Download as PDF, PPTX
![Structural trauma and toxic stress—The roots of racial health inequities
Foundational themes
• Individual and communities suffer from the effects of trauma
• Life-course of toxic stress, structural racism, and discrimination
• Toxic stress effects a child’s learning, behavior, and health for life
• Policy, systems, structural priorities must reach the most vulnerable
• Neighborhood, Family-centered, Life-course (NFL)4 focus is essential
• Trauma effects are transmitted across generations socially and biologically
4
The acronym NFL makes us think of the “National Football League” who is infamous for the
systematic denial of permanent brain injury (chronic trauma encephalopathy [CTE]) from playing
football (see http://www.pbs.org/wgbh/frontline/film/league-of-denial/). For us, NFL means
having a relentless focus on the Neighborhood, Family-centered, Life-course (NFL) approach when we
prioritize social policy: we aim to always reach the most vulnerable—children ages 0 to 5 years.
11](https://image.slidesharecdn.com/aragon-tomaspopulation-health-101beaver-170421032440/75/What-is-population-health-11-2048.jpg)
Uploaded byTomas J. Aragon
What is population health?
- Population health is a framework for studying and improving the health of populations through collective action and learning. It aims to protect health and promote equity. - Health inequities exist along racial lines in San Francisco due to unevenly distributed social and economic obstacles to health. Structural racism and discrimination contribute to toxic stress that affects health across the lifespan. - Improving population health requires a life-course approach that addresses the roots of inequities from early childhood through strengthening neighborhoods and families, especially for vulnerable groups. Leaders must prioritize policies that support population health from birth.
In this document
Powered by AI
Overview of population health and the challenges of improving it, focusing on racial health inequities.
Definition of population health, health equity goals, and public health as collective societal effort.
Overview of wellness dimensions and socioecological models highlighting health inequities in San Francisco.
Discussion on racial health inequities, focusing on trauma, toxic stress, and structural inequalities.
Impact of childhood adversities on mental health, neural development, and lifelong health trajectories.
Role of leaders in enhancing population health, and introduction to Leadership San Francisco's mission.
Ending acknowledgments, questions, and important online resources for further exploration in population health.
More Related Content
Similar to What is population health?
What is population health?
- 1. What is PopulationHealth? Leadership San Francisco—Celebrating 32 years of leaders! Tomás J. Aragón, MD, DrPH Thursday, April 20, 2017 Health Officer, City & County of San Francisco Director, Population Health Division (PHD) San Francisco Department of Public Health http://phlean.org (quality improvement) http://phdata.science (data science) [email protected] (email) 415-78-SALUD (415-787-2583) PDF slides produced in Rmarkdown LATEX Beamer—Metropolis theme 1
- 2. What is populationhealth? How do we explain racial health inequities? How can we, as leaders, improve popuation health? 2
- 3. What is populationhealth? 3
- 4. Causes of prematuredeaths in men and women, San Francisco, 2003–2004 Age-adjusted Expected Years of Life Lost (eYLL): Male (left), Female (right); Black (colored red), Latino, × Asian/PI, + White; Source: Aragón TJ, et al. PubMed ID: 18402698 4
- 5. Some definitions Health isa state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (World Health Organization, 1946). Public health is what we, as a society, do collectively to assure the conditions in which people can be healthy (Institute of Medicine, 1988). Population health1 is a systems2 framework for studying and improving the health of populations through collective action and learning (Aragon & Garcia, 2017).3 1 Essential population health goals include (1) protecting and promoting health and equity, (2) transforming people and place, (3) ensuring a healthy planet, and (4) achieving health equity. 2 Complex adaptive socioecological systems (CASES) 3 http://www.escholarship.org/uc/item/825430qn; for discussion of the term "population health" see http://www.phdata.science/p/about.html 5
- 6. Health includes the8 dimensions of wellness Source: http://www.samhsa.gov/wellness-initiative 6
- 7. Socioecological model ofpopulation health Source: California Department of Public Health, Office of Health Equity 7
- 8. San Francisco residentsdo not have equitable opportunities for good health Unevenly distributed obstacles to health (left); Health inequities (right) Source: San Francisco Community Health Needs Assessment (http://sfhip.org) 8
