The River Bends Towards Health in All Policies North Carolina Public - - PowerPoint PPT Presentation

The River Bends Towards Health in All Policies

North Carolina Public Health Association Spring Conference May 5, 2016

Julia Caplan, MPH, MPP

Program Director, Public Health Institute

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Outline

• 1. What is a healthy community?
• 2. Health in All Policies: A new paradigm
• 3. HiAP in action
• 4. Equity & environmental sustainability
• 5. Success factors and next steps

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The French Broad River in Western North Carolina  Source: Visitnc.com/rivers-lakes

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“It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change.”

• Institute of Medicine

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Sticky or “Wicked” Problems

• Multi-factorial
• Difficult to fully define
• Lack a clear solution
• Not the responsibility of any single
• rganization

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a collaborative approach to improving the health

• f all people by

incorporating health considerations into

Health in All Policies is…

decision-making across sectors and policy areas.

Source: Rudolph, L., Caplan, J., Ben-Moshe, K., & Dillon, L. (2013). Health in All Policies: A Guide for State and Local Governments. Washington, DC and Oakland, CA: American Public Health Association and Public Health Institute.

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The 5 Key Elements of Health in All Policies

• 1. Promote health, equity, and environmental

sustainability

• 2. Support intersectoral collaboration
• 3. Benefit multiple partners
• 4. Engage stakeholders
• 5. Create structural or procedural change

Source: Rudolph, L., Caplan, J., Ben-Moshe, K., & Dillon, L. (2013). Health in All Policies: A Guide for State and Local

• Governments. Washington, DC and Oakland, CA: American Public Health Association and Public Health Institute.

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California Health In All Policies Task Force

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California Health in All Policies: Climate Change and Childhood Obesity

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• Active

Transportation

• Farm to Fork
• Food Procurement
• Health & Equity in

Land Use Planning

• Housing Siting and

Air Quality

• Land Use, Schools

and Health

• Violence Prevention

Multi-Agency Work Groups

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• Convening
• Facilitation
• Research
• Technical assistance
• Monitoring and reporting
• Subject matter expertise
• Draft consensus documents
• Stakeholder engagement

Public Health’s Role

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A Transportation Story

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Key Element #1: HiAP is about health, equity, and environmental sustainability

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North Carolina Social and Economic Well-Being Indicators

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• Children and families

in poverty

• Dropout rates
• Percent not owning a

home, by race/ethnicity

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North Carolina data: health and social determinants of health

21.3% 21.3 6.7% 6.7 Number of infant deaths per 1,000 live births (Infant Mortality Rate) (2008) Percent of families living below the Federal Poverty Level (2008) African American/Black White

Sources: North Carolina State Center for Health Statistics, Vital Statistics, 2014 Statistics for North Carolina; North Carolina Office of Minority Health and Health Disparities and State Center for Health Statistics: Racial and Ethnic Health Disparities Report Card 2010.

Health Inequity: Disparities in health that are a result of systemic, avoidable and unjust social and economic policies and practices that create barriers to

• pportunity.
• Virginia Department of Public Health

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Assumes all people have the same needs Ensures all people have what they need

Adapted from: Community View Collaboration of the Saskatoon Health Region, Canada.

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Source: The Williams Institute, University of California, Los Angeles

35% of LGBT Americans live in the South

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Health inequities: LGBT youth

• 20% - 40% of homeless youth are LGBT
• Overrepresented in child welfare and juvenile justice

systems

• 63.5% of LGBT students felt unsafe
• 81.9% were verbally harassed
• 38.3% were physically harassed
• Harassment leads to lower grades
• 8.4 times more likely to attempt suicide

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Discrimination causes health inequity

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Discrimination

Health inequities: Cancers, heart disease, high blood pressure, kidney disease, etc. Chronic stress Differential access to resources Differential living conditions Increased allostatic load Epigenetic changes

Applying an Equity Lens

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How might this decision affect different groups?

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Doctors Issue Call to Combat Climate Change

They say respiratory illnesses, heat stroke and infectious diseases are growing threats due to a warmer planet - HealthDay, National Institute of Health

Monday, April 18, 2016

• Respiratory illnesses
• Ozone pollution, smoke,

allergens

• Toxic mold and fungi
• Heat exhaustion and heat stroke
• Insect-borne illnesses
• Water-borne illnesses
• Mental health disorders
• - Wayne Riley, M.D., president,

American College of Physicians

American College of Physicians: “Climate change is already harming people's health”

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Public Health and Climate Change in North Carolina

According to the Federal government, North Carolina is vulnerable to:

• Sea level rise and increasing storm surge
• Drought and decreased water availability
• Extreme heat events
• Hurricanes
• Mold and allergens
• Insects and pathogens
• Reduced crop productivity

Who is most vulnerable?

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Comic by Joel Pett

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How wo wonderful ful it is that t nobody dy need wait t a si single gle moment nt befor

• re

e begin inni ning ng to to impr prov

• ve the wo

world ld. .

• Anne Fran

ank

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HiAP is Spreading

• Baltimore, Maryland
• Chicago, Illinois
• Del Norte County, California
• Galveston, Texas
• Monterey County, California
• Nashville, Tennessee
• New Orleans, Louisiana

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What will

YOU

do?

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Health in All Policies: A Guide for State and Local Governments (October 2013)

• What is HiAP and Why Do We Need It?
• The Nuts and Bolts of HiAP
• Getting Started
• Partners and Roles
• Working Together Across Sectors
• Structures to Support HiAP
• Creating Healthy Public Policy
• Talking about HiAP
• Case Study: California HiAP Task Force
• Appendices

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For more information

Julia Caplan, HiAP Task Force Program Director: julia.caplan@cdph.ca.gov HiAP Task Force website: http://sgc.ca.gov/s_hiap.php

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