Phyisicans, health reform, and health equity: When we fight, we win!

When we fight we win Physician leaders, health inequities and the movement for healt

Physicians, health reform, and health equity: When we fight, we win!Jim Bloyd, MPHCollaborative for Health Equity Cook CountyCHECookCounty.org @CHECookCounty

February 15, 2016 3:00-4:15 p.m.Health Advocacy and Policy ForumUniversity of Illinois, College of Medicine Collaborative For Health Equity Cook CountyWHERE PEOPLE, PLACE, AND POWER MATTER

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My topics today:When we fight we win!Collaborative for Health Equity Cook CountyPhysician-leaders who inspire meExamples of health inequities in the USEvidence, power & policy changeWhat produces health inequities? (Theres nothing as practical as a good theory)Health care reform-community benefits (a bit)

2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER2

The time is ripe for a radical expansion of public health leadership. Begun & Malcolm 2014 http://www.springerpub.com/leading-public-health.html2

When we fight, We win!Jobin-Leeds & AgitArte 2016 The New Press. New YorkMovements are sources of lessonsTrying is the path to victoryWinning requires a weTransformative change, in the face of powerful forces, requires a fightWe win our own personal transformationClaiming our humanity and right to fight is a winWhen we fight we win: voices of cutting edge leaders addressing root causes of inequities2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER3

WHENWE FIGHT, WE WIN!: Twenty-First-Century Social Movements and the Activists That Are Transforming Our WorldLongtime social activist Greg Jobin-Leeds joins forces with AgitArte, a collective of artists and organizers, to capture the stories, philosophy, tactics, and art of todays leading social change movements. When We Fight, We Win! weaves together interviews with todays most successful activists and artists from across the country and beyond. Whenwefightwewin.com

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2015 STRATEGIC PLAN FINAL REPORT April 2011To optimize health and achieve health equity for all people and communities of Cook County through our leadership and collaborations.we need to make significant changes in how we workBecause health depends causally on its environmental, economic, technological, informational, cultural and political contexts, social justice is prerequisite to achieving optimal and equitable public health.

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19 interdisciplinary pLACE MATTERS teams work in the United States through an initiative of the National Collaborative for Health Equity. The mission of the National Collaborative is to promote health equity by catalyzing collaboration among racial equity advocates, grassroots and community-based organizations, researchers, public health professionals, and other key stakeholders. PLACE MATTERS is designed to build the capacity of leaders and communities around the country to identify and address social, economic, and environmental factors that shape health inequities; Two other teams frm the midwest are Wayne and Cuyahoga counties. IN the East are teams from Boston, Baltimore, and Washington DC, Prince Georges and Marlboro Counties. South Delta Counties, Orlenas Parish, and Mid-Mississippi Delta Teams are from the Delta areas. Teams in New Mexico are from the of San Juan, Mcknley, Bernalillo and Dona Ana Counties. And in the West teams are located in the Martin Luther King, Jr., Alameda and San Joaquin Counties. I want to thank my fellow Team mates and the National Collaborative for their their generosity in sharing their tools and lessons learned and for their steadfast commitment to health equity.

The project will connect research, policy analysis, communications, and activism to ultimately support policy, systems, and environmental change that addresses the legacy of racism, particularly its less visible-but more insidious-structural manifestations, and their health consequences. The National Collaborative will convene leaders to share innovative ideas, provide technical assistance to support multi-sector racial equity initiatives, and conduct research and policy analysis that supports on-the-ground activism.

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Collaborative For Health Equity Cook County19 National Collaboratives For Health EquityLearning Communitywww.checookcounty.org @checookcounty


Rudolph Virchow

2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER7Father of social medicine and virologyInfectious diseases due to social conditionsFor the prevention and eradication of epidemics, political and economic change was as important as medical intervention if not more so (Howard Waitzkin Nov 8 2010 Illness-generating conditions of capitalism and empire: The contributions of Engels, Virchow, and Allende)

May the rich remember during the winter, when they sit in front of their hot stoves and give Christmas apples to their little ones, that the shiphands who brought the coal and the apples died from cholera. It is so sad that thousands always must die in misery, so that a few hundred may live well.

