ACKNOWLEDGING THAT THE LAND ON
WHICH WE GATHER IS THE TERRITORY
OF THE COMING AYE PEOPLE. WHO
HAVE STEWARDED THIS LAND
THROUGHOUT GENERATIONS. WE THANK
THEM FOR THEIR STRENGTH. AND
RESILIENT AND PROTECTING THIS
LAND AND INSPIRED TO UPHOLD OUR
RESPONSIBILITIES ACCORDING TO
THEIR EXAMPLE. THE GOOD MORNING
AGAIN AND THANK YOU ALL SO MUCH
FOR JOINING US TODAY WHETHER YOU
ARE HERE ARE WATCHING VIRTUALLY
. I AM ASSEMBLY MEMBER DR CULA
WEBER AND I REPRESENT THE
SEVENTY NINE TH ASSEMBLY
DISTRICT. WHICH CURRENTLY
ENCOMPASSES THE CITIES OF LA
MESA LEMON GROVE BENITA PARTS OF
NATIONAL CITY CHULA VISTA AND
SAN DIEGO. I WANT TO START BY
THANKING DR WALLACE AND THE
GROSSMONT HEALTHCARE DISTRICT.
OPENING YOUR DOORS TO US AND
LETTING US HOLD OUR HEARING HERE
TODAY. AS CHAIR OF THIS
COMMITTEE IT IS VERY SPECIAL FOR
ME TO HOST THE FIRST HEARING OF
THE SELECT COMMITTEE ON THE
SOCIAL DETERMINANTS OF HEALTH IN
MY DISTRICT AND ESPECIALLY IN A
PLACE THAT UNDERSTANDS THE
IMPORTANCE OF TACKLING THE
SOCIAL DETERMINANTS OF HEALTH.
IN AN EFFORT TO IMPROVE THE
HEALTH OUTCOMES FOR THE PEOPLE
THAT USE OUR- I ALSO WANT TO
THANK MY COLLEAGUES AND OTHER
COMMITTEE MEMBERS WHO ARE
JOINING US VIRTUALLY. AND GIVE A
VERY SPECIAL THANK YOU TO MY
COLLEAGUES ASSEMBLY MEMBER CHRIS
WARD OF THE SEVENTY EIGHTH
ASSEMBLY DISTRICT WHO IS HERE
WITH US THIS MORNING. MEMBERS OF
THE PUBLIC MAY VIEW THIS HEARING
ON THE ASSEMBLY LIVESTREAM
WEBSITE. OR BY CALLING INTO THE
TOLL FREE NUMBER WHICH IS EIGHT
SEVEN SEVEN. SIX NINE TWO EIGHT
NINE FIVE SEVEN. AND THE PUBLIC
ACCESS CODE IS. ONE THREE ONE
FIVE ONE EIGHT FIVE ZERO. TODAY
WILL BE AN INFORMATIONAL HEARING
GIVING US AN OVERVIEW ON WHAT
ARE THE SOCIAL DETERMINANTS OF
HEALTH. WE WILL LAY THE
FOUNDATION WHICH WILL BUILD ON
IN FUTURE HEARINGS. THE PURPOSE
OF THIS COMMITTEE IS TO EXAMINE
THE RELATIONSHIP BETWEEN THE
ENVIRONMENT IN WHICH PEOPLE ARE
BORN. LIVE WORK PLAY AND H. AND
HOW THOSE CONDITIONS IMPACT THE
OUTCOME OF ONE'S HEALTH AND
QUALITY OF LIFE. SOCIAL
DETERMINANTS OF HEALTH ARE
SOMETHING THAT WE HAVE DISCUSSED
WITH THEM THE HEALTH CARE SPACE
FOR A LONG TIME. CITIES HAVE
SHOWN THAT AROUND 7280% OF WHAT
HAPPENS TO ONCE HEALTH. IS THE
RESULT OF SOCIETAL FACTORS
INDEPENDENT OF WHAT OCCURS IN A
HEALTHCARE SETTING. AS A RESULT
OF COVERT NINETEEN THE
DISCUSSION OF SOCIAL
DETERMINANTS IS NOW BEING
DISCUSSED OUTSIDE THE HEALTHCARE
SETTINGS TO. THE DURING THIS
PANDEMIC WE HAVE SEEN THAT
CERTAIN COMMUNITIES ARE
DISPROPORTIONATELY NEGATIVELY
IMPACTED BY COLBERT NINETEEN.
THE SAME COMMUNITIES WERE OFTEN
SEEM TO HAVE HIGHER RATES OF
MEDICAL CONDITIONS SUCH AS HIGH
BLOOD PRESSURE DIABETES OBESITY
COPD. THAT PUT THEM AT HIGHER
RISK FOR NEGATIVE OUTCOMES IF
INFECTED BY COVERT NINETEEN. BUT
WHEN YOU LOOK INTO THOSE VERY
SAME COMMUNITIES ALSO SAW THAT
THOSE COMMUNITIES LET GROCERY
STORES. TO GET FRESH FRUITS AND
VEGETABLES EAT HEALTHY. LACK
PARK AND OTHER GREEN OPEN SPACES
TO PLAY AN EXERCISE. TO STAY IN
SHAPE. LACK EASY ACCESS TO
HOSPITALS AND OTHER HEALTH CARE
FACILITIES TO GET PREVENTATIVE
HEALTH CARE. YOU ALSO NOTICE
THAT THE SCHOOLS IN THOSE VERY
SAME COMMUNITIES OFTENTIMES HAVE
THE LOWEST ACADEMIC ACHIEVING
OUTCOMES. AN ACADEMIC
OPPORTUNITY AND EXPECTATION GAP
IS WIDE BETWEEN THE CHILDREN AND
THOSE COMMUNITIES VERSUS
CHILDREN AND OTHER AREAS. THESE
COMMUNITIES ALSO HAVE HIGHER
RATES OF DISTRUST WITH LAW
ENFORCEMENT AND HIGH RATES OF
USE OF FORCE WHICH CREATES MORE
STRESS WITHIN THE MEMBERS OF
THOSE COMMUNITIES. AND MANY OF
US KNOW. THE DEVASTATING
NEGATIVE IMPACTS OF STRESS ON
ONE'S HOUSE. I COULD GO ON AND
ON AND TO DISCUSS THE ECONOMIC
HOUSING TRANSPORTATION
ENVIRONMENTAL DISPARITIES IN
THESE COMMUNITIES BUT I THINK
YOU GET THE PICTURE. AND ALL OF
THIS HAS A DIRECT IMPACT ON YOUR
HEALTH RISK AND YOUR HEALTH
OUTCOME. THE INTERSECTION
BETWEEN WHAT HAPPENS IN SOCIETY
AND WHAT HAPPENS TO YOUR HEALTH
ISRAEL. AND IN ORDER TO IMPROVE
HEALTH OUTCOMES FOR EVERYONE IN
CALIFORNIA WE MUST DISCUSS AND
BE INTENTIONAL ABOUT DISMANTLING
THESE INEQUALITIES AND ALL
ASPECTS OF LIFE. SO THIS SELECT
COMMITTEE WILL HOLD INTER
DISCIPLINARY HEARINGS TO DISCUSS
THE IMPACT OF HOW THE SOCIAL
DETERMINANTS WILL MAKE POLICY
AND MAKE POLICY RECOMMENDATIONS.
ON HOW TO BEST IMPROVE THE
HEALTH EDUCATIONAL ECONOMIC
ENVIRONMENTAL AND SOCIETY
OUTCOME FOR ALL CALIFORNIANS.
