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Why Are We Unhealthy?

Why Are We Unhealthy?. Adrian Dominguez Bob Lutz. All of us should have the opportunity to make the choices allowing us to live a healthy life, regardless of income , education, ethnic background or where we live. Health is a resource for everyday life, not the objective of living.

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Why Are We Unhealthy?

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  1. Why Are We Unhealthy? Adrian Dominguez Bob Lutz

  2. All of us should have the opportunity to make the choices allowing us to live a healthy life, regardless of income, education, ethnic background or where we live.

  3. Health is a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.

  4. The Ladder Position • A metaphor to explain health inequities • Societies are structured like ladders • The rungs of the ladder represent the resources that determine whether people can live a good life or a life plagued by difficulties

  5. Dynamic Relationship Between Health and Ladder Position Retirement Income Retirement/ Income Health Health

  6. A Framework Socio-Ecological Medical Model Individual Health Knowledge Genetics UpstreamDownstream • Race • Class • Gender • Immigration status • National origin • Sexual • orientation • Disability • Corporations & other businesses • Government agencies • Schools • Neighborhood conditions • Social • Physical • Residential segregation • Workplace conditions • Education Social Inequities • Smoking • Nutrition • Physical activity • Violence • Chronic stress • Infectious disease • Chronic disease • Injury (intentional / unintentional) • Infant mortality • Life expectancy Institutional Power Discriminatory Beliefs (ISMS) Risk Factors & Behaviors Disease & Injury Mortality Health Status Healthcare Access Social Factors

  7. Individual Enhancing skills, knowledge, attitudes and motivation Interpersonal Increasing support from friends, family and peers Organizational Changing policies and practices of organizations Community Collaborating and creating partnerships to effect change in the community Public Policy Developing, influencing, and enforcing local, state and national laws Socio-ecological Model

  8. That which does not kill us makes us stronger.Friedrich Nietzche

  9. Health Inequities in Spokane County

  10. Data Sources Washington State Population Survey Behavioral Risk Factor Surveillance Survey (BRFSS) Birth Certificates Death Certificates Community Health Assessment Tool (CHAT) Office of Financial Management, Washington State Washington State HIV Surveillance Report Strategic Research Associates, Omnibus Survey

  11. Purpose of Health Inequity Report The goal of this assessment is to increase awareness about different health and social factors in Spokane County and provide information that can be used for potential changes that affect health outcomes. • Build awareness • Identify further areas for exploration • Intended for health professionals, legislators (policy makers), administrators, community members, and anyone interested in addressing health concerns in Spokane County

  12. Health Disparity Definitions Differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups. Health Inequity Concerns those differences in population health that can be traced to unequal economic and social conditions and are systemic and avoidable; thus being inherently unjust and unfair.

  13. Social Determinants of Health Definitions Factors (i.e., determinants) in our social and economic environment that researchers have been found to negatively (or positively) affect health. Social Gradient An individual's or population group's position in society and different access to and security of resources such as education, employment and housing, as well as different levels of participation in civic society and control over life.

  14. Components of Health Inequities

  15. Why Education? What We Heard When invited to discuss what could be done to improve quality of life, many focus group participants discussed the importance of jobs and education: “You said jobs, I say schooling to get a job. Jobs are good, but I think to get a solid job is to get an education.” Focus Group Participant (income <35k)

  16. The Faces of Inequities in Spokane

  17. Effects of Education on Poverty Adults 25 Years of Age or Older Living in Poverty by Education, 2000 to 2008 Data Source: Washington State Population Survey

  18. General Health Status by Education General Health Status by Education among Adults 25 Years of Age or Older, 2000 to 2008 Adults with less education are more likely to rate their health as poor or fair. Data Source: Behavioral Risk Factor Surveillance System (BRFSS)

  19. Smoking by Education Smoking by Education among Adults 25 Years of Age or Older, 2005 to 2009 More adults with less education smoke compared to adults with a higher education. Data Source: Behavioral Risk Factor Surveillance System (BRFSS)

  20. Effects of Education on Cardiovascular Disease Cardiovascular Disease by Education among Adults 25 Years of Age or Older, 2005 to 2009 Data Source: Behavioral Risk Factor Surveillance System (BRFSS)

  21. Diabetes by Education Diabetes by Education among Adults 25 Years of Age or Older, 2005 to 2009 Diabetes significantly decreases as the level of education increases. Data Source: Behavioral Risk Factor Surveillance System (BRFSS)

  22. Children in Poverty by Parent’s Education Children Living in Poverty by Parent’s Highest Level of Education, 2000 to 2008 Data Source: Washington State Population Survey

  23. Infant Mortality by Mother’s Education Infant Mortality by Mother’s Education of Women 25 Years or Older, 2003 to 2009 Data Source: Birth and Death Certificates

  24. Health Starts in Our Homes, Schools and Communities

  25. A Framework Socio-Ecological Medical Model Individual Health Knowledge Genetics UpstreamDownstream • Race • Class • Gender • Immigration status • National origin • Sexual • orientation • Disability • Corporations & other businesses • Government agencies • Schools • Neighborhood conditions • Social • Physical • Residential segregation • Workplace conditions • Education Social Inequities • Smoking • Nutrition • Physical activity • Violence • Chronic stress • Infectious disease • Chronic disease • Injury (intentional / unintentional) • Infant mortality • Life expectancy Institutional Power Discriminatory Beliefs (ISMS) Risk Factors & Behaviors Disease & Injury Mortality Health Status Healthcare Access Social Factors

  26. Adrian E. Dominguez, M.S.EpidemiologistSpokane Regional Health DistrictDisease Prevention and ResponseCommunity Health Assessmentadominguez@spokanecounty.org509.324.1670

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