Virchows visions of the social origins of illness pointed out the wide scope of the medical task:Study of social conditions as part of clinical research and health workers engagement in political actionVirchow frequently drew connections among medicine, social science, and politics: "Medicine is a social science, and politics is nothing more than medicine in larger scale."

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Paul Bertau Cornely (1906-2002)

1970 critiqued public health as outside the power structure, acting as a mere bystander.(Fairchild etal 2010)1st Black President American Public Health Association1st Black DrPH, and Doctorate in anatomy (via Murray, L. n.d.)2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER8

In the view of critics, public health professionals have, over the course of a century, defined their mandate ever more narrowly and shrunk from political engagement with powerful interests such as corporations and business that created unhealthful environments. They failed to con-front medical specialists interested in defining preventive interventions as clinical and hence as reimbursable. This critique was made perhaps most memorably by Paul Cornely in a 1970 address to the American Public Health Association. Newly elected as the groups first African American president, Cornely leveled a blistering attack on what he saw as the complacency of his profession. It had been a mere bystander to the profound changes in the health care system pressed to join the coalitions mak- professionals committed both to that had taken place in the 1960s; its members wasted their time on piddling resolutions and their wordings. Public health, he charged, remained outside the power structure.52 Cornelys ad-dress was a clarion call for more aggressive action against a host of health problems integral to modern industrial society.5 Fairchild et al 2010 page 608

Salvador Allende (1908-1973)

2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER9Salvador Allende, La Realidad Medico-Social Chilena, 1939 (Waitzkin 2010) Pathologist, student of Engels and Virchow (and Max Westenhofer) Later senator, president of Chile Health and mental health in wide-ranging epidemiological study

Salvador Allende, late president of Chile and a pathologist, helped establish the field of Latin American social medicine with his path-breaking epidemiological work, accomplished during the 1930s. Although social medicine has become a widely respected field of research, teaching, and clinical practice in Latin America, the accomplishments of this field remain little known in the English-speaking world p. 739 (Waitzkin, H. (2005). Commentary: Salvador allende and the birth of latin american social medicine. International Journal of Epidemiology, 34(4), 739-41. doi:10.1093/ije/dyh17)9

Ernesto Che Guevara (1928-1967)

The life of a single human being is worth a million times more than all the property of the richest man on earth.2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER10

https://www.marxists.org/archive/guevara/1960/08/19.htm

was an Argentine Marxist revolutionary, politician, author, physician, military theorist, and guerrilla leader during the Cuban revolution. Following his execution in Bolivia, he became both a stylised countercultural icon and symbol of rebellion for leftist movements worldwide.

After graduation, due to special circumstances and perhaps also to my character, I began to travel throughout America, and I became acquainted with all of it. Except for Haiti and Santo Domingo, I have visited, to some extent, all the other Latin American countries. Because of the circumstances in which I traveled, first as a student and later as a doctor, I came into close contact with poverty, hunger and disease; with the inability to treat a child because of lack of money; with the stupefaction provoked by the continual hunger and punishment, to the point that a father can accept the loss of a son as an unimportant accident, as occurs often in the downtrodden classes of our American homeland.10

H. Jack Geiger (L),John W. Hatch (b1928)(R) construction of Delta Health Center, Bayou Mound, Mississippi 1968

John Hatch: Head of community organizing Delta CHC; first African-American endowed chair UNC School of Public Health.Jack Geiger: used health care as an instrument of social justice and empowerment for those oppressed by racism and poverty.The Flint Disaster: Why Doesnt Black Health Matter? (Geiger. Feb 3 2016 physicansforhumanrights.org/blog)Photo: Dan Bernstein2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER11

when Delta Health Center physicians literally wroteand arranged to fillemergency prescriptions for food for impoverished families with seriously malnourished and infected children, and charged the costs to the centers pharmacy budget, the voernor of Mississippi accused them of communism.