THAT IS OUR PURPOSE. THAT IS OUR
MISSION. AND THAT IS WHAT WE
WILL DO. BEFORE WE BEGIN THE
PRESENTATION I WOULD LIKE TO
BRING UP DR CHRISTIAN WALLACE
THE C. E. O. OF GROSSMONT
HEALTHCARE DISTRICT TO GIVE SOME
OPENING REMARKS. DR WALLACE
THANK YOU ASSEMBLY MEMBER WEBER
WE VERY MUCH APPRECIATE YOU IN
THE COMMITTEE MEMBERS CHOOSING
GROSSMONT HEALTHCARE DISTRICT TO
HOLD THIS IMPORTANT TOPIC. WE
ARE VERY PROUD AND HONORED TO
HAVE YOU ALL HERE OUR MISSION IS
TWO FOLD- GROSSMONT HEALTHCARE
DISTRICT ONE IS THE OVERSIGHT IN
THE PARTNERSHIP THAT WE HAVE
WITH OUR HOSPITAL THE SHARP
GROSSMONT HOSPITAL IN MAKING
SURE THAT PROVIDE THE GOOD
QUALITY ACCESSIBLE CARE TO WORK
OUR PATIENTS IN THE COMMUNITY IN
THESE COUNTY COMMUNITY. AND THEY
DO VERY WELL AT THIS AND THAT
ALLOWS US TO FOCUS ON OUR SECOND
MISSION. OUR SECOND PART OF THE
MISSION IS TO GO OUT THERE AND
MAKE SURE THAT. LOW LIVING.
HEALTHY AND WELL LIVES. AND
TAKING INTO ACCOUNT THE SOCIAL
DETERMINANTS OF HEALTH A
COMMUNITY HEALTH NEEDS
ASSESSMENT. ALLOWS US TO GET OUT
OF THE COMMUNITY AND FOCUS OUR
PARTNERSHIPS ARE PROGRAMS IN OUR
OUTREACH. TO MAKE SURE WE GET TO
THE PEOPLE WHO NEED US. SO THANK
YOU ONCE AGAIN WE APPRECIATE YOU
BEING HERE AND- YOU'RE ALWAYS
WELCOME. THANK YOU DOCTOR
WALLACE AND TO THE ENTIRE.
GROSSMONT HEALTHCARE DISTRICT
FAMILY AND BOARD FOR ALLOWING US
TO BE HERE TODAY- GROSSMONT
HEALTHCARE IS ONE OF THE
HOSPITALS OR WHEN IT IN MY
DISTRICT AND VERY PROUD OF THE
RELATIONSHIPS THAT WE HAVE A
WITH THE SURROUNDING COMMUNITY.
SO I WOULD LIKE TO ADDRESS SOME
QUICK AND IMPORTANT GUIDELINES
FOR THOSE WHO ARE PRESENT HERE
IN THE ROOM. WE ASK THAT YOUR
FACE MASK REMAIN ON FOR THE
DURATION OF THE HEARING. AND AT
THE CONCLUSION OF THE LAST
PANELIST PRESENTATION WILL BEGIN
THE PUBLIC COMMENT PERIOD. YOU
WILL BE ALLOTTED NINETY SECONDS
FOR YOUR COMMENT. IF YOU ARE
CALLING INTO OUR TOLL FREE LINE.
PLEASE FOLLOW THE INSTRUCTIONS
FROM THE PHONE MODERATOR WHEN IT
IS YOUR TURN TO SPEAK. ONCE
AGAIN THE TOLL FREE PHONE NUMBER
IS EIGHT SEVEN SEVEN SIX NINE
TWO. EIGHT NINE FIVE SEVEN. AND
THE PUBLIC ACCESS CODE IS. ONE
THREE ONE FIVE ONE EIGHT FIVE
ZERO AND IT WILL BE AVAILABLE ON
THE SCREEN AS WE OPEN UP THE
PUBLIC COMMENT. WE HAVE A FULL
AGENDA THIS MORNING WITH EXPERT
PANELISTS THROUGHOUT THE STATE
THEY'LL BE PROVIDING A VARIETY
OF INFORMATION THAT WILL BE
BENEFICIAL AND VALUABLE. FIRST
WE HAVE THE DEPUTY DIRECTOR OF
THE OFFICE OF HEALTH EQUITY
WITHIN THE CALIFORNIA DEPARTMENT
OF PUBLIC HEALTH. DR RONEN RAT
RADHA KRISHNA. DR RONEN SUPPORTS
COVERT NINETEEN VACCINE EQUITY
EFFORTS IN CALIFORNIA SERVES AS
THE TRIBAL LIAISON FOR THE CD.
LEAVES THE OFFICE OF HEALTH
EQUITIES BROAD PORTFOLIO.
ADVANCING ANTI RACISM THROUGH
RACIAL HEALTH EQUITY INITIATIVE
ADVANCING HEALTH IN ALL POLICIES
INCLUDING CALIFORNIA'S CLIMATE
CHANGE PLANNING. ADVANCING
BEHAVIORAL WELLNESS AND
RESILIENCY FOR DIVERSE
POPULATION THROUGH THE
CALIFORNIA REDUCING DISPARITIES
PROJECT. PROMOTER GENDER HEALTH
EQUITY AND MEETING- AGENCIES
STATUTORY MANDATE HE HAS A LOT
ON HIS PLATE. DR ON IN HAS
TWENTY YEARS OF EXPERIENCE
LEARNING FROM AND WORKING WITH
IMPACT TO COMMUNITIES HE SPENT
TEN YEARS AT THE LOCAL HEALTH
DEPARTMENT MOST RECENTLY SERVING
AS CO CHAIR OF THE HEALTH EQUITY
COMMITTEE. AT THE CALIFORNIA
CONFERENCE OF LOCAL HEALTH
OFFICERS AND DEPUTY HEALTH
OFFICER AT CONTRA COSTA HEALTH
SERVICES. I WILL NOW TURN THE
FLOOR OVER TO DR RADHAKRISHNAN
WHO WILL BE PRESENTING VIRTUALLY. THANK YOU SO MUCH ASSEMBLY
MEMBER AND DR WEBBER ONLINE WARD
MEMBERS OF THE PUBLIC. THE
SEVENTY NINE SEVENTY EIGHT
DISTRICTS AND THE PEOPLE OF
CALIFORNIA. IT'S MY PLEASURE TO
BE WITH YOU TODAY THE SUBTITLE
OF MY TALK IS RISK FACTORS ARE
NOT PREDICTIVE FACTORS HE HAS A
PROTECTIVE FACTORS. WHEN LOOKING
IT AGREES OF THE STATE OF HEALTH
AND BACK TO THE HUNDREDS DURING
THE GOLD RUSH TIMES WHEN OUR
STATE WAS FOUNDED AS WELL AS THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH. NINE OUT OF TEN PEOPLE
DIED FROM COMMUNICABLE DISEASES
LIKE CHOLERA AND TYPHOID. BUT IT
WAS THE SOCIAL DETERMINANTS OF
HEALTH THAT IS DETERMINE WHO
DIED MORE OFTEN. OUR HOUSING
UNSAFE WORKING CONDITIONS AND
POTTERY AS ON HEALTHY LIVING
CONDITIONS THE STAGE FOR DISEASE
TO SPREAD. PASSWORD NINETEEN
EIGHTEEN GLOBAL INFLUENZA
PANDEMIC WHEN WE SAW THE HIGHEST
CASE AND DEATH RATES ARE THE
DEADLY VIRUS UNITS HAD NOT SEEN
BEFORE AND IT WAS MORE IN
CERTAIN NEIGHBORHOODS WITH A
SIMILAR SOLUTION IS A HELP.
