Local Public Health; Agents Local Public Health; Agents for Health Equity for Health Equity

Adewale Troutman,M.D., M.A., M.P.H.

University of Louisville

Louisville Department of Public Health and Wellness

Core Public Health FunctionsCore Public Health Functions Assessment •Assess the health needs of the community

•Investigate the occurrence of health effects and health hazards in the community

•Analyze the determinants of identified health needs

Policy development •Advocate for public health, build constituencies, and identify resources in the community

•Set priorities among health needs

•Develop plans and policies to address priority health needs

Assurance •Manage resources and develop organizational structures

•Implement programs

•Evaluate programs and provide quality assurance

•Inform and educate the public

The Essential Public Health The Essential Public Health ServicesServices

1. Monitor health status2. Diagnose and

investigate health problems

3. Inform and educate4. Mobilize communities

to address health problems

5. Develop policies and plans

6. Enforce laws and regulations

7. Link people to needed health services

8. Assure a competent health services workforce

9. Evaluate health services10. Conduct research for

new innovations

Healthy People 2010Healthy People 2010

Two Goals

Increase Quality and Years of Health Life

Eliminate Health Disparities

HealthHealth

“The presence of physical, psychological, social, economic and spiritual well being not merely the absence of disease or infirmity”

“The maintenance of a harmonious balance of mind, body and spirit” – Community and individual

EquityEquity

Justice according to natural law or rightFreedom from bias or favoritism

Health EquityHealth Equity

“The absence of unfair and avoidable or remediable differences in health among social groups” ( The Commission )

A value position supported by an evidence base

There is and will be political opposition to the core value of health equity

Health inequitiesHealth inequities are systemic, are systemic, avoidable, unfair and unjust differences in avoidable, unfair and unjust differences in

health status and mortality rates and in health status and mortality rates and in the distribution of disease and illness the distribution of disease and illness across population groups. They are across population groups. They are

sustained over time and generations and sustained over time and generations and beyond the control of individualsbeyond the control of individuals

““The time has come to herald The time has come to herald human rights as both the human rights as both the

foundation of public health foundation of public health and the compass of public and the compass of public

policy”policy”JAPHA 2000JAPHA 2000

Looking UpstreamLooking Upstream

Determinants of Health; A Determinants of Health; A Holistic ApproachHolistic Approach

Social and Economic EnvironmentPhysical EnvironmentHealth BehaviorsHealth Care AccessPolicies & The Political EnvironmentThe Balance of PowerGenetics/Biology

Why Social Determinants?Why Social Determinants?

Socioeconomic StatusSocioeconomic Status

OccupationEducationIncome

– Income gaps

Racism & discriminationHousingPolitical power

Social Determinants ( WHO )Social Determinants ( WHO )

The Social Gradient Stress Early Life Social Exclusion Work Unemployment Social Support Addiction Food Transport

HousingHousing

Public Health and the Built Public Health and the Built EnvironmentEnvironment

Housing and HealthHousing and Health

LeadIndoor air qualityUnsafe environmentsObesityAsthmaStress

Cotter LaneCotter Lane

Park DuVallePark DuValle

Park DuVallePark DuValle

Center ActivitiesCenter Activities

Center ActivitiesCenter Activities

Staff Training on Community Organizing Staff and Community Training on Capacity

Building Community Policy Mini-grantsSpeakers seriesOn line learning in Health Equity for

consumers and state employees in healthTraining in policy development

ActivitiesActivities

Food Security Task ForceCommunity Visioning ProcessDialogue Process- Yale UniversityFraming Research followed by Social

Marketing StrategyEmergency Preparedness and Health

Equity/Social Justice

ActivitiesActivities

School of Public Health and Information Sciences course development

“White Paper” on Health Equity and Social Justice

Implementation of focus on HIA’sOffice of Faith and Health ( Social Justice )Tommie Smith Youth Athletic Initiative Undoing Racism workshops

Adewale Troutman, M.D.,M.P.H.Adewale Troutman, M.D.,M.P.H.The Troutman GroupThe Troutman Group

5109 Forrest Grove Place5109 Forrest Grove PlaceLouisville, Ky 40059Louisville, Ky 40059denzibell@aol.comdenzibell@aol.com adedrum@aol.comadedrum@aol.com

www.adewaletroutman.comwww.adewaletroutman.comwww.thetroutmangroup.orgwww.thetroutmangroup.org