a shocking public health failure. It is an assault on human rights a recognition that has been largely absent from most discussions of how and why this could have happened in the advanced industrial democracy of the United States. It is arguably the largest discrete violation of its type since the infamous and grossly unethical Tuskegee syphilis medical study of the last century. The water poisoning in Flint was finally forced into official recognition by a brave and stubborn pediatrician, Dr. Mona Hanna-Attisha, who documented what was really happening to Flints vulnerable children and other residents. - See more at: http://physiciansforhumanrights.org/blog/the-flint-disaster-why-doesnt-black-health-matter.html#sthash.z2ALH6HQ.0TpcT6qP.dpuf

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Linda Rae Murray (b1948)

Past-President American Public Health AssociationFaculty UIC School of Public HealthU Med Alum 1977Internal medicine, Occupational therapy, Cook County HospitalChief Med Officer Amb & Comm Health Network Cook County 2005policy is not made by p-valueRacism is critical to how capitalism functions


Social Movements and Collective Action (House Staff Strike 1975) County Ansel (2011)


#SavetheNHS


Camara Phyllis Jones

President, American Public Health AssociationLevels of Racism: A theoretical framework and a gardeners tale AmJPH 2000;90(8):1212-1215it is difficult for any of us to recognize a system of inequity that privileges usI hope that your understanding will move you to action. Email me. [email protected] (thenationshealth.org Feb2016)


MD, MPH, PhD15

Mona Hannah-Attisha

Dir of Pediatrics Hurley Childrens Hospital, Flint MichiganProfessor, Michigan State UniversitySo I was called an "unfortunate researcher," that I was causing near hysteria, that I was splicing and dicing numbers, and that the state data was not consistent with my data. ..we regrouped and told them "No, you were wrong.Photo: Junfu Han The Ann Arbor News2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER16Jan15-2016 http://www.democracynow.org/2016/1/15/flint_doctor_mona_hanna_attisha_on

http://www.mlive.com/news/ann-arbor/index.ssf/2016/02/flint_pediatrician_at_u-m_you.html

Jan15-2016 http://www.democracynow.org/2016/1/15/flint_doctor_mona_hanna_attisha_on

"There's a lot we know that we can do," she said. "A lot of that lives in the policy world, a lot lives in the world of the primary caregivers, and a lot lives in the public health world.

Well, that evening, we were attacked. So I was called an "unfortunate researcher," that I was causing near hysteria, that I was splicing and dicing numbers, and that the state data was not consistent with my data. And as a scientist, as a researcher, as a professional, you double-check and you triple-check, and the numbers didnt lie. And we knew that. But when the state, with a team of like 50 epidemiologists, tells you youre wrong, you second-guess yourself. But that lasted just a short period, and we regrouped and told them why, "No, you were wrong." And after about a week and a half or two weeks, after some good conversations, they relooked at their numbers and finally said that the states findings were consistent with my findings.

Gov. Snyder (Why Austerity Kills: Book)Violation of ph ethics: Public health malpracticeJack Geiger Why Doesnt Black Health MatterWhat is Illinois or Chicagos parallel crisis: Education, housing, police killings, young adult unemployment-not-in-school,

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Quentin Young (b 1923), ChicagoMany othersYou!2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER17


Bd. President Preckwinkle continued saying People living in areas with a median income greater than $53,000 per year have a life expectancy that is almost 14 years longer than people living in areas with a median income below $25,000 per year. July 26, 2012 Press Conf/ PM Action Lab, Chicago

Our Teams Report made 6 recommendations, including that sufficient funds be allocated to increase healthy food retail in neighborhoods with low food access, and that the voices and aspirations of neighborhood residents be reflected in solutions to hunger and poor nutrition; to Ensure workplace justice for workers throughout the food chain and specifically included the restaurant industry; that persistent poverty be addressed by engaging multiple sectors, and the the 2008 WHO Final Report of the Commission on the SDH be implemented.