DIFFERENT BILL BURDENS ON
NEIGHBORHOODS LOWER LITERACY
HIGHER POPULATION DENSITY HIGHER
UNEMPLOYMENT THE STATE ACCORDING
TO THE PROCEEDINGS OF THE
NATIONAL ACADEMY OF SCIENCES
SHOWS THAT IT WASN'T CLINICAL.
CONDITIONS AND IF ANYONE ASKS IS
HOW OUT OF THIS LADY I TALKING
ABOUT IN TACKLING THE
NEIGHBORHOOD SOCIAL FACTORS
RESIDE THE TITLE SEVENTY SECTION
HOLES IN SIX THE HEALTH GO TO.
WHICH STATE THAT HELD A PART
CHAU OFFICERS DRIVEN INTO THE
SOCIAL. AFFECTING HEALTH. IT OUR
MANDATE TO WORK OF ST. LAST FOUR
SAID LATER. THE NEW IRISH THE
SARS TO BUYERS HAS COST. AND
THEN AND ALL HELPFUL IS DOING
BETTER THAN MOST OTHERS. I'M
PROUD OF OUR IS. A SKILL SET
THREE THOUSAND HOW. ONE OUT OF
FIVE AND CALIFORNIA. IT'S
ESTIMATED THAT TWO MARVEL NIGHT. WE LOOK AT ACCESS DEBT JUNE
THAT TWELVE THERE'S A STRONG
QUARTER THE SAME FACTORS AND
DURING THE GOLD RUSH TIME IN A
CENTURY INCLUDE OF HAND AND- IT
IS A CLINICAL. IT IS THE
CONDITION. WHAT'S THIS PANDEMIC
AS THIS OVER STRUGGLE TO NEVER
SEEN SINCE THEN SINAL OVERLAP
THE PRICE. MY NEEDS INEQUITY
RACISM CRYING CHANGE ALL OF
WHICH- AND SYNERGISTICALLY. THE
RISK THE EXPO AND OVER- TO
ILLNESS AND DEATH. HE SAID THE
POVERTY OR THE HOUSING
INSTABILITY YOU INCREASE THE
DISPROPORTIONATE DEATH IN OUR
STATE LAST YEAR NOT A SINGLE IT
. ALL CAUSES. WE WANT TO SHOW IN
THIS ACCIDENT MORTALITY DATA
RELIEF WITHIN CITATION BOTTOM
THAT LATINOS OFF VERY. WHO HEARD
OTHER GROUPS BUT IT ENDED UP
DYING MORE THAN OTHER. AGAIN DO
THAT. DO SO DETERMINANTS OF THAT
MADE OF IRON. MORE SO. OUR HOUSE
. ASSEMBLY WORK WITH THE
DIVISION JOBBERS AND POVERTY
PEOPLE BEING PAYCHECK AWAY FROM
FINISHING OFTEN AT HIGH RISK THE
DISEASE. WHEN THEY HAD A WORKING
HE. HE CALIFORNIA NINE. THEIR
FAMILIES THAT. PERSONAL HAVING
SPENT TEN YEARS A PRIMARY CARE.
LEARNING FROM COMMUTER AROUND
WORLD IN HEARING HEALTH. I SAID
TODAY AS A FAMILY I THE
NECRONOMICON COSTA AND I CARE
FOR OF STRUGGLING VAN OVER THESE
ARE THEY WERE DEALT THAT
AFFECTED THEIR BEHAVIOR IN THEIR
HOUSE AT. INSURABLE THIS MIGHT
ENERGY MORE UPS. INDIVIDUAL ON
ONE TO THIS WILL TO PROMOTE SO
COHESION RESILIENCY. WITH A- OF
CLIENTS HEARING A PHOTO ON THE
YOU SEE A GROUP OF ACT AMERICAN
A LITTLE HIGHER. EACH TEAM A
MATTER OF LIFE AND LIMB. YOU
CAN'T TAKE INSULIN NINETY SEVEN
YOU DON'T HAVE. YOU CAN'T
REFRIGERATED INSULIN IF YOU'RE
LIVING IN YOUR CAR AND
EXPERIENCING HOMELESSNESS THAT'S
WHY- PRESCRIPTIONS FOR
CALIBRATION BENEFITS AND HOUSING
CONNECTIONS IN ADDITION TO
INSULIN. IN THE BACK YOU SEE IT
. OUR COMMUNITY ORDER INTO
COOKING AND- I TO EAT HEALTHY
WITH ID WITH IT BUT. THERE'S
STILL HOME. ACT THE SITE AND HE
AND THAT FOR DOCTOR LIKE ME.
SHOULD TEAM CLINICAL. I THAT MY
SAYS BECAUSE MUCH OF THE DAY IS
A DOCTOR WILL SAID TO. IT IS
DRIVEN BY THE KINGDOM OUTSIDE OF
WORLD OF CLINIC. IS A REQUIRE
GOING UP THREE TO RESIDENTIAL
DETERMINANTS ANSWER MICHAEL
MARMOT THE- WHAT'S THE OF PEOPLE
ONLY TO SEVEN BACK THE KING THAT
MAKE THEM NOW. FOR MORE WORK AGE
LUCKILY. IN HIS WORK. AGED SIXTY
FIVE. WE SAW THE RISK WAS HIGHER
ESPECIALLY INDIANS AND- REALLY
HEALTH WITH TEN THAT OF WHITES.
WE SEE WEARING. IT A FEW MINUTES
HEALTH. LATER PACIFIC ISLANDER
LOW INCOME ROLE RIGHT LGBT CAL
WERE JUST REPORT AND HOW. AND
GENETIC CODE BUT DIDN'T
INCLUDING REST WAS ALL NEED
UNDERLINE SOCIALIZATION OF
HEALTH. SO DR WEBER AS YOU AND-
THAT. IS AND UNJUST AND- THE
BIRTH EQUITY CHALLENGES OUR
STATE. WIDE CALIFORNIAN BLACK ON
LADIES SIX BELIEF THE RATE OF
OUR MOMS. WHAT WHAT KIND OF WITH
YEAR LESS THAN A CALIFORNIA WILL
. RACE IS DIMINISHED. RACES IS A
RISK FACTOR. THAT WOULD AND LYFT
EXPECT AT WEEK AND RACISM A
TRADITION OF HEALTH. WHO DIED IN
THE CINEMA WILDFIRES THAT SPREAD
INTO TOWN. IT WAS THOSE
TECHNOLOGICALLY LESS CONNECTED
ELDERS IN THE NON ENGLISH
SPEAKERS WHO DID NOT RECEIVE
LIFESAVING INFORMATION ANTI. THE
DIGITAL DIVIDE LANGUAGE ACCESS.
THOSE MISSION OF HOW. WE LOOK AT
STRUCTURE RACISM PRESIDENT
REDLINING CERTAIN COMMUNITY LOW
INCOME WOMEN COMMUNITIES OF
COLOR WE'RE NIGHT HOUSING LOANS
MID LAST CENTURY IS CORRECT THAT
WEALTH ACCUMULATION ACROSS
GENERATIONS AND FAMILIES. IT'S
LESS COMMUNITIES WITH LESS
ABILITY TO WEATHER THE STORM.
