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The Doctor is Out: HEALTH HAPPENS WHERE YOU LIVE, LEARN, WORK & PLAY Douglas Jutte, MD, MPH Arizona Healthy Communities Conference March 19, 2014
The Doctor is Out: HEALTH HAPPENS
WHERE YOU LIVE, LEARN, WORK & PLAY
Douglas Jutte, MD, MPH
Arizona Healthy Communities ConferenceMarch 19, 2014
DEFININGHEALTH
Health
Health Care
DEFININGHEALTH
Health
Health Care
Medical Care
CONTRIBUTIONSTO PREMATUREDEATH
BehavioralPatterns
40%
Genetic Predisposition
30%
Environmental Exposure
5%
Social Circumstances
15%
Health Care
10%
DEFININGHEALTH
“Health is a state of complete physical, mental
and social well-beingand not merely the absence
of disease or infirmity” – Preamble to the Constitution of the World Health Organization, June 1946
9.9.13HEALTH AND COMMUNITY DEVELOPMENT
SOCIAL DETERMINANTS OF HEALTH
Source: www.smartcitymemphis.com/cartoon/toxic-stress/
TOXIC STRESS & NEURO-DEVELOPMENT
SOCIOECONOMICGRADIENT IN HEALTH
4.7
7.3
12.4
17.6
0
5
10
15
20
ADMINISTRATIVE PROFESSIONAL AND EXECUTIVE
CLERICAL SEMI-SKILLED AND UNSKILLED
MO
RT
AL
ITY
RA
TE
PE
R 1
,00
0
BRITISH CIVIL CLASS
Mortality rate per 1,000, ages 40 to 64 years
SOCIOECONOMIC GRADIENTCROSSES RACIAL/ETHNIC LINES
23.9
19.2
20.9
18.3
15.614.8
11.210.3
7.76.8 6.4
4
0
5
10
15
20
25
30
BLACK, NON-HISPANIC HISPANIC WHITE, NON-HISPANIC
PE
RC
EN
T O
F P
ER
SO
NS
WIT
H P
OO
R/
FAIR
HE
ALT
H
<100%
100–199%
200–399%
400%
HEALTH DISPARITIESGLOBAL LIFE EXPECTANCIES
HEALTH DISPARITIESSHORT DISTANCES:LARGEDIFFERENCES
WASHINGTON,DC
Source: Robert Wood Johnson Foundation, Commission to Build a Healthier America
HEALTH DISPARITIESSHORT DISTANCES:LARGEDIFFERENCES
NEW ORLEANS
Source: Robert Wood Johnson Foundation, Commission to Build a Healthier America
HEALTH DISPARITIESSHORT DISTANCES:LARGEDIFFERENCES
MINNEAPOLIS –ST. PAUL
Source: Robert Wood Johnson Foundation, Commission to Build a Healthier America
IN DETERMININGYOUR HEALTH…
85201
COMMUNITY DEVELOPMENT IS IN THEZIP CODE IMPROVEMENT BUSINESS
AFFORDABLE HOUSING &SUPPORTIVE HOUSING
SMALL BUSINESS& COMMUNITY INFRASTRUCTURE
COMMUNITY DEVELOPMENT ATTACKS THE CORROSIVE EFFECTS
OF POVERTY THAT LEAD TO POOR HEALTH & REDUCED LIFE
CHANCES
WHY WE SHOULD ALL CARE
$2.9 TRILLION
WHY WE SHOULD ALL CARE
The U.S. Is Not Getting Good Value for its Health Dollar
Number of people age 65 and over: 1900–2000 and projected 2010–2050
WHY WE SHOULD ALL CARE
WHY WE SHOULD ALL CARE
“Every child
is precious”
THE STATUS QUO ISSTUPID AND EXPENSIVE
WE SPEND MONEY ON THE WRONG THINGS
vsPRISON PRESCHOOL
vsSPECIAL EDUCATION TUTORS
vsEMERGENCY ROOM VISITS SUMMER CAMPS
vsPOLICE JOB TRAINING
COMMUNITY DEVELOPMENT AND HEALTHWORK SIDE-BY-SIDE
COMMUNITY DEVELOPMENT AND HEALTH COULD BE A POWERFUL TEAM…
COMMUNITY
DEVELOPMENTHEALTH
…BUT WE NEED MORECOORDINATION & INTEGRATION
COMMUNITY
DEVELOPMENTHEALTH
AND WE NEEDMORE PARTNERS
COMMUNITY
DEVELOPMENTHEALTH
EDUCATIONPUBLIC
SAFETY
ECONOMIC
DEVELOPMENT
COMMUNITY
EMPOWERMENT
IT REQUIRESALL HANDS ON DECK
COMMUNITY
DEVELOPMENTHEALTH
EDUCATIONPUBLIC
SAFETY
ECONOMIC
DEVELOPMENT
COMMUNITY
EMPOWERMENT
NATIONAL PARTNERSHIP FOR COMMUNITY DEVELOPMENT & HEALTHBUILDHEALTHYPLACES.ORG
BRIGHT EYES
THE DOCTOR IS OUT: HEALTH HAPPENS WHERE YOU LIVE, LEARN, WORK & PLAY
Douglas Jutte, MD, MPHSchool of Public Health, University of California, Berkeley
www.buildhealthyplaces.org
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