The report found evidence of a relationship between life expectancy and neighborhood income. Among Chicago census tracts and suburban Cook County municipalities grouped into quintiles (5 equal groups) based on median income and calculated the average life expectancy of each quintile. People living in areas with a median income greater than $53,000 per year had a life expectancy that was almost 14 years longer than that of people living in areas with a median income below $25,000 per year. 18

Map of Child Opportunity in Cook County (Source: Diversitydatakids.org)

Children in Cook County grow up in neighborhoods with stark, unfair differences in opportunity for healthy development. Nationally, 40% of Black and 32% of Hispanic children live in very low-opportunity neighborhoods compared to 9% of White children.(Acevedo-Garcia, etal 2015)2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER19

Metro Chicago: Poverty Composition of Neighborhoods Where Poor Children Live By RaceSource: Diversitydata.org, (2011, from 2000 Census Data)

2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER20Poor Children by Race%

This slide shows the dramatic affect of segregation on Metro Chicago which exposes only poor children of color to high levels of concentrated poverty, while locating poor white children in neighborhoods of low poverty.

While 90% of poor white children live in low poverty neighborhoods about 75% of Black children and 45% of Latino Children are exposed to the health and life threatening environments of higher poverty neighborhoods. This is also described by the 2008 Institute Of Medicine report by J A Cohen.

Cohen, J. A., Ed. (2008). CHALLENGES AND SUCCESSES IN REDUCING HEALTH DISPARITIES. Washington, D.C., INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES.

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Reform Can move us toward health equity if we understand the origins of health inequities and take power and systems of advantage-disadvantage into account

Solar & Irwin, WHO (2010) For example p5

We have repeatedly referred to Hilary Grahams warning about the tendency to conflate the social determinants of health and the social processes that shape these determinants unequal distribution, by lumping the two phenomena together under a single label. Maintaining the distinction is more than a matter of precision in language. As Graham argues, blurring these concepts may lead to seriously misguided policy choices. There are drawbacks to applying health-determinant models to health inequalities. To do so may blur the distinction between the social factors that influence health and the social processes that determine their unequal distribution. The blurring of this distinction can feed the policy assumption that health inequalities can be diminished by policies that focus only on the social determinants of health. (Solar and Irwin, 2010 p47)21

World Health Organization Commission on the Social Determinants of Health Conceptual FrameworkSolar & Irwin (2010) http://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf 2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER22

Structural Determinants: The social determinants of health inequitiesSource: World Health Organization, 2010, Solar and Irwin p. 35.


Gradient & Fundamental CausesAge standardized mortality rate for avoidable (left axis) and non-avoidable (right axis) causes of mortality by Carstairs deciles for women 1981-2001. (Scott et al 2013 NHS Scotland)


Thatavoidablemortalityshoulddisplayasocioeconomicgradient whilstnonavoidablemortalitydoesnot,suggeststhatsocioeconomicgradientsinmortalityresultfrom eitheradifferenceinknowledgeonhowtoavoidharmoradifferenceintheabilitytoactonthat knowledge.Recentworkexploringtherelationshipbetweenknowledge,motivationandoutcomesina Scottishpopulationsampleindicatesthelatterismorelikely(24).Thisisfurthersupportedbyrecentwork whichhasshownthattrendsinhealthinequalitiesmirrortrendsinsocioeconomicinequalities(2,3).Taken togethertheseobservationssignalthat:socioeconomicinequalityisafundamentalcauseofhealth inequalities;focusingoncontrollingproximalmediatorssuchastobaccowillultimatelyfailtoeradicate socioeconomicinequalitiesinhealth;andthateliminationofhealthinequalitieswillrequirethatunderlying resourceinequalitiesbeaddressed.page 33

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Evidence, power and policy


Wall Street Journal page 1 January 19, 2016 online story at http://www.wsj.com/articles/unitedhealth-reports-profit-decline-amid-exchange-weakness-14532044042/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER26

