Jim Bloyd, MPHCook County Department of Public Health

March 16, 2012 Good Food Festival and Conference , Chicago

UIC Forum

Cook County Place Matters: Working Together for Health Equity 1. Education & Awareness2. Building Alliances with Residents to Increase

Power3. Advocating for Policy ChangeWhat you can do:

•Sign up so you can become involved•Like us on Facebook www.facebook.com/ccplacematters•Attend our meetings—next is Wednesday, March 21st•Support our upcoming health equity report—July 2012

Evidence of health inequity

The death rate from diabetes in southern suburban Cook County is about 70% higher than in northern Cook. (Source: CCDPH)

Access to chain supermarkets in metro-Chicago is associated with life expectancy --Areas with the least access were found to have a life expectancy 12 years shorter than the areas with the highest access. (Note: association does NOT mean ‘cause.’) ( Source: unpublished preliminary Cook County Place Matters Community Health Equity Report, in press)

Retail Food Presence and HealthEvidence is mixed

Ruopong & Sturm (2012) “No robust relationship between food environment and consumption is found.”

Lee (2012) “differential exposure to food outlets does not independently explain weight gain over time in this sample of elementary school-aged children.”

351,024 people live in low food access areas in suburban Cook County, accounting for about 14.5% of the population

Block, et.al (2011)

Percent of Population with “Low Food Access” in Suburban Cook County, Spring 2011Source: Block, etal (2011)

Low Food Access by Census Block Group, Spring 2011

Block, et.al. (2011)

Poverty and Obesity are LinkedSource: Drewnowski (2009)

“Obesity and type 2 diabetes follow a socioeconomic gradient.”

“Obesity is the toxic consequence of economic insecurity and a failing

economic environment.”

Energy Density & Energy CostsSource: Drewnowski (2009)

Note: cost differentials can be several thousand percent!

Does place matter? Yes.“The opportunity to move from a neighborhood

with a high level of poverty to one with a low level of poverty was associated…with reductions in …extreme obesity and diabetes.”

New England Journal of Medicine, 2011

Place matters: Neighborhood deprivation and cardiometabolic risk factorsin the Diabetes Study of Northern California (DISTANCE) (Laraia et. al (2012) Soc Sci & Med)

“…higher levels of neighborhood deprivation were positively associated with indicators of cardiometabolic risk among adults with diabetes, suggesting that neighborhood level deprivation may influence individual outcomes.”

Deprivation: an area’s income, poverty, housing, education, employment and occupation.

Opportunity-based Housing and Constellation of Opportunity Structures Source: Luce et al (2005) reproduced from Powell (2001)

94% of Black residents and 83% of Latino residents live in ‘low opportunity’ communities.[4]

Segregation in Metro Chicago Source: Luce et al (2005)

Opportunity and Health

The distribution of opportunity across neighborhoods can have a profound effect on socio-economic advancement and health outcomes.

National Academy of Sciences, 2008

Racial Equity for African Americans:100 US Metro Areas Source: Urban Institute, 2011

Metro Area Overall Grade

Chicago (2nd Worst) F

Milwaukee (Worst) F

St. Louis D

Little RockBaton Rouge

C

Chattanooga,Richmond (VA)Atlanta

B

Albuquerque (best)Greenville (SC)

A

Closing the gap in a generation - how?

Tackle the inequitable distribution of power, money, and resources

Inequity in the conditions of daily living is shaped by deeper social structures and processes. The inequity is systematic, produced by social norms, policies and practices, and practices that tolerate or actually promote unfair distribution of and access to power, wealth and other necessary social resources. Source: http://www.who.int/social_determinants/thecommission/finalreport/closethegap_how/en/index2.html

World Health Organization

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PlacePolicy

Narrative

power

awareness/understanding, Power, Policy advocacy‘Fair Health Movement’ Gail Christopher

Kellogg

Addressing ‘root causes’ of health inequitiesHealth equity Report rollout late JulyAction Lab in Chicago, late July!!Build an Alliance: See Sign In Sheetplacematterscookcounty@gmail.com;

facebook.com/ccplacematters 708-633-8314

Cook County Place MattersThank you Jim Bloyd, MPHCook County Dept. Public healthjbloyd@cookcountyhhs.org 708-863- 8314