Advancing Health Through Social and Economic Change

1
Advancing Health Through Social and Economic
Change

• Strategies for Addressing
• Health Disparities
• June 27, 2002
• Lee Kingsbury
• Minnesota Department of Health

2
Minnesota Health Improvement Partnership

• Healthy Minnesotans 2004
• 30 Public, Private, Non-profit Members

3
Healthy Minnesotans 2004

• Goal 18
• Foster the understanding and promotion
• of
• social conditions that support health.

4
Social Conditions and Health Action Team Charge

• Deepen understanding of the social conditions
  that affect the health of Minnesotans.
• Identify action steps to address these issues.

5
A Call To Action Report

• Biology
• Healthcare Services
• Physical Environment
• Behavior
• Social and Economic Conditions

6
Health disparities and social conditions

• Low SES, racism and discrimination shape risks
• Strategies to improve access and reduce
  behavioral risks have only limited potential to
  eliminate disparities
• Reducing socioeconomic and racial/ethnic
  disadvantage remain the most powerful tool

• Findings summarized by the Institute of Medicine.
• http//www4.nas.edu/iom/iomhome.nsf (pg 11)

7
A healthy community provides everyone access to

• Quality education, health care and other
  community services
• Economic opportunity
• Opportunities to participate fully in the
  cultural and civic life of the community
• Opportunities to develop their full potential

Oct 2000 Community Dialogues convened by the
Urban Coalition and MDH
8
This is not new

• The fact is, poverty is the greatest problem in
  public health. A living wage is essential to a
  healthful standard of living.

American Journal of Public Health, 1918
9
Alternative tips for better health

• Dont be poor. If you can, stop. If you cant,
  try not to be poor for long.
• Dont have poor parents.
• Have transportation.
• Dont work in a stressful, low paid manual job.
• Have a job with benefits.
• Dont live in damp, low quality housing.

Adapted from David Gordon, University of Bristol,
1999
10
Advocate for Healthy Public Policy

• Help people move out of poverty
• Promote optimal early childhood development and
  attachment
• Assure opportunities for quality education and
  lifelong learning
• Link economic development, community development
  and health improvement

11

• The year we got the largest increase in Head
  Start at the legislature was when the
  Commissioner of Corrections came and told a
  story. Instead of the usual moms and early
  childhood advocates, the Commissioner said this
  is how much it costs in the end.

• Connie Greer
• Department of Children Families and Learning

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What Can We Do?

• Build broader coalitions
• Build and use a representative and culturally
  competent workforce

13
What Can We Do?

• Improve data.
• Get the word out This affects all of us.
• Take action.

14
Health Impact Assessment

• A combination of procedures or methods by which
  a policy, program, or project may be judged as to
  the effects it may have on the health of a
  population.

• Source WHO Regional Office for Europe
  http//www.who.dk/hs/ECHP

15
HIA An Overview

• A route to understanding potential health risks
  and BENEFITS of a proposal.
• Designed to be flexible.
• A way for all sectors to contribute to health
  improvement.

• Source A Short Guide to Health Impact
  Assessment. Londons Health, August 2000.
  www.londonshealth.gov.uk

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HIA Pilot Projects

• Bloomington Youth Coffeehouse Initiative

• St. Paul Elders Lodge

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Bloomington Youth Coffeehouse

• Youth developed and run coffeehouse for area high
  school students
• Will inform development process to maximize
  benefit

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BLOOMINGTON YOUTH COFFEEHOUSE

• A prospective HIA expected to take approximately
  6 months
• Initial Rapid Appraisal

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St. Paul Elders Lodge

• An independent living facility for American
  Indian Elders and others.
• HIA to examine impact of living in facility on
  residents health.
• A concurrent HIA expected to take one year.

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Summary

• There are pronounced differences on many health
  indicators, depending on factors such as income,
  education and race/ethnicity.
• Community health is about more than health care
  or public health programs and policies.

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Summary

• We cannot eliminate health disparities without
  addressing the social and economic environment.
• A healthful social environment benefits the whole
  community.

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• Some of these ideas need to ripen.

• Brian Rusche
• Joint Religious Legislative Coalition

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Website Addresses

• Minnesota Department of Health
• http//www.health.state.mn.us
• MN Public Health Improvement Goals
• http//www.health.state.mn.us/divs/chs/hsd/goals.h
  tm
• A Call to Action Report and Executive Summary
  http//www.health.state.mn.us/divs/chs/hsd/schteam
  .htm
• Health Impact Assessment Information
• http//www.health.state.mn.us/divs/chs/hsd/hiateam
  .htm