The Coverage GapSupreme Courts decision in 2012 allowed States to opt out of Medicaid ExpansionIndividuals below the FPL living in states that have not expanded Medicaid experience difficulty accessing affordable health coverage4 million people fall into the coverage gap created by states not expanding Medicaid85 percent of these individuals reside in the South, half are African American or Hispanic

Opportunity to align hospitals community benefits with community needs


sample does some-what underrepresent hospitals affiliated with systemssample was limited to tax-exempt hospitals that reported their community benefit expenditures to the IRS at the individual hospital level and were not exempt from Form 990 Schedule H reporting under a group exemption .sample was limited to 1 year of data (2009), the first year for which hospitals were required to report their community ben-efit expenditures to the IRS.some measurement error may existconsistent with previous studies, we defined a hospitals community as the county in which the hospital is located.5,11 Clearly, the communities for most hospitals are not fully equivalent to the county in which they are located.For community benefit reporting, the IRS allows hospitals to define their community.

hospitals are free to define the community they serve in terms of, for instance, specific geographical areas or target populations served.

Conclusiongs: important opportunities exist for hospitals to improve the alignment between their charitable activities and community needs.the lack of a relationship between community health needs and hospitals provision of community benefits aimed at broadly improving the health of their communities,

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Working Definition of Population Health IOM Roundtable on Population Health Improvement (2014)

defining population health solely in terms of clinical populations can draw attention away from the critical role that non-clinical factors such as education and income play in producing health. Geopolitical areas rather than simply geographic areas are recommended when measuring total population health since funding decisions and regulations are inherently political in nature (Jacobson and Teutsch, 2012) [emphasis added]The Roundtable uses population health in the spirit of the Jacobson-Teutsch critique.2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER29

many embrace a population health or population medicine perspective (Harvard Pilgram Health Care Institute, 2013), a few are striving towards a geographic regional emphasis in their definition of population health (Kindig and Whittington, 2011). there is variation in how Triple Aim practices define population health.Enrollees in a health planpopulation of patients in a hospital

This shift from volume-based payment to value-based payment may result in more hospital prioritization of community health initiatives, partic-ularly among hospitals in communities with a relatively high incidence of chronic illness, because hospitals will have financial incentives to reduce service utilization for individuals for whom they are responsible. (Singh et al p 919)

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Community Benefits: An opportunity to tackle health inequities in metro-ChicagoACA requires non-profit hospitals to conduct community health needs assessments (CHNA)Community BenefitsTax exempt statusNationally in 2009, 7.5% avg of operating budgets; 85% for clinical services (Young)Value of tax exemption $24.6 billion 2011 Rules affect more than 80% of hospitalsthe health needs of a community include not only the need to address financial and other barriers to care but also the need to prevent illness, to ensure adequate nutrition, or the need to address social, behavioral, and environmental factors that influence health in the community (IRS, 2014 in Rosenbaum 2015). requires non-profit hospitals to conduct and implement a community health needs assessment at least every three years with participation from public health professionals and community members (Folkemer et al., 2011 in Woodcock & Nelson 2015).


do hospitals respond to greater community health needs by spending more on health? Is there a general correspondence between types of community needs and types of community benefit expenditures?We investigated the pattern of hospital community benefit expenditures in relation to community health needs on the basis of a broad set of indicators of health needs from the County Health Rankings.12

We sought to assess the relationship between hospital community benefit expenditures and com-munity health needs before the ACA. This information can help gauge the success of the community health needs assessment mandate in the future.

Hospitals did not, however, dedicate more financial resources to programs and activities that would benefit the community more broadly in the form of direct spending on community health initiatives or financial and in-kind contributions to community groups. In fact, the group of hospitals that spent the most on community health improvement initiatives were hospitals in quartile 1 (i.e., hospitals serving the healthiest communities).

Our multivariate model did not reveal any relationship between our global community health needs indicator and hospital spending on community health improvement initiatives.

