Local Public Health; Agents for Health Equity
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Local Public Health; Agents Local Public Health; Agents for Health Equity for Health Equity
Adewale Troutman,M.D., M.A., M.P.H.
University of Louisville
Louisville Department of Public Health and Wellness
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Core Public Health FunctionsCore Public Health Functions Assessment •Assess the health needs of the community
•Investigate the occurrence of health effects and health hazards in the community
•Analyze the determinants of identified health needs
Policy development •Advocate for public health, build constituencies, and identify resources in the community
•Set priorities among health needs
•Develop plans and policies to address priority health needs
Assurance •Manage resources and develop organizational structures
•Implement programs
•Evaluate programs and provide quality assurance
•Inform and educate the public
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The Essential Public Health The Essential Public Health ServicesServices
1. Monitor health status2. Diagnose and
investigate health problems
3. Inform and educate4. Mobilize communities
to address health problems
5. Develop policies and plans
6. Enforce laws and regulations
7. Link people to needed health services
8. Assure a competent health services workforce
9. Evaluate health services10. Conduct research for
new innovations
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Healthy People 2010Healthy People 2010
Two Goals
Increase Quality and Years of Health Life
Eliminate Health Disparities
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HealthHealth
“The presence of physical, psychological, social, economic and spiritual well being not merely the absence of disease or infirmity”
“The maintenance of a harmonious balance of mind, body and spirit” – Community and individual
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EquityEquity
Justice according to natural law or rightFreedom from bias or favoritism
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Health EquityHealth Equity
“The absence of unfair and avoidable or remediable differences in health among social groups” ( The Commission )
A value position supported by an evidence base
There is and will be political opposition to the core value of health equity
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Health inequitiesHealth inequities are systemic, are systemic, avoidable, unfair and unjust differences in avoidable, unfair and unjust differences in
health status and mortality rates and in health status and mortality rates and in the distribution of disease and illness the distribution of disease and illness across population groups. They are across population groups. They are
sustained over time and generations and sustained over time and generations and beyond the control of individualsbeyond the control of individuals
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““The time has come to herald The time has come to herald human rights as both the human rights as both the
foundation of public health foundation of public health and the compass of public and the compass of public
policy”policy”JAPHA 2000JAPHA 2000
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Looking UpstreamLooking Upstream
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Determinants of Health; A Determinants of Health; A Holistic ApproachHolistic Approach
Social and Economic EnvironmentPhysical EnvironmentHealth BehaviorsHealth Care AccessPolicies & The Political EnvironmentThe Balance of PowerGenetics/Biology
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Why Social Determinants?Why Social Determinants?
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Socioeconomic StatusSocioeconomic Status
OccupationEducationIncome
– Income gaps
Racism & discriminationHousingPolitical power
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Social Determinants ( WHO )Social Determinants ( WHO )
The Social Gradient Stress Early Life Social Exclusion Work Unemployment Social Support Addiction Food Transport
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HousingHousing
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Public Health and the Built Public Health and the Built EnvironmentEnvironment
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Housing and HealthHousing and Health
LeadIndoor air qualityUnsafe environmentsObesityAsthmaStress
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Cotter LaneCotter Lane
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Park DuVallePark DuValle
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Park DuVallePark DuValle
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Center ActivitiesCenter Activities
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Center ActivitiesCenter Activities
Staff Training on Community Organizing Staff and Community Training on Capacity
Building Community Policy Mini-grantsSpeakers seriesOn line learning in Health Equity for
consumers and state employees in healthTraining in policy development
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ActivitiesActivities
Food Security Task ForceCommunity Visioning ProcessDialogue Process- Yale UniversityFraming Research followed by Social
Marketing StrategyEmergency Preparedness and Health
Equity/Social Justice
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ActivitiesActivities
School of Public Health and Information Sciences course development
“White Paper” on Health Equity and Social Justice
Implementation of focus on HIA’sOffice of Faith and Health ( Social Justice )Tommie Smith Youth Athletic Initiative Undoing Racism workshops
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Adewale Troutman, M.D.,M.P.H.Adewale Troutman, M.D.,M.P.H.The Troutman GroupThe Troutman Group
5109 Forrest Grove Place5109 Forrest Grove PlaceLouisville, Ky 40059Louisville, Ky [email protected]@aol.com [email protected]@aol.com
www.adewaletroutman.comwww.adewaletroutman.comwww.thetroutmangroup.orgwww.thetroutmangroup.org