RIGHT EXECUTIVE SENIOR RESIDENTS
OF TEN TO TWENTY YEARS IN THE
ZIP CODE NEXT TO YOURS. YOU KNOW
WE HONOR YEAH ARE SAD SAID IN TO
WHAT WE SAW. IN THE SHE FOR THAT
AND- BECAUSE WE'RE NOT PUTTING
OF SO. INTO A- PREVENTIVE GOES
BACK. WHEN I REMIND US WE ARE IN
CONNECTED AND I WILL GET LEANING
HELD AS THOSE ARE US. THAT IS
UNLESS IN DISEASE FOLLOWING A
THAT WE ARE SET. AND IT ON HOW
WELL EVERYONE ELSE IS SUPPORT.
IT WILL INITIALLY WHY ACT WITH
AND WE- THE LATEST I CAN SEE
ROAD HOW. OF RACIAL ETHNIC WORDS
. TRANSACTION USING DEPRESSION.
INCREASES SEVERAL POPULAR. I IT
IS EASIER TO DESPAIR. THREATEN
OUR PANDEMIC RECOVERY. HOWEVER I
MIGHT HANDLE SAYS I BELIEVE
PROCESS ARE PREDICTED FACTORS
BECAUSE OF THE PER FACTORS.
LEADING BURDENS AND HOPE THE
STATE GOVERNMENT HELLO IN THE
SERVICES THAT ARE PUBLIC IN OUR
HEALTH EQUITY I NEED. NEED TO
BOTH BE PROTECT FACTOR WITH THE
SUPPORT OF THIS COMMITTEE. FOR
TOO LONG SAME SEVENTEEN- AND
WORST. PART OF THE COMMUNITY IN
OF THE- IN PURPLE UPS FACTOR
THAT AND OF HELP OUT. IT SHARING
HOW CITIES. MY PREVENTING THE
ROOM OF ILLNESS BUT DISEASE
TAKES PLACE. ADVERTISING HELP BY
INVESTING UPSTREAM STRUCTURE
DRIVERS IS WE EFFICIENT AND
LOWERS COSTS. FOR EVERY DOLLAR
SPENT ON HEALTH NINETY SEVEN
CENTS TO THE DOWN ON THE RIGHT
OF THIS MEDICAL. IN ONLY REASON
TO THE MINISTRY PUBLIC HEALTH
PREVENTION. HOW WE KNOW THERE
ARE ON A FOR EVERY DAY SPENT ON
PREVENTION WE'LL GET BACK FIVE
DOLLARS AND SIXTY CENTS AND
SAVINGS. SO WE HAVE TO THE
FUNDED APPROPRIATELY 80% DRIVING
HEALTH OUTCOMES NOT THE 10%
HEALTHCARE OUR FRAMEWORK IS
ALIGNED WITH OUR REGIONAL
PARTNERS THAT AREA USUALLY
HOLDEN ACQUISITION OF THAT
CREATED THIS AMERICAN OVER
FIFTEEN YEARS AGO AND THIS IS
REALLY OPERATIONALIZED AT THE
NEIGHBORHOOD LEVEL RIGHT SIZING
OUR HISTORIC WRONGS AND
ESTIMATES. FOR THIS REASON OUR
OFFICE IS HELD IT WILL BE EASIER
WORK ON THE GUIDANCE AND
DIRECTION A COMMUNITY LISTENERS
WHO KNOW THE PROBLEMS AND
SOLUTIONS FOR THEIR. COMMUNITIES
AND FANS. OUR HOW A NEWS SERVICE
. AGENCY AND ENVISIONS REFER THE
RIDING JUSTICE. HELLO CALIFORNIA
WHERE EVERY INDIVIDUAL LONG SHE
WAS STRONG AND THRIVING
COMMUNITY. WELL I'M CONSTANTLY
PROCEDURAL AND RACIAL JUSTICE BY
NOT ONLY LIFTING ALL BOATS BUT
ESPECIALLY THOSE THOSE THAT NEED. TO BE LISTED MORE. WE ARE
COMMITTED TACKLING ECONOMIC. AND
INSTEAD OF THE LIKE HOW AND
CHILDCARE. HELLO THAT WILL
SATISFY THE OLD CITY COULD HAVE
BEEN AROUND SINCE TWO THOUSAND
AND TWELVE AND HONOR LEADING
THIS GROUP. WE TO CHANGE THAT.
IN A LITTLE TO SAY. NOW THAT
SAYING HOLDEN SAFETY CODE AT
YOUR RESTAURANT- SAFE IN YOUR
WATER CLEAN DEFINES THIRTEEN
SOCIAL DETERMINANTS OF HEALTH
EIGHT THROUGH AN MANY MENTION ON
THE WEBSITE OF DOCTOR WHATEVER
AS PRIORITY AREAS AND IN OUR
OPENING REMARKS. NEED TO SEE
HERE THAT WE HAVE TO ADDRESS
INCOME SECURITY- SECURITY
EDUCATION EARLY CHILDHOOD
DEVELOPMENT ACCESS TO SAFE
AFFORDABLE HEALTHY HOUSING YOUR
PARKS NEAR HEALTHY FOODS
ENVIRONMENTAL QUALITY ADULT
ENVIRONMENT THAT SUPPORTS ACTIVE
TRANSPORTATION PARKS AND GREEN
SPACE ADDRESSING DISCRIMINATION
MINORITY STRESSORS NEIGHBORHOOD
STATING COLLECTED AT THE RESULT
OF ISLANDS. AND ONE OF THE WAYS
WE DO THIS IS BY WORKING IN ALL
SOCIETY ALL THE GOVERNMENT ALSO
AFTER APPROACH IS CALLED HEALTH
IN ALL POLICIES. WE MONITOR. THE
FACTS AND WORKING IN PARTNERSHIP
. HERE YOU CAN SEE HELLO THESE
HIGH FORCE BY. ORDER IN THE TEN
NAY HOW THE GLOBAL LEADER IN
THIS UP OF. THAT HELD EVERY IN
EVERY IS HOW WE HAVE TO DEPART
WITH OTHER SACKED. THAT ENDED
DAY THE WORST AND- MARTIN KING
IT HELPED. AND THE WORST. IT IS
DISPROPORTIONATE TO FOR SOMETIME
THAN OTHERS. WHEN IT IS
PREVENTABLE. SO WE HAD MEN NEEDS
. OR THE PAST ELEVEN YEARS DOING
THIS WORK WE REALLY EITHER WITH
A STRATEGIC COUNCIL PUBLIC
HEALTH INSTITUTE. TWENTY TWO
NEED A PART AGENCIES AND OFFICES
. CAPITALIZATION INCLUDING
TRANSFER. AND BY PREVENTION.
SYSTEM WE BEEN ABLE TO GUIDE ALL
AN ACT BILLING INTO TO POINT
NINE BILLS DOLLARS CITY GRANTS.
RECORDED A CALIFORNIA FARM TO
FORK OPPOSITIONIST TO THE LOCAL
FARMERS AND BUYERS THE HELP
PROVIDED LOCAL HEALTHY FOOD TO
ALMOST THREE THOUSAND SCHOOLS.
IN TWO MILLION CHILDREN. I THINK
PEOPLE'S OF THIS TYPE OF A TO
WALKING IT CAN SHE WHEN WORK
SECTOR TO ADDRESS THEM CAUSES.
WE ALL CREATED A FOR DATE WITH
INITIALLY CALLED CAPITAL
AUTOMATION EQUITY. BY PRIOR HALL
INCREASE RACIAL ACT ACT PLAN AT
AGENCY. WE AN AFTER LEADER IN
SOCIAL DETERMINANTS HEALTH AND
EQUITY FRAMEWORK IN OUR RESPONSE
AS YOU CERTAIN SCHOOL HELP
PLACES AND ACTIVITIES SEE HERE.