Hospitals in communities with greater needs do not appear to spend more on community improvement initiatives than do hospitals in communities with fewer needs. Page 917

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IRS Form 990for purposes of Form 990 Schedule H reporting hospitals have a good deal of latitude in what they call a community health improvement initiative. Hospitals may report expenditures on activities that have more to do with their organizational priorities than with the health needs of their communities. (p918 Singh et al 2015)2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER31

for purposes of Form 990 Schedule H report-ing hospitals have a good deal of latitude in what they call a community health improvement initiative. Hospitals may report expenditures on activities that have more to do with their organizational priorities than with the health needs of their communities. P 918

he IRS and other fed-eral agencies should closely monitor the implementation of the ACA community health needs assessment requirement and evaluate its impact on aligning hospital community benefit activities with community health needs.

with the advent of Form 990 Schedule H, there may eventually be more transparency and scrutiny of the community benefits hospitals provide, a development that may lead to shifting hospital spending priorities for community benefits that are better aligned with community needs.8,23 Community advocacy groups are beginning to take steps to improve the publics access to Form 990 Schedule H data through Web-based re-sources. Better access to this information will likely result in further discussion of the adequacy of hospitals community benefit activities because of the specific needs of the population served.

The IRS has amended Schedule H, which accompanies Form 990, to include extensive facility-specific information regarding 501(r) compliance. (Schedule H also requires a hospital organizations to provide organization-specific information about its community benefit expenditures as a charitable organization under 501(c)(3)). (Rausenbaum, Health Affairs Blog, 2015)31

Defining community benefitsFor example, hospitals may report expenditures for community-based services that function, at least in part, as referral programs for specific clinical programs the hospital offers. Hospitals may also report expenditures for activities that are located in geographical areas where the hospital is attempting to expand its reputation or market share rather than areas with the greatest health needs (p918 Singh etal 2015) 2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER32

least in part, as referral programs for specific clinical programs the hospital offers. Hospitals may also report expenditures for activities that are located in geographical areas where the hospital is attempting to expand its reputation or market share rather than areas with the greatest health needs32

Disagreements about USA Fed Govt Spending Levels expand, cut back, or keep the sameCut backExpand

(Page, Bartels & Seawright 2013)2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER33

If wealthy Americans wield an extra measure of influence over policy making, and if they strongly favor deficit reductions through spending cutsincluding cuts in Social Security and Medicarethis may help explain why a number of public officials have advocated deep cuts in the very social welfare programs that are most popular among ordinary Americans. Page 5633

Page et al 20132/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER34

Page et al 20132/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER35

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Affluence and Influence: The preference/policy link (Gilens 2012)under most circumstances, the preferences of the vast majority of Americans appear to have essentially no impact on which policies the government does or doesnt adopt. [loc196]When less-well-off Americans hold preferences that diverge from those of the affluent, policy responsiveness to the well-off remains strong but responsiveness to lower-income groups all but disappears. [Loc278]


Justice Brandeis: We can have democracy in this country, or we can have great wealth concentrated in the hands of a few, but we cannot have both.Main data set: 1,923 survey questions asked of national samples of the US population between 1981-2002. Supplemented with additional survey questions asked during 196469 and 2005-2006.

how the level of support or opposition to a policy among poor, middle-class, or affluent Americans affects the probability of that policy being adopted

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When we fight, We win!Movements are sources of lessonsTrying is the path to victoryWinning requires a weTransformative change, in the face of powerful forces, requires a fightWe win our own personal transformationClaiming our humanity and right to fight is a winWhen we fight we win: voices of cutting edge leaders addressing root causes of inequities2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER37

Reading Suggestions

The Health Gap (Marmot)Epidemiology and the Peoples Health (Krieger)The New Jim Crow (Alexander)Racing To Justice (powell)The History of White People (Painter)Globalization and Health (Kawachi & Wamala)The Assassination of Fred Hampton (Haas)

Ella Baker and the Black Freedom Movement (Ransby)Talking the Walk (Cutting & Themba-Nixon)Leading Public Health (Begun & Malcolm)Medicine and Public Health at the End of Empire (Waitzkin)Forked (Saru Jayaraman, ROC United)Beyond Evidence-based Policy in Public Health (Smith)2/15/16Collaborative For Health Equity Cook County WHERE PEOPLE PLACE AND POWER MATTER38

