www.healcitiescampaign.org www.expedia.com Neighborhood and Built Environment
National Prevention Strategy (2011) World Health Organization. www.who.int BMJ 1999;318:1686-9 Neighborhood and Built Environment • Housing • Environmental conditions • Physical surroundings • Crime and violence • Healthy foods • http://www.ers.usda.gov/data-products/food-access-research-atlas/go-to-the-atlas.aspx#.UhQDPLw-KKx • Transportation
www.ci.bellvue.wa.us Case • Identify NEIGHBORHOOD AND BUILT ENVIRONMENT determinants of health
UNNATURAL CAUSES… is inequality making us sick? Movie Break
Upstream Program and Policy Corporations and businesses Government agencies Schools Social Inequities Class Race Gender Immigration status Physical Environment Housing Land use Transportation Behavior Smoking Nutrition Physical activities Violence Disease and Injury Chronic disease Infectious disease Injury Mortality Infant mortality Life expectancy Downstream
Eliminating Health Disparities Addressing the Social Determinants of Health
How Do We Address Social Determinants of Health? • Why is important for us as pharmacists to address social determinants of health? • How do we address the social determinants of health? • How can we have an impact on social determinants of health? • http://www.healthypeople.gov/2020/about/DOHAbout.aspx
Experiential Learning Public Health Project Worksheet Please work on PART 1
Healthy People 2020. www.healthypeople.gov www.endvawnow.org Social Ecological Model Society Community Relationship Individual
Evidence Based Interventions • Community Toolbox • http://ctb.ku.edu • What Works for Health • http://www.countyhealthrankings.org/policies • The Campbell Collaboration • http://www.campbellcollaboration.org/ • Primary literature
J Public Health ManagPract 2008;14:s8-17. J Med Internet Res 2011;13:e28 Individual • Biology • Age • Education • Health literacy • Income Motivation
Case • Indentify individual level interventions to improve the health outcomes of the patient in your case • Find evidence for at least one intervention
J Public Health ManagPract 2008;14:s8-17 Healthy Families America. www.healthyfamiliesamerica.org Home Visiting Evidence of Effectiveness. http://homvee.acf.hhs.gov/document.aspx?rid=5&sid=20&mid=2 Relationship • Friends • Partners • Family • Social circle UPMC Living at Home
Case • Indentify relationship level interventions to improve the health outcomes of the patient in your case • Find evidence for at least one intervention
J Public Health ManagPract 2008;14:s8-17 Healthy People 2020. www.healthypeople.gov National Prevention Strategy (2011) Community • Neighborhoods • Schools • Work • Health Affairs 2012;31:177-8 • What Works for Health. www.countyhealthrankings.org/policies • School Breakfast Scorecard: School Year 2011-2012 • Obesity reviews 2011;12:406-29.
Case • Indentify community level interventions to improve the health outcomes of the patient in your case • Find evidence for at least one intervention
BMJ 1999;318:1686-9 Health Affairs 2011;30:1852- National Prevention Strategy (2011) Society School Breakfast Programs • Cultural and societal norms • Health policies • Economic policies • Educational policies • Social policies
Case • Indentify society level interventions to improve the health outcomes of the patient in your case • Find evidence for at least one intervention
Case Discussions • Case 1 • Case 2 • Case 3
Experiential Learning Public Health Project Worksheet Please work on PART 2
Interventions Summary Health
Discussion • Why is it important for pharmacists to understand the social determinants of health? • What is one thing you’ve learned at your practice site that is relevant to your practice as a pharmacist?
References • World Health Organization – www.who.int • Healthy People 2020 - http://www.healthypeople.gov/2020/default.aspx • http://www.portal.state.pa.us/portal/server.pt/community/health_statistics/14136/other_health_statistics/590085 • http://www.portal.state.pa.us/portal/server.pt?open=514&objID=596652&mode=2 • Braveman P, Egerter S, Williams DR. The Social Determinants of Health: Coming of Age. Annu Rev Pub Health 2011;32:381-98 • Marmot, M., & Wilkinson, R. (Eds.). (2009). Social determinants of health. Oxford University Press. • National Prevention Council, National Prevention Strategy, Washington DN: US Department of Health and Human Services, Office of the Surgeon General, 2011. • http://www.achd.net/biostats/pubs/Gabe/disparities.html • Mohi P, Kweon BS, Lee S, Ard K. Air Pollution Around Schools is Linked to Poorer Student Health and Academic Performance. Health Affairs 2011;30:852-62. • Woolf SH, Braveman P. Where Health Disparities Begin: The Role of Social and Economic Determinants and Why Current Policies May Make Matters Worse. Health Affairs 2011;30:1852-9. • Egan M, Tannahill C, Petticrew M, Thomas S. Psychosocial Risk Factors in Home and Community Settings and Their Associations with Population Health and Health Inequalities: A Systematic Meta-Review. BMC Public Health 2008;8:239. • Commission of Social Determinants of Health. CSDH Final Report: Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Geneva: World Health Organization, 2008. • Marmot M, Friel S, Bell R, Houwelling TAJ, Taylor S, on behalf of the Commission on Social Determinants of Health. Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Lancet 2008;372:1661-9. • Dora C. A Different Route to Health: Implications of Transport Policies. BMJ 1999;318:1686-9. • Williams DR, Costa MC, Odunlami AE. Moving Upstream: How Interventions that Address the Social Determinants of Health can Improve Health and Reduce Disparities. J Public Health ManagPract 2008;14:s8-17 • Eysenbach G. Social Cognitive Determinants of Nutrition and Physical Activity Among Web-Health Users Enrolling in an Online Intervention: The Influence of Social Support, Self-Efficacy, Outcome Expectations, and Self-Regulation. J Med Internet Res 2011;13:e28 • Peek ME, Wilkes AE, Roberson TS, Goddu AP, Nocon RS, Tang H, et al. Early Lessons From An Initiative on Chicago’s South Side to Reduce Disparities in Diabetes Care and Outcomes. Health Affairs 2012;31:177-8 • Azagba S, Asbridge M. The association between smoking bans and nicotine dependence: A longitudinal analysis of current smokers in Canada. Addictive Behaviors 2013;38:2817-20. • Healthy Families America – www.healthyfamiliesamerica.org • Home visiting evidence of effectiveness .http://homvee.acf.hhs.gov/document.aspx?rid=5&sid=20&mid=2 • School breakfast programs – www.fns.usda.gov/cnd/breakfast • What works for health - www.countyhealthrankings.org/policies • School Breakfast Scorecard: School Year 2011-2012. Food Research and Action Center, January 2013. • Verweji LM, Coffeng J, Mechelen WV, Proper KI. Meta-analyses of workplace physical activity and dietary behaviour interventions on weight outcomes. Obesity reviews 2011;12:406-29. • Reblin M, Uchino. Social and emotional support and its implication for health. Current Opinion in Psychiatry 2008;21:201-5. • Center for Disease Control – www.cdc.gov • Equity, social determinants and public health programmes – WHO • West JF. To Fight Bad Suga', Or Diabetes, My Neighborhood Needs More Health Educators Health Affairs, 32, no.1 (2013):184-187. • Marmot M. Social Determinants of Health Inequalities. Lancet 2005;365:1099-104 • CDC Vital Signs – www.cdc.gov/obesity/childhood/basics.html. .
Contact Information • Marisa Sochacki, PharmD • PGY2 Global Health/Underserved Care • email@example.com