THANK AND HOT SPOT OKAY. THAT
HAS LEASEHOLD NEIGHBORHOOD AND
GET MORE RELEASE THERE. HAVE NOW
OUR MOBILE CLINICS OUT WE YOU
OUR BACKS DOUBLING IN THESE
NEIGHBORHOODS. THE ONLY S. AS IN
ACID GEOSPATIAL SCHOOL WHICH
PROGRESS LAGS EXPECTED AT BIRTH
. BASED ON WAITED FOR. OF TWENTY
FIVE DIFFERENCE YOU'RE GONNA
FACTORS ALSO LOCATION IS IT.
HERE YOU CAN SEE THAT IN THEIR
EIGHT BUCKETS OF AND I AREA.
WAITED LIFE EXPECTANCY AT BIRTH
NEWS HIM FOR THAT WE DEAL WITH
THE L. THE DALLAS HEALTH ACT TO
HAVE TO DEAL YOU BY HOW NEAR SO
. CHANGE FOR EDUCATE AND ACTING
BACK BECAUSE THEY DRY HELP. THE
BEAUTIFUL ABOUT IT EXISTS. BEEN
PRESSURE TESTED FREE PRESS OF.
IN EFFECT A BILL THE- A STATE
GRANT. ASSISTANCE A MEETING AND
GUIDANCE. THIS IS A HELL OF WAY
. TO GREEN. READ AREAS IN THE
PAST I PER. THESE INCLUDING LOS
MORE THAN WHICH IS NOT. IT IS AN
ASSOCIATED GUIDE THAT. THIRTY
DIFFERENT AREAS AND YOU FOR YOUR
- LITERACY. OR TOWN. SO ASIAN
POLICY INTERNET. AND BASE. TO
ADDRESS THOSE UPSTREAM FACT. I
AM A CHANGE BECAUSE OF THE- OF
HUMANS FACTORS BUYERS WE NEED TO
ENSURE PAN AM SOONER THAN WE
CAN'T IMAGINE. THE CLIENT HOW
AND WE ASSESSMENT APPROACH ALL
DECISION CAN HELP US A THOSE
FACTORS. IN BILL RESILIENCE. SO
YOU WANT TO KNOW WHICH
NEIGHBORHOOD IN HOCKEY ARE MORE
LIKELY TO SUFFER EXTREME HEAT
SUMMER YOU NOT. STARTETE
INTERVENTION TO PUT IN. HOLISTIC
RULING. CENTERS THAT MULTIPLE
THAT. IN RIGHT NEIGHBORHOODS. I
AM A NEW WAY TO BUSINESS WHERE
EQUITY INTERNATIONALLY I CRIME
CONSIDERING. ARE ASPECTS OF
GOVERNMENT HOUSE IN DECISION
MAKING. WHAT THIS IS WILLIAM.
TRIPLE A LINE BY. SO AND
SUSTAINABILITY WE RISK WIDENING
THE GAPS IN HIS THE STAGE FOR
TODAY AND OF COURSE THAT OR SOME
FOR AND MANY SUFFER. AS PLANNED
OR FUTURE ARE DRY VALLEY EXACTLY
CHOICES TO LEARN FROM THE AND SO
ALL THE GOVERNOR ISN'T ARE BOTH
THROUGH THE RIGOROUS USE OF MÀ
. TREES OUTCOME. IN BASED
INTERVENTIONS. WE MUST RAPIDLY
MAKE THE CALIFORNIA FOR ALL
SLOWLY INTO A REALITY. THIS WILL
REQUIRE OF THE IS A SIGN A PRO.
AS THIS PUBLICATION THE FIELD
PROBLEM OF THE POPULATIONS. IS
ABOUT THAT LITTLE PRO. THE WIFE
STARTING- IN THE FIRST
DEVELOPMENT AND THE ROOT CAUSE
IN EQUITY HARRY'S AND CHIEF IN
COSTA. PRIMARY PREVENTION. YOU
THIS PANDEMIC HAS AN EXCELLENT
OPTION. IS OUR SHE CHANGES FOR.
AND WE KNOW THAT ABOUT ME. SEVEN
PUBLIC EMERGENCY WHAT HAPPENS
SAY EQUITIES SHOWING ON DASH.
SHE OUR INTERNAL CALL PRACTICES
PROCEDURES AND ALLOW US TO
DIVERSIFY OUR- SO WE LOOK AND
SOUND MORE LIKE HOW LEAST C.
USING EVIDENCE BASED POLICY
STRATEGY AT LEAST TALENT POINT.
WE BOLSTER THE PROTECTIVE FACTOR
. SERVICE IN BECOME OF WHO LIVES
IN DIES IN WHICH GOES. HELLO BY
SAYING THAT WE WILL NOT LET
HISTORY ITSELF. CALIFORNIA
HEARING ME IN A FEW BY PROMOTING
CLIMATE CONNECT ALL CALLS
APPROACH TO ADDRESS THE-
INSTRUMENTS HEALTH. CALIFORNIA
FOR ALL IS A POWER. NARRATIVE
IMPULSE CLASS TO THAT ALL HELL.
AND SHE DID THE BEST HELP. HE
WAS MOVING THE WORD ACTIONS
OUTCOMES. THANK YOU FOR THE LAST
WORK AT COMMUNITIES PARTY I AM
YOUR ALLY ENSURE AND MICHAEL IS
FOR US IMAGES WILL INTO INTERNET
MOVEMENT. THANK YOU. THANK YOU
SO MUCH DR ROWE HAND BREADED
FRIED KRISHNA. THAT WAS AN
AMAZING PRESENTATION- THANK YOU
FOR HELPING US UNDERSTAND BETTER
WHAT EXACTLY THE SOCIAL
DETERMINANTS OF HEALTH ARE AND
THE IMPACT THAT IT HAS HAD ON
CALIFORNIA'S SOCIETY OVER TIME.
AND SHOWING IS ALSO A
CALIFORNIA'S DOING I'M VERY
IMPRESSED WITH ALL OF THE THINGS
ON THE WEBSITE THE PROGRAMS THAT
WE HAVE. THE CALIFORNIA HEALTHY
PLACES INDEX FOR OUR RESIDENTS
TO BE ABLE TO GO IN AND REALLY
GET A GOOD ASSESSMENT OF WHERE
THEY LIVE AND THE RISK FACTORS
FOR HEALTH RISK FACTORS AS A
RESULT OF THAT. AND THAT YOU
HAVE CHALLENGED US IN THE
LEGISLATURE TO FOCUS MORE ON-
UPSTREAM WHEN WE'RE TALKING
ABOUT POLICIES AND FUNDING AND
NOT JUST FOCUS ON THE
DOWNSTREAM. ON BECAUSE IT IS
EXTREMELY IMPORTANT THAT WE
BUILD RESILIENT COMMUNITIES
THROUGHOUT ALL OF CALIFORNIA. I
LOOK FORWARD TO WORKING WITH YOU
ARE WE LOOK FORWARD TO SITTING
DOWN WITH YOU WHEN I GET BACK UP
TO SACRAMENTO IN TALKING ABOUT
THIS. ONE PERSON BUT REALLY
APPRECIATE YOU JOINING US ON OUR
FIRST HEARING THIS AFTERNOON OR
THIS MORNING. NEXT WE HAVE. ONE
OF THE JEWELS AND SAN DIEGO
MEDICAL SOCIETY. DR RODNEY HAD.
