“Understanding Social Determinants of Health: A Prosperity Strategy”

Renée Branch Canady, PhD, MPAIngham County Health Dept.

December 9/10, 2013

• Many of us think that if we want to stay healthy, we simply need to eat our vegetables, get our exercise and sleep and go to the doctor from time to time. But there are many other factors besides personal behavior that shape our health.

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• For example, the way your neighborhood is built can affect your health.

• The condition of your business district can affect your health.

• Other peoples’ behavior in your neighborhood can affect your health.

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• Building conditions affect our health. Whether structural, plumbing…

• Paint…• … or indoor air quality. Some of us live in

multi-unit dwellings, where a neighbors’ smoke can affect our indoor air quality.

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• Your health might also be different depending on the view from your backyard…

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• It might also be different depending on what school you attend. The picture on the upper left is of a new, environmentally-friendly certified school. The picture on the lower right is of a school in Central Florida built next to the jail. You can’t tell from the photo which is the school and which is the jail. The school is referred to by the locals as the “House of Brats” because of the high juvenile delinquency rate. Some people theorize that when you put people in buildings that look like jails, they might act like inmates.

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• Your health is also affected by the kind of work you do, and other factors related to who you are and where you live.

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Learning a New Language…

Health Disparity“A disproportionate difference in health between groups of people.” By itself, disparity does not address the chain of events that produces it.

Health Inequity“Differences in population health status and mortality rates that are systemic, patterned, unfair, unjust, and actionable, as opposed to random or caused by those who become ill.” Margaret Whitehead

I have the audacity to believe that peoples everywhere can have three meals a day for their bodies, education and culture of their

minds, and dignity, equality, and freedom for their spirits.

Martin Luther King, Jr.

Social Determinants of Health:the missing link…

• Clinical determinants of health – 1800s black babies– 1900s black babies

• Social Determinants of Health Inequities

Social Structure

Power and Wealth Imbalance

Social Determinants of Health

Disparity in the Distribution of Disease, Illness, and Wellbeing

SafeAffordableHousing

SocialConnection

& SafetyQuality

Education

Job Security

LivingWage

Transportation Availabilityof Food

Psychosocial Stress / Unhealthy Behaviors

Moving beyond business as usual: Shifting a Mindset

We must change the way we think about PH problems

Applying a Health Equity Lens to our Work

Instead of only asking:

Why do people smoke?

Perhaps we should also ask:

What social conditions and economic policies predispose

people to the stress that encourages smoking?

Applying a Health Equity Lens to our Work

Instead of only asking:

Who lacks access to healthy food options and why?

Perhaps we should also ask:

What policy changes would redistribute healthy food

resources more equitably in our community?

Applying a Health Equity Lens to our Work

Instead of only asking:

How can we create more green space, bike paths, and farmer’s markets in vulnerable

neighborhoods? Perhaps we should also ask:

What policies and practices by government and commerce discourage access to

transportation, recreational resources, and nutritious food in neighborhoods where

health is poorest?

Imagining Health…

• My role

• Your role

• Our roles

“The Healthiest Nation”• What is health? Are we a healthy community/nation?

• Are we a healthy nation? What demonstrates that we are or are not?

• What would we look like if we were indeed the Healthiest Nation?

• Do you believe we can do what is needed to improve our health? If not, what’s stopping us? If so, how do we proceed?

If you want to build a ship, don't drum up people to collect wood and don't assign them tasks and work, but rather teach them to long for the endless immensity of the sea.

Antoine de Saint Exupery