- 9. How do weexplain racial health inequities? 9
- 10. The lifecourse, two-generationroots of health and well-being, 2004–2016 My family: early childhood sets life trajectory 10
- 11. Structural trauma andtoxic stress—The roots of racial health inequities Foundational themes • Individual and communities suffer from the effects of trauma • Life-course of toxic stress, structural racism, and discrimination • Toxic stress effects a child’s learning, behavior, and health for life • Policy, systems, structural priorities must reach the most vulnerable • Neighborhood, Family-centered, Life-course (NFL)4 focus is essential • Trauma effects are transmitted across generations socially and biologically 4 The acronym NFL makes us think of the “National Football League” who is infamous for the systematic denial of permanent brain injury (chronic trauma encephalopathy [CTE]) from playing football (see http://www.pbs.org/wgbh/frontline/film/league-of-denial/). For us, NFL means having a relentless focus on the Neighborhood, Family-centered, Life-course (NFL) approach when we prioritize social policy: we aim to always reach the most vulnerable—children ages 0 to 5 years. 11
- 12. Childhood adversities andmental health outcomes in homeless adults San Francisco, 2016 (Am J Geriatr Psychiatry 2016) Source: http://www.centerforyouthwellness.org/ 12
- 13. Neural connections andneuroplasticity in the early and late years of life Source: Center on the Developing Child (http://developingchild.harvard.edu/) 13
- 14. Lifecourse Health Development—Variabletrajectories Health development trajectories: Latent, cumulative, and pathway effects Source: Halfon N, et al. PubMed PMID: 23975451 14
- 15. How our corecapabilities work (1/2) Executive function, attention, and automatic and intentional self-regulation Executive function skill proficiency Source: Center on the Developing Child (http://developingchild.harvard.edu/) 15
- 16. How our corecapabilities work (2/2) Executive function, attention, and automatic and intentional self-regulation Source: 16
- 17. The lifecourse healthdevelopment of adult inequities Re-conceptualizing early lifecourse policies to strengthen lifelong health Source: Center on the Developing Child (http://developingchild.harvard.edu/) 17
- 18. How can we,as leaders, improve popuation health? 18
- 19. How can we,as leaders, improve popuation health? Established in 1985, Leadership San Francisco is a community service program operated as a nonprofit affiliate of the San Francisco Chamber of Commerce. Each year, approximately 60 future community leaders are selected to participate in LSF’s 10-month program. Participants are challenged to increase their understanding of the environment in which they live and work, and to learn how to respond effectively to community issues. They are part of a unique network of concerned citizens, taking an active role in influencing quality of life in the San Francisco Bay Area. (Source: http://leadershipsf.org/) 19
- 20. How can we,as leaders, improve popuation health? Source: Center on the Developing Child (http://developingchild.harvard.edu/) 20
- 21. Questions? Preguntas? Mgakatanungan? Des questions? Acknowledgments (in alphabetical order) Abbie Yant, Alice Chen, Amor Santiago, Anda Kuo, Aneeka Chaudhry, Ayanna Bennett, Barbara A Garcia, Barry Lawlor, Belle Taylor-McGhee, Brittney Doyle, Cecilia Thomas, Christine Siador, Cindy Garcia, Colleen Chawla, Colleen Matthews, Curtis Chan, Darlene Daevu, David Serrano Sewell, Deborah Sherwood, Deena Lahn, Dianne M. Easton, Ellen Chen, Estela Garcia, Greg Wagner, Guliana Martinez, Hali Hammer, Iman Nazeeri-Simmons, Isela Ford, Israel Nieves-Rivera, Jacque McCright, James Illig, Jeannie Balido, Jenee Johnson, Jessica Wolin, John Grimes, Jonathan Butler, Jonathan Fuchs, Judith Martin, Karen Pierce, Karen Strickland, Kavoos Ghane Bassiri, Kenneth Epstein, Kenneth Hardy, Kevin Grumbach, Kim Shine, Kirsten Bibbins-Domingo, Leigh Kimberg, Lisa Golden, Maria X Martinez, Marlo Simmons, Mary Hansell, Maximilian Rocha, Michelle A. Albert, Michelle Kirian, Michelle Long, Muntu Davis, Nadine Burke Harris, Neal Halfon, Patricia Erwin, Paula Fleisher, Perry Lang, Rachael Kagan, Rhea Bailey, Rhonda Simmons, Roberto Vargas, Robin George, Roland Pickens, Ron Weigelt, Stuart Fong, Susan Ehrlich, Susan Philip, Tessa Rouverol Collejo, Thomas Boyce, Tracey Packer, Veronica Shepard, Wanda Materre, Wanetta Davis, Wylie Liu 21
- 22. Key online resources •The Raising of America http://www.raisingofamerica.org/ • Center on the Developing Child at Harvard University http://developingchild.harvard.edu/ • Center for Youth Wellness—San Francisco http://www.centerforyouthwellness.org/ • All Children Thrive—ACT Now http://www.allchildrenthrive.org/ • Trauma Transformed—Bay Area http://www.t2bayarea.org/ • Trauma and Learning Policy Initiative https://traumasensitiveschools.org/ 22