DR HEARD IS PRESIDENT OF THE
MULTICULTURAL HEALTH FOUNDATION
AND FORMER PRESIDENT OF THE
NATIONAL MEDICAL ASSOCIATION. A
PHYSICIAN OF INTERNAL MEDICINE
AND PRIVATE PRACTICE DOCTOR HOOD
IS THE MANAGING PARTNER OF THE
CARE VIEW MEDICAL GROUP. HE'S
THE PRESIDENT OF THE
MULTICULTURAL IPA WHICH
SPECIALIZES IN SERVING AFRICAN
AMERICANS LATINOS. ASIAN AND
MIDDLE EASTERN PATIENTS. HE IS A
NATIONAL AUTHORITY ON HEALTH
DISPARITIES MEDICAL HISTORY AND
RACISM AND MEDICAL CARE. HE
SERVES ON LOCAL STATE AND
NATIONAL BOARD AND COMMISSIONS
AND IT'S TRULY A PILLAR OF OUR
COMMUNITY. I AM SO GRATEFUL THAT
HE'S HERE WITH US TODAY. WITH NO
FURTHER DELAY IT IS MY HONOR TO
INTRODUCE DR RONNY HEAD. A GOOD
MORNING AND- THANK YOU ASSEMBLY
MEMBER- DOCTOR WEBER AND-
ASSEMBLY MEMBER- CHRIS WARD FOR
INVITING ME. I'M GONNA GIVE A
BRIEF OVERVIEW OF TALKING ABOUT
SOCIAL DETERMINANTS OF HEALTH
BUT GIVING IT FROM THE HISTORIC
POINT OF VIEW. SO OVER THE PAST
THIRTY YEARS. I'VE BEEN ON-
PHYSICIAN IN SOUTHEAST SAN
DIEGO. AND AS PAST PRESIDENT
NATIONAL MEDICAL ASSOCIATION
I'VE BEEN RESEARCHING THE
ORIGINS OF RACE ETHNICITY AND
HOW IT INTERSECTS WITH WHAT WE
CALL SOCIAL DETERMINANTS OF
HEALTH. IN THERE FOR MY TALK
TODAY HISTORIC ASPECTS OF
AMERICAN SOCIAL DETERMINANTS OF
HEALTH IN THE RELATIONSHIP WITH
RACE AND ETHNICITY. D. AND IS IT
SHOWING. AT THE MONOLOGUE WORK
ON OUR TECHNICAL SUPPORT.
THE
WELL THEY'RE DOING THAT- I
REALLY APPRECIATED THE-
PREVIOUS- DISCUSSION. OUR WITH
THE OFFICE OF- HELP THE EQUITY-
WHEN I FIRST STARTED DO SO
RESEARCH OF PEOPLE- WE DIDN'T
REALLY CALL WITH THE SOCIAL
DETERMINANTS OF HEALTH. WE
TALKED ABOUT- HOW RACE AND
ETHNICITY- HAD SOME TYPE OF A
RELATIONSHIP WHAT WE NOW KNOW
THAT THE DIFFERENCES THAT WE SEE
BETWEEN HEALTH OUTCOMES BETWEEN
THE VARIOUS RACES AND
ETHNICITIES IS REALLY NOT ABOUT
GENETICS IS MORE ABOUT. WE LIVE
AND HOW YOU TREATED AND HOW YOU
PROCEED IN THIS- SOCIETY- SO-
WHEN I TALK ABOUT SOCIAL
DETERMINANTS OF HEALTH EARLY ON
THERE WAS A FOCUS ON SOCIAL
ECONOMIC STATUS. THE GEOGRAPHY
JOB STATUS YOUR ACCESS TO HEALTH
CARE TO FOOD. IN YOUR GENDER AND
THEN WE MENTIONED RACE ETHNICITY
RACISM BIAS DISCRIMINATION AND
TOXIC STRESS THE REALLY DIDN'T
HAVE MUCH UNDERSTANDING ABOUT
HOW THAT INTO PLAY BECAUSE HELP
. I'M AND I'M ALSO A MEDICAL
HISTORIAN AND I THINK IN ORDER
TO REALLY UNDERSTAND THAT WE
NEED TO UNDERSTAND A LITTLE
HISTORY TO PUT IT INTO CONTEXT.
I'M OUR SOCIAL DETERMINANTS OF
HEALTH OTHER CONDITIONS IN
PLACES WHERE PEOPLE LIVE LEARN
WORK PLAY THAT AFFECT A WIDE
RANGE OF- OUTCOMES. ON AND- I'M
GONNA TALK MORE ABOUT RACE
ETHNICITY AND TOXIC STRESS. IN
HISTORY.
DOES HAVING A FLIGHT
HOME FOR BIGELOW ALL RIGHT. SO
LET ME TALK ABOUT HOW I SEE THE
CULTURE OF RACISM IN AMERICA. SO
I AM AN EXPERT IT EATING GUMBO
BUT CERTAINLY NOT AN EXPERT AT
MAKING UP IT WAS MY WIFE THE
INTRODUCED ME TO GUMBO AND IF
ANYBODY KNOWS ANYTHING ABOUT
GUMBEL IS LOOKS DIFFERENT IN
TASTE DIFFERENT DEPENDING UPON
WHO'S MAKING IT AND WHAT PART OF
THE COUNTRY. I THINK IT'S THE
SAME THING WITH RACE AND RACES
IN THE INGREDIENTS FOR BUMBLE IS
ROOT VEGETABLES SAUSAGE CHICKEN
SEAFOOD IF YOU LAY POWDER
DEPENDING UPON WHO'S MAKING IT
WHAT PART OF THE COUNTRY SOME OF
THAT HAS A LOT A LOT OF- TOMATO
BASIC CETERA. WHAT IS THE
INGREDIENTS TO THE CULTURE
RACISM IN AMERICA IT INCLUDES
THE ISN'T A COLUMN RACISM SEXISM
CLASSISM AND COLORIST. AND I
MENTION COLORISM BECAUSE NO
MATTER WHAT ETHNICITY YOU
TALKING ABOUT THERE IS
DISCRIMINATION IN HEALTH
OUTCOMES DIFFERENCE. BASED UPON
YOUR SKIN COLOR. THEY WE MIX AND
YOU KNOW. HUGE DOSE OF IGNORE
AND INTOLERANCE. SOME RELIGIOUS
DOGMA AND WE HAVE INGREDIENTS
FOR AMERICAN CULTURE BREAKS IT'S
EXPRESSED IN FELT DIFFERENTLY
DONE SELF ON THE WEST EASE. BUT
IT'S ALL GONE. SO LET'S TALK
ABOUT THE PAST HOW DID ALL THIS
COME ABOUT. WELL IF WE GO BACK
CENTURIES IN THE SEVENTEEN
HUNDREDS AND EIGHTEEN HUNDREDS
THERE WAS A GENTLEMAN BY THE
NAME OF J. F. BLUMENBACH WHO WAS
CONSIDERED ONE OF THE FATHERS
OF- OF PALEONTOLOGY. AND HE
TAUGHT IN THE SCIENCE THAT ON.
