Karen Minyard, GHPC Director, presented "Social Determinants of Health Equity and Levels of Potential Impact in the System: Opportunities for Leverage" at the Georgia Grantmakers Alliance in Macon, GA on August 25, 2011.

1. Social Determinants of Health Equity and Levels of Potential Impact in the System: Opportunities for Leverage Karen J. Minyard, Ph.D.Executive Director Georgia Health Policy Center Georgia State University

4. How Healthy Are Georgians? Health Status by County

5. 5 Georgia’s Health Ranking Among States: 2010

6. Factors Influencing Health Status Schroeder, Steven A., We Can Do Better -- Improving the Health of the American People, N Engl J Med 2007 357: 1221-1228

7. Social Determinants of Health Equity

8. Health Disparities The unequal burden in disease morbidity and mortality rates experienced by ethnic/racial groups as compared to the dominant group. Source: Healthy People 2010, US HHS, 2000

9. Social Determinants of Health The conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. Source: World Health Organization, 2008

10. Community-Level Determinants of Health Equity Source: Grantmakers in Health, 2009; Institute of Medicine, 2008; PolicyLink, 2002; Prevention Institute, 2003

12. Identified 200 community-based interventions in six areas

13. Reviews in three areas complete

14. Early childhood development = effective

15. Affordable and safe housing = effective

17. Early Childhood DevelopmentSource: Anderson et al., 2003; CDC, 2009; Williams et al., 2008

19. Significant outcomes:

20. Reduced risks for antisocial behaviors for children

21. Reduced childhood injury

22. Reduced child abuse, maternal crime & substance abuse

23. Improved prenatal outcomes

24. Increased school readiness for children

25. Increased maternal employment & father involvement

26. ROI=$5 for every $1 spentSource: http://www.nursefamilypartnership.org

28. Promise Academy Charter schools & 22 birth-to-college community programs

29. Baby College, The Three Year Old Journey, Get Ready for Pre-K, Harlem Gems

30. Significant outcomes:

31. 100% of Harlem Gems school ready for 6 consecutive years

32. 97-100% of 3rd graders at-level in math & English language arts

33. 97% of 8th graders at-level in math

34. vs 7% avg for Black 8th graders

35. Closing Black-White achievement gapSource: Dobbie & Fryer, 2009

36. A Lesson in North Karelia In the 1970’s, North Karelia, Finland was plagued by exceedingly high deaths from cardiovascular disease “It was a question of general lifestyle of the community - not just some people with high risk factors. The whole environment had to change - the food industry, restaurants, cafeterias, supermarkets.” - PekkaPuska, Project Director

37. A Lesson in North Karelia What they did: Towns were pitted against each other in cholesterol-lowering competitions. Food-labeling laws were changed The national school-lunch program got a major overhaul They convinced bread companies to use less salt and replace butter with vegetable oil They made sure walking paths were clear They passed laws to provide facilities for their citizens to get exercise Results: The smoking rate dropped from 52% to 31% Coronary heart disease mortality fell by 73% Lung cancer mortality dropped by 71% All-cancers mortality dropped by 49% Overall mortality declined 45% 6 to 7 extra years of life expectancy were added

38. Levels of Impact

39. Sustainability Institute, adapted from other versions from the organizational learning field

40. Philanthropic Collaborative for a Healthy Georgia Individual Providers Incentives for Collaboration Change the System/Policy/Environment

41. Opportunities for Leverage

42. Strategic AlignmentTriple-Layer Chess National State Local

43. Visit www.gsu.edu/ghpc or follow us on Facebook for more information and resources.