: Intervention strategies from social and behavioral research (B. D. Smedley & L. S. Syme, Eds.). Washington, DC: National Academies Press.
The health inequities we see…are not about just individual bad
choices:
Nancy Krieger, Harvard School of Public Health
“”they are about things not
being fair
Health Equity
“Health equity means that every person, regardless of who they are—the color of their skin, their level
of education, their gender or sexual identity, whether or not they have a disability, the job that they have, or the neighborhood that they live in—
has an equal opportunity to achieve optimal health.”
Source: Braveman PA, et al. Health disparities and health equity: The issue is justice. 2011.
Race/Ethnicity in California
Photo Source: Nationalequityatlas.org
Child Restraint and Safety Belt Use Smoking Prevention Bans on School Junk Food School-Based Wellness Policies for PA Childhood Immunizations Motorcycle and Bicycle Helmet Laws
Child Restraint & Safety Belt Use
Oh, Britney…
Smoking Prevention
Pharmacy Tobacco Ban
Social, Physical, Economic
Environment&Behaviors 70%
Medical Care, 10%
Genetics20%
$2.2 Trillion
Current Health Care Spending
Factors Influencing
Health
National Health
ExpendituresReferences: Bipartisan Policy Center. “Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future.” June 2012
Medical Care, 10%
Genetics20%
Prevention, 3%
Health Care Services
97%
$2.2 Trillion
Current Health Care Spending
Factors Influencing
Health
National Health
ExpendituresReferences: Bipartisan Policy Center. “Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future.” June 2012
Social, Physical, Economic
Environment&Behaviors 70%
Source: 2013 Community Health Needs Assessment Kaiser Permanente
1. Access to Primary Care
2. Obesity/Overweight for Adult and Youth
3. Mental Health
4. Dental Health Services
5. Uninsured Population
6. Physical Environment/Transportation
7. Poverty Rates
8. Diabetes
9. Prenatal Care
10. Breastfeeding
Source: 2013 Community Health Needs Assessment Kaiser Permanente
Community Health Needs Assessment Priorities
Take 2 Steps to Prevention
Health Care
Services
Exposures &
Behaviors
Environment
Source: http://www.schmidtlaw.com
The 1st step ...
Health Care
Services
Exposures &
Behaviors
Environment
Heart Disease
Cancer
Stroke
Type 2 Diabetes
Injuries & Violence
Diet & Activity Patterns
Tobacco
Alcohol & Drugs
Making Links to Exposures & Behaviors
SOURCE: McGinnis JM , Foege WH. Actual causes of death in the United States. Journal of the American Medical Association. 1993; 270: 2007-2013.
Let’s take another step ...
Health Care
Services
Exposures &
Behaviors
Environment
Parks & open space
Elements of Community HealthPLACE
THRIVETool for Health and Resilience In Vulnerable Environments
http://preventioninstitute.org/thrive/index.php
Social Networks & trust Participation & willingness
to act for the common good Norms & Culture
Living wages & local wealth
Education
What’s sold & how it’s promoted
Look, feel & safety Parks & open space Getting
around/Transportation
Housing Air, water, soil Arts & cultural
expression
Elements of Community Health
PEOPLE
PLACEEQUITABLE OPPORTUNITY
THRIVE Framework
Community Health Factors
PLACELook, feel & safety Parks & open spaceGetting
around/Transportation
HousingWhat’s sold and
how it’s promotedAir, water, soil Arts & cultural
expression
The physical environment in which people live, work, play, and go to school.
People
Place
EquitableOpportunity
Parks and Open Space Improving Opportunities for Walking and Jogging
Boyle Heights, CA
What’s Sold & How It’s PromotedHouston, TX
Salud America! Growing Healthy Change
Community Health Factors
EQUITABLEOPPORTUNITY
Living wages & local wealth
Education
People
Place
EquitableOpportunity
The level and equitable distribution of opportunity and resources.
Library Cards For AllSalinas, CA
Education
Community Health Factors
PEOPLE Social networks & trust Participation & willingness
to act for the common good
Norms & CultureThe relationships between people, the level of engagement, and norms, all of which influence health outcomes.
EquitableOpportunity
Place
People
Social Networks & TrustHealthy Hometown Restaurant Initiative
Louisville, KY
Source: A Practitioner's Guide for Advancing Health Equity: Community Strategies for Preventing Chronic Disease (CDC)
Participation & Willingness to Act for the Common Good
Source: Multnomah County Health Department
Multnomah County, OR
Norms & CultureTurlock School District, CA.
Eden Area Livability Initiative (EALI)
Designing Initiatives for Health Equity
Select, Design and Implement Health Equity Oriented Strategies
Assess Impacts of Potential Policies on Equity
Building Organizational Practices that Support Equity
Partner and Collaborate for Health Equity
Focus on Nontraditional Providers with high degree of contact with populations experiencing inequities
“Intellectuals solve problems.
Geniuses prevent them.”
Albert Einstein
@preventioninst
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www.preventioninstitute.orgPhoto credit: Emily Barney
TOOLS
Collaborator 4Expertise:
DesiredOutcomes:
Key Strategies:
Collaborator 3Expertise:
DesiredOutcomes:
Key Strategies:
Collaborator 1Expertise:
DesiredOutcomes:
Key Strategies:
Collaborator 2Expertise:
DesiredOutcomes:
Key Strategies:
Shared Outcomes
Partner Strengths
Joint Strategies
Collaboration Multiplier
The Spectrum of Prevention
Source: National Academy of Sciences
Funded by: Robert Wood Johnson Foundation
Health Equity & Prevention Primer
Communities Taking Action
Developing Effective Coalitions: The 8-Step Process
1. Analyze program objectives, determine whether to form a coalition
2. Recruit the right people
3. Devise preliminary objectives and activities
4. Convene the coalition
5. Anticipate necessary resources
6. Develop a successful structure
7. Maintain coalition vitality
8. Improve through evaluation
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