WHITES AND BLACKS WERE DIFFERENT
IN THAT THERE WAS A HIERARCHY
THAT WHITES WERE ON TOP FOLLOWED
BY BLACKS FOLLOWED BY EIGHT. AND
THEN YOU COULD MEASURE THE
FACIAL ANGLE IN THE SCOPE
CAPACITY. AND WROTE ATREUS IS
CALLED THE NATURAL ORDER OF
HUMAN BEANS DEEMING WHITE
SUPERIA FOLLOWED BY BLACKS THE
BEGINNING OF DEHUMANISATION SO
WE TALK ABOUT RACISM BUT IT'S
REALLY DEHUMANISATION. THERE WAS
A PHYSICIAN BY THE NAME GEORGE
KOFI WHO IS A FRENCH WAS ISSUED
IN PARIS WHO TAUGHT MANY.
AMERICAN PHYSICIANS HERE IN THIS
COUNTRY AND NOT COOPERATING- WAS
INVOLVED IN FOLLOWING A AFRICAN
A LADY THAT WAS COAST FROM SOUTH
AFRICA TO EUROPE. THEY PARADED
HER AROUND LIKE AN ANIMAL HER
NAME WAS TO TEACH APARTMENT PART
OF THE COCHON TRY. AND HE WAS
TRYING TO PROVE THAT HER BODY
HABITAT. WAS INFERIOR IN CLOSE
TO EIGHT HE FOLLOWED HER AROUND
UNTIL SHE DIED. TOOK A BODY PART
TO PUT HIM ON DISPLAY IN THE
MUSEUM OF PARIS. WHERE THEY
STAYED UNTIL- MANDELA BECAME
PRESIDENT. AND ASKED FOR HER
RETURNS TO GET A PROPER BURIAL.
WE HAVE DOCTOR SAM PART RIGHT
BUT SAM CARTWRIGHT WAS A
GRADUATE OF THE UNIVERSITY OF
PENNSYLVANIA WHICH WAS THE FIRST
MEDICAL SCHOOL IN THIS COUNTRY
EVEN BEFORE HARVEY VERY
PRESTIGIOUS. HE ARE GRADUATED
FROM THE ANY WENT TO A SCHOOL
DOWN IN. NEW WALLETS IN UGH IN
NEW ORLEANS HIS. TITLED WAS
PROFESSOR OF DISEASES OF
INTEGRAL IN THE MEDICAL
DEPARTMENT AT THE UNIVERSITY OF
LOUISIANA. SO BLACK FOLKS WERE
SPECIALTY NOW DURING THIS TIME
THEY WERE SLAVES AND THEY WERE
TREATED AS PROPERTY. THE SLAVE
OWNERS WERE HAVING A PROBLEM
BECAUSE THEY WERE RUNNING AWAY.
THEY WENT TO THE UNIVERSITY HE
DID A STUDY. TO FIND OUT WHY
THAT WAS HAPPENING HE WROTE AN
ARTICLE IN THE BOSE MEDICAL
JOURNAL DECLARING THAT THE
REASON WHY THEY WERE RUNNING
AWAY IS BECAUSE THEY SUFFERED
WITH THEM MENTAL DISEASE CALLED
DRAKE DAMANIA RUN AWAY MATT. AND
WHEN THIS LEYVA SAID YEAH BUT- I
HIT THE TREATMENT WAS
CONDESCENSION HIM A LITTLE TIME
OFF DANCE ON SUNDAYS. AND
INSPIRED TO DO AND THAT SOME OF
THEM STILL RAN AWAY AND HE SAID
A HA THOSE SLAVES HAVE ANOTHER
MENTAL PROBLEM CALLED JUSTICE
DIGIT AETHIOPICA. REBELLIOUSNESS
NOW TOOK ME FIFTY YEARS TO FIND
OUT WHAT I WAS SUFFERING FROM.
BUT THE TREATMENT FOR THAT WAS
MEDICAL WITH THE- HE WITH THE
DEVIL OUT OF THEM THIS WAS A
PHYSICIAN AND THAT WAS HIS
TREATMENT WE HAVE DOCTOR SENT
SAMUEL MORTON WHO WAS AT THE
UNIVERSITY OF PENNSYLVANIA WHO
TAUGHT THE THEORY OF CRANEY
OLOGY. IN UP OUR PHRENOLOGY
MEASURING THE SKULL CAPACITY.
THE FIRST EUROCENTRIC IQ TEST
STATING THAT BLACKS WERE
INFERIOR BECAUSE THEY HAD A
SMALLER SCOPE CAPACITY THIS IS
BEING TAUGHT IN THE UCS IN AND A
MEDICAL SCHOOLS IN THIS COUNTRY.
WE GOT DR JOSHUA NOT WHO IS ALSO
A PHYSICIAN. AND LECTURER IN A
SLAVE OWNER AND HE TAUGHT THE
THEORY OF RICK WROTE ABOUT
CALLED NUMEROLOGY IN WHICH SHE
TAUGHT. THE DIFFERENCE BETWEEN
BLACKS AND WHITES. IN THE WE
HAVE. DOCTOR J. MARION SIMS HE'S
CONSIDERED THE FATHER OF
GYNECOLOGY. WHO OPERATED ON
BLACKS AND POOR WHITES TO
DEVELOP A SURGICAL PROCEDURE
WITHOUT. THE AID OF ANESTHESIA.
THESE ARE JUST A FEW THERE WAS A
BOOK WRITTEN BY HARRIET
WASHINGTON CALLED MEDICAL
APARTHEID THAT DOCUMENTED DOZENS
AND DOZENS OF IN HUMAN
EXPERIMENTATION. ON BLACKS
THROUGHOUT SENTRIES SO IT'S NOT
JUST ABOUT TO SKI IT'S ABOUT A-
LEGACY AND HISTORY OF-
EXPERIMENTATION. SO MONDAYS ARE
IN THE NINETEEN EIGHTIES AND
NINETEEN. NINETIES LITERATURE
STARTED PUBLISHING OUTCOMES THAT
WOULD BE DIFFERENT FOR BLACKS
AND HISPANICS. AND THEY USED TO
SAY WELL WE'RE NOT REALLY SURE
WHY IT MUST HAVE SOMETHING TO DO
MAYBE IT HAS TO DO WITH THAT
GENETICS MAYBE IT HAS TO DO
WITH- POOR COMMUNICATION. THIS
WAS A STUDY IN NINETEEN NINETY
NINE PUBLISHED IN THE NEW
ENGLAND JOURNAL OF MEDICINE IN
WHICH THESE WITH THE ACT WHAT
ACTUAL PARTICIPANTS THESE WERE
ALL ACTORS WHO DRESSED UP LIKE
PATIENTS THEY ALL HAD A SCRIPT
EXACTLY THE SAME. THOUSANDS OF
DOCTORS INTERVIEWED THEM AND IN
THE END I ASKED WHAT IS THE
DIAGNOSIS PHYSICIANS WELL
TRAINED IN THIS COUNTRY THEY
CAME UP WITH THE CORRECT
DIAGNOSIS CARDIO VASCULAR
DISEASE THEN THEY ASK WHAT DO
YOU DO NEXT IN FOR SOME REASON.
FOR THE BLACK PATIENTS SIXTY
PERCENT. OF THESE PHYSICIANS
RECOMMENDED THE PROPER TREATMENT
LASTS FOR BLACKS THAN FOR
WHITES. SO THAT PROMPTED. US
STUDY BY THE INSTITUTE OF
MEDICINE REPORT THAT CAME OUT IN
TWO THOUSAND AND TWO. COATS I
NEED FOR TREATMENT THIS WAS ONE
OF THE STUDIES THEY LOOKED AT
TWO HUNDRED TO OTHER STUDIES.
