www.nchealthyschools.org social determinants of health: what can we do? rebecca h. reeve, phd, ches...
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www.nchealthyschools.org
Social Determinants of Health: What Can We Do?
Rebecca H. Reeve, PhD, CHES
Senior Advisor for Healthy Schools, NC DHHS
www.nchealthyschools.org
www.nchealthyschools.org
NC IOM Prevention PlanReduce Socioeconomic Health Disparities
Priority Recommendations
•Increase economic security by increasing the State Earned Income Tax Credit
•Increase enrollment in the Supplemental Nutrition Assistance Program
•Increase High School Graduation rates
www.nchealthyschools.org
Socioeconomic Indicators & Social Determinants
MATCH• HS Graduation• College Degrees• Unemployment• Children in Poverty• Income Inequality• Single Parent
Households• Homicide Rates
Healthy NC 2020• Decrease % Living
in Poverty• Decrease % Spend
>30% income on rental housing
• Increase 4-yr Graduation Rate
• Reduce % Uninsured <Age 65
www.nchealthyschools.org
21st Century Coordinated School Health
Education
Health Wealth
Eliminate Health Disparities& Achievement Disparities
www.nchealthyschools.org
2010 Four-Year Cohort Graduation Rates by Student Subgroup (DPI 2010)
All Students 74.2%
Asian 85.2 %
White 79.6 %
Female 78.9%
Multi-Racial 71.2 %
Male 69.6%
American Indian 67.9%
Black 66.9 %
Economically Disadvantaged 66.3%
Hispanic 61.4 %
Students with Disabilities 57.5%
Limited English Proficient 48.3%
*U.S. Department of Education, National Center for Education Statistics, Common Core of Data (CCD), “Local Education Agency Universe Dropout and Completion Data File: School Year 2000–01
12,599 @ +$10K per Year= +$99.2 Million per Year
4,065 @ +$10K per Year=$40.7 Million per Year
Up from 63% ’01*=12,599 more grads
Up from 55% ’01*=4,065 more grads
http://ayp.ncpublicschools.org
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7 Educationally Relevant Health Disparities
• Vision• Asthma• Teen Pregnancy • Aggression and
Violence• Physical Activity • Breakfast• Inattention and
Hyperactivity
Develop NC Evidence
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Addressing Teen Pregnancy• Nationally 31-33% of pregnant teens
graduate on time.• NC Adolescent Parenting Program in ’06-’07
enrolled 785 teens from 31 Counties.• Only 35 (4%) of them dropped out of school. Expected Dropouts = 526 Actual Dropouts = 35 Additional graduates 491
491 X $10K = $4.9M
http://tppi.its.state.nc.us/info/tppi.htm
www.nchealthyschools.org
Health Risk Behaviors & Academic Grades NC High Schools 2007 YRBS
25
13
37
28
13
36
18
52
36
19
42
26
31
47
68
48
44
61
50
70
0
20
40
60
80
Weapon carried inpast 30 days
Cigarette use(current)
Alcohol use (current) Ever had sex Watched TV morethan 3 hrs/day
% of st
uden
ts
Mostly A's
Mostly B's
Mostly C's
Mostly D/F's
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8 Components of a Coordinated School Health Approach
Family &CommunityInvolvement
PhysicalEducation &
PhysicalActivity
Nutrition Services
Counseling, Psychological & Social Services
ComprehensiveSchoolHealth
Education
HealthySchool
Environment
School-site Health
Promotion forStaff
School Health
Services
1.5 Million Children180,000+ Employees2,500 Schools
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We Can Work Together To:• Promote Collaboration Between Health
and the Education Agencies & Groups.
• Advocate for school level assessment of the Coordinated School Health components.
• Use 2010 Profiles & SLIMs data to plan.
• Advocate for 2011YRBS participation.
www.nchealthyschools.org
Healthy Schools Contact Infowww.nchealthyschools.org
• Vacant- DPI Section Chief for Healthy Schools– [email protected]– 919-807-3859
• Rebecca Reeve – Sr. Advisor-DHHS– [email protected]– 919-707-5662
• Tanya Bass- HIV– [email protected]– 919-807-3867
• Johanna Chase - Healthful Living– [email protected]– 919-807-3857
• NakishaFloyd- PANT– [email protected]– 919-807-3942
• Chris Minard – Allied Health– [email protected]– 919-807-3858
• Melody Hudson - Administrative Assistant – [email protected]– 919-807-3939
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CSHP/HE SLIM #3 The % of schools that have ever assessed
their policies, activities and programs by using the School Health Index or similar self-assessment.
2008 Baseline 34%2010 SLIM 26%2013 Goal >39%
NC Healthy Schools Coordinated School Health Priority SLIMs
*three areas Physical Activity, Nutrition, tobacco
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NC IOM Prevention PlanReduce Tobacco Use
Priority Recommendation:
Increase North Carolina’s Tobacco Taxes
Other recommendations include funding and implementing the Comprehensive Tobacco Control Program; expanding tobacco-free policies; and expanding access to cessation services, counseling, and medications for smokers who want to quit.
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NC Healthy Schools Priority SLIMTobacco SLIM #5 The % of schools that provide tobacco-use
cessation services to faculty, staff and students through direct service at school or arrangements with providers not on school property 2008 Baseline 48%2010 SLIM 43%2013 Goal > 53%