ResourcesDemocracy Now! Flint Doctor Mona Hanna-Attisha on How She Fought Gov't Denials to Expose Poisoning of City's Kids January 15, 2016 http://www.democracynow.org/2016/1/15/flint_doctor_mona_hanna_attisha_onBrown, T. M., & Fee, E. (2011). Paul B. Cornely (1906-2002): Civil rights leader and public health pioneer. American Journal of Public Health, 101(Supplement 1), S164. doi:10.2015/AJPH.2010.30005Fafard, P. (2008). Evidence and healthy public policy insights from health and political sciences. Ottawa, Ont.: Canadian Policy Research Networks. Retrieved from National Collaborating Centre for Healthy Public Policy: http://www.ncchpp.ca/docs/FafardEvidence08June.pdfGilens, M. (2012). Affluence and influence : Economic inequality and political power in America. Princeton, N.J: Princeton University Press ; New York : Russell Sage FoundationHanna-Attisha, M., LaChance, J., Sadler, R. C., & Champney Schnepp, A. (2016). Elevated blood lead levels in children associated with the flint drinking water crisis: A spatial analysis of risk and public health response. American Journal of Public Health, 106(2), 283-90. doi:10.2105/AJPH.2015.30300Jobin-Leeds, G., & AgitArte. (2016). When we fight, we win: Twenty-First-Century social movements and the activists that are transforming our world. New York: New Press, ThePage, B., Bartels, L., & Seawright, J. (2013). Democracy and the policy preferences of wealthy americans. Perspectives on Politics, 11(01), 51-73. doi:10.1017/S153759271200360Rosenbaum, S., Kindig, D., Bao, J., Byrnes, M., & OLaughlin, C. (2015, June 17 [Epub ahead of print]). The value of the nonprofit hospital tax exemption was $24.6 billion in 2011. Health Affairs. Rosenbaum, S. (2015). Additional requirements for charitable hospitals: Final rules on community health needs assessments and financial assistance. Health affairs blog [Web page]. Retrieved from http://healthaffairs.org/blog/2015/01/23/additional-requirements-for-charitable-hospitals-final-rules-on-community-health-needs-assessments-and-financial-assistance/#_ftnref1Scott, S., Curnock, E., Mitchell, R., Robinson, M., Taulbut, M., Tod, E., & McCartney, G. (2013). What would it take to eradicate health inequalities? Testing the fundamental causes theory of health inequalities in Scotland. NHS Health ScotlandSingh, S. R., Young, G. J., Daniel Lee, S. -Y., Song, P. H., & Alexander, J. A. (2015). Analysis of hospital community benefit expenditures alignment with community health needs: Evidence from a national investigation of tax-exempt hospitals. American Journal of Public Health, 105(5), 914-921. Retrieved from Google ScholarWoodcock, & Nelson. (2015). HospitalcommunitybenefitsaftertheACAleveraginghospitalcommunitybenefitpolicytoimprovecommunityhealth Retrieved fromhttp://www.hilltopinstitute.org/publications/HospitalCommunityBenefitsAfterTheACA-LeveragingPolicyIssueBrief11-June2015.pdfWaitzkin, Howard Illness-generating conditions of capitalism and empire: The contributions of Engels, Virchow, and Allende November 8, 2014 Presented at the Annual Meeting of the American Public Health Association.Young, G. J., Chou, C. H., Alexander, J., Lee, S. Y., & Raver, E. (2013). Provision of community benefits by tax-exempt U.S. Hospitals. The New England Journal of Medicine, 368(16), 1519-27. doi:10.1056/NEJMsa121023


Thank youJim Bloyd, [email protected] County Department of Public Health15900 S. CiceroOak Forest, IL 60452

@j_bloyd


Phyisicans, health reform, and health equity: When we fight, we win!

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Transcript of Phyisicans, health reform, and health equity: When we fight, we win!