DOCUMENTING THAT YES I NEED-
TREATMENT IS TAKING PLACE IN THE
HEALTH CARE SYSTEM. IN IS
ACTUALLY BEING IMPLEMENTED BY
PHYSICIANS. SO WHAT IS THE
SCIENCE OF RACES. THERE IS A
VIDEO THAT GOES WITH THIS I'M
NOT GOING TO SHOW YOU ONE
INTERNET THIS CALL CREATORS FOR
CHANGE BUT THEY TALK ABOUT THE
SIDE TO RACES. IN ORDER TO
UNDERSTAND DECIDES WE HAVE TO
UNDERSTAND COLLECTED TRUMP. WHAT
IS COLLECTIVE TRAUMA IT'S A
COMBINATION OF ETHNO HISTORIC
TRAUMAS SUCH AS THAT SEEN WITH
BLACKS IN SLAVERY NATIVE
AMERICANS WITH GENOCIDE. THE
HOLOCAUST X. CENTER MIX THAT
WITH INTERGENERATIONAL RACISM
AND CULTURAL DISCRIMINATION. AND
THE SCIENCE CONCEPT OF
EPIGENETICS WHICH IS BIOLOGY IN
A MIXING WITH ENVIRONMENT THAT
EXPRESSES JIM DIFFERENTLY AND WE
WIND UP WITH MULTI GENERATIONAL
SOCIAL INEQUITIES IN HEALTH
DISPARITIES. HOW IS THAT
MANIFEST PAST AND CURRENT EVENTS
THAT INCREASE- INDIVIDUAL
COLLECTIVE TOXIC STRESS OF
CAUSING A PUBLIC HEALTH CRISIS-
IN THE BEGINNING. I DON'T KNOW
IF I WAS ABLE TO SHOW THE
ORIGINAL SLIDE BUT IN JANUARY OF
THIS YEAR. THE SAN DIEGO BOARD
OF SUPERVISORS DECLARED RACISM A
PUBLIC HEALTH CRISIS HERE IN-
SAN DIEGO. ONE RESEARCH IS IN
THIS AREAS DR DAVID WILLIAMS
HE'S AT THE HARVARD SCHOOL OF
PUBLIC HEALTH HUNDREDS OF
ARTICLES HE'S PUBLISHED IN THIS
IS JUST ONE HE PUBLISHED TALKING
ABOUT STRESS PATHWAYS THAT CAUSE
DISCRIMINATION AND AFFECT YOUR
HEALTH. ANY TALK ABOUT FIRST
EXPOSURE TO STRESS GIVES RISE TO
NEGATIVE EMOTIONAL STATES
GENERATING PSYCHOLOGICAL
DISTRESS ADVERSELY AFFECT HEALTH
SUCH AS DEPRESSION AND ANXIETY.
AND THEN BEHAVIORAL COPING
RESPONSES TO MANAGE STRESS
LEADING TO UNHEALTHY BEHAVIORS
SUCH AS- DRUGS CIGARETTES
ALCOHOL ABUSE AND POOR LIFESTYLE
HABITS. IN THIRD THE
PSYCHOLOGICAL AND BEHAVIORAL
RESPONSES TO CHRONIC STRESS CAN
LEAD TO PSYCHOLOGICAL SYSTEM
CHANGES PHYSIOLOGICAL CHANGES
THAT CAN CAUSE DISEASE. I'M
GONNA TALK BRIEFLY ABOUT TO
CONCEPTS ONE IS AT THE BOTTOM
ADVERSE CHILDHOOD EXPERIENCES
CALLED ACES AND THE OTHERS OUR
STATIC GLOW WHICH TO CHRONIC
PHYSIOLOGICAL RESPONSE THAT YOUR
BODY HAS TO LESS STRESS. AND
WHEN THEY HAVE DONE STUDIES
THEY'RE NOW FINDING OUT THAT ONE
OF THE FIRST- STUDIES OF ACES
WAS ACTUALLY DONE HERE IN. SAN
DIEGO AND THEY FOUND THAT THE
MORE ADVERSE EVENT YOU HAD TO
OUR CHILDHOOD. THE GREATER
NUMBER OF DISEASES YOU HAD WHEN
YOU OWED INCLUDING DIABETES AS
MERRICK CETERA. THEY LOOKED AT
IT BY RACE AND ETHNICITY BLACKS
HISPANICS HAVE HIGH SCORES IN
HIGH ALLOSTERIC LOAD LEVELS THEN
ALL OF THE ETHNICITIES THIS
CONTRIBUTES TEXAS DISEASE BURDEN
SHORTER LIFE EXPECTANCIES SIX
CETERA. THIS IS JUST. AN EXAMPLE
OF WHAT THIS STUDY SHOWED THAT
DEPENDED UPON THE NUMBER OF
FACES AND YOU GO ACROSS ONE TWO
THREE FOUR ACES YOU CAN SEE THE
EXPONENTIAL INCREASE. IN THE-
NUMBER OF EVENTS THAT HAPPEN
LATER ON IT LIKE SUICIDE
ATTEMPTS INJECTION OF DRUGS
ALCOHOL ABUSE DEPRESSION LUNG
DISEASE CARDIOVASCULAR DISEASE
X. CETERA. AND HOW IS POSTULATED
TO WORK IS THAT THESE ADVERSE
CHILDHOOD EXPERIENCES LEAD TO
SOCIAL EMOTIONAL COGNITIVE
IMPAIRMENT. ADOPTION OF HEALTH
RISK BEHAVIORS THAT RESULT IN
PHYSIOLOGICAL RESPONSES CAUSING
DISEASE DISABILITY SOCIAL
PROBLEMS AND EARLY DEATH. WHAT
IS OUR STATIC LOW. I LIST THE
CONCEPT AVAILABLE SPACES IS HOW
WE INTERNALIZE OUR ENVIRONMENT.
WE MEASURE IT BY WHAT WE CALL
ALICE STATIC. INVESTOR CHRONIC
INSIDIOUS PHYSIOLOGICAL STRESS
CAUSING WEAR AND TEAR ON THE
BODY ORGANS LEADING TO DISEASE
AND AS YOU CAN SEE SOME OF THOSE
MANY OF THE NEGATIVE SOCIAL
DETERMINANTS OF HEALTH. INCREASE
OUR STATIC LOW. VIOLENCE POOR
HOUSING LACK OF SOCIAL CAPITAL
FOR EMPLOYMENT POVERTY AND YES
RACISM. NOW WE TALK ABOUT THE
SOCIAL DETERMINANTS OF HEALTH
BUT I'D LIKE TO SUGGEST HERE IN
AMERICA MANY OF THE SOCIAL
DETERMINANTS OF HEALTH THE
RACIALIZED WE GOT STRUCTURAL
RACIAL RACISM WHICH STRUCTURAL.
AND RACIALIZED SOCIAL
DETERMINANTS OF HEALTH. IN THE
PUBLIC HEALTH LITERATURE IN IN
THE BEHAVIORAL HEALTH LITERATURE
THERE ARE MANY ARTICLES NOW
COMING OUT TALKING ABOUT DALLAS
LOAD AND HOW IT'S MEASURED IN
TWO THOUSAND AND SIX THIS WAS
ONE PUBLISHED IN THE JOURNAL OF
PUBLIC HEALTH. IN WHICH THEY
MEASURED ALLOSTERIC LOAD ARE NOT
IN WHITES VERSUS BLACKS SOME OF
THE PRIMARY STRESS BIOMARKERS
INCLUDE. ENZYMES AND- PROTEINS
SEARCHES- CORTISOL CATECHOLAMINE
ANGIOTENSIN ENDOTHELIUM. AND
SOME OF THE SECONDARY WAