State and Local Policy Initiatives to Reduce Health Disparities Workshop Summary (2011) / Chapter Skim
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2 Changing the Conditions of Communities Where People Live
2 Changing the Conditions of Communities Where People Live
Pages 5-14
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Death certificates are among the most comprehensive data sets available to public health researchers. For example, in California a death is not officially recorded until the local registrar of vital records, the county health officer signs the death certificate.
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Looking again at the data from Alameda County, the neighborhoods with the longest average life expectancies (census tracts depicted in green) also had high rates of high school graduation, low rates of unemployment, relatively low rates of poverty, and high rates of home ownership.
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Using the Alameda County data, Iton and his colleagues in the county (Alameda County Public Health Department, 2008) produced a report concluding that the most important drivers of the differences in life expectancies were not related to access to health care.
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Figure 2-4.eps bitmap
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. These principles were adapted from the Alameda County Public Health Department report (2008)
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report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (IOM, 2003) , document the disparities between people of color and whites in health outcomes that occur because of a lack of access to health care for people of color.
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It is possible, then, to create a system that brings health care, health care institutions, and the community together in support of better health outcomes. SPECIFIC RECOMMENDATIONS Larry Cohen, the final presenter and author, described the 32 recommendations from the paper (see Appendix A, page 61, for the complete list)
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This implies a very different approach to health and also implies that this is an ideal opportunity to promote health equity as a component of health care reform. DISCUSSION Roundtable member Bill Vega asked whether the real goal is to create better living conditions for people living in concentrated poverty neighborhoods.
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He believes that using the life expectancy data supports the argument that poverty, educational attainment, and other social determinants affect access to health care and overall health status. The final question referred to the federal health care reform efforts that got under way in 2009.
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