Health, economic and environmental sustainability: Three perspectives or one?

Transcription

1 Health, economic and environmental sustainability: Three perspectives or one February 7, 2012 Sustainability Linkages in the Federal Government The National Academies David Fleming, MD Director and Health Officer Public Health-Seattle & King County

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3 A look through the health lens

4 Average years US, Australia Canada Finland France Hong Kong Iceland Israel Italy Japan Macao Norway Spain Sweden Switzerland

5 Life expectancy, by county, compared to the world s 10 best countries Murray, C JL and Ezzati, M. Falling behind: life expectancy in US counties from 2000 to 2007 in an international context, Population Health Metrics, June 2011

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7 Changing leading causes of death US 1900 Pneumonia Tuberculosis Diarrhea Mortality Rate Epidemiologic Transition 2010 Heart Disease Cancer Stroke

8 Health Measures measures Across across King County Obesity 8% - 35% Uninsured 3% - 30% Smoking 3% - 22% Lake Kenmore Bothell Shoreline Forest Park Woodinville Duvall Lake Kenmore Bothell Shoreline Forest Park Woodinville Duvall Lake Kenmore Bothell Shoreline Forest Park Woodinville Duvall Kirkland Redmond Kirkland Redmond Kirkland Redmond Medina Medina Medina Seattle Mercer Island Bellevue Sammamish Seattle Mercer Island Bellevue Sammamish Seattle Mercer Island Bellevue Sammamish Newcastle Issaquah Newcastle Issaquah Newcastle Issaquah Burien Tukwila Renton Burien Tukwila Renton Burien Tukwila Renton Normandy Park SeaTac Normandy Park SeaTac Normandy Park SeaTac Des Moines Kent Des Moines Kent Des Moines Kent CovingtonMaple Valley CovingtonMaple Valley CovingtonMaple Valley Federal Way Algona Pacific Auburn Black Diamond Federal Way Algona Pacific Auburn Black Diamond Federal Way Algona Pacific Auburn Black Diamond Lowest Average Highest

9 Community traits and health effects Community attribute Food deserts Substandard housing Lack of bike paths, sidewalks Brownfields Limited public transportation Health effect Obesity, heart disease, cancer Asthma, lead poisoning Obesity, diabetes, heart disease Toxic exposures, cancer Obesity, diabetes, stress, motor vehicle injury

10 Health improvement Environmental improvement Economic development

11 Health improvement Environmental improvement! Economic development

12 Community traits and health, economic and environment effects Community attribute Health Economy Environment Food deserts Obesity, heart disease, cancer Fewer economically viable local businesses; fewer markets for local farmers Less land use diversity; increased long distance transport of goods Substandard housing Asthma, lead poisoning Lower home values, less worker and student productivity Larger carbon footprint Lack of bike paths, sidewalks Obesity, diabetes, heart disease Lower property values Traffic congestion, poor air quality Brownfields Toxic exposures, Cancer Unusable land; fewer business opportunities Dead zones, pollution and toxic run off Limited public transportation Obesity, diabetes, stress, motor vehicle injury Less access to jobs, shopping and education Traffic congestion, poor air quality

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14 Catalyze collaboration Create reasons and opportunities for different stakeholders to mingle. Examples: Robert Wood Johnson & Federal Reserve forums on health and economic development King County Strategic Plan Equity and Social Justice law

15 Foster adaptive leadership Create and manage active processes to guide parties down the path to mutually agreed upon goals. Examples: National Prevention Council King County Vision 2040 King County Board of Health land use planning process The White House Office of the Press Secretary For Immediate Release June 10, 2010 Executive Order Establishing the National Prevention, Health Promotion, and Public Health Council EXECUTIVE ORDER ESTABLISHING THE NATIONAL PREVENTION, HEALTH PROMOTION, AND PUBLIC HEALTH COUNCIL By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 4001 of the Patient Protection and Affordable Care Act (Public Law ), it is hereby ordered as follows: Section 1. Establishment. There is established within the Department of Health and Human Services, the National Prevention, Health Promotion, and Public Health Council (Council).

16 Pay for a change Provide joint financing for multidisciplinary projects targeting cross-cutting goals. Examples: Sustainable Communities (HUD/EPA/DOT) Communities Putting Prevention to Work (CDC) Lower Duwamish Clean-up

17 Summary Think global, act local. Health outcomes are increasingly and profoundly driven by the characteristics of highly disparate, local communities. These characteristics overlap with the drivers of economic and environmental sustainability in these same communities. Joint progress is less about aligning goals, more about removing barriers to collaboration from mutual self-interest. Catalyzing local collaboration, fostering adaptive leadership and paying for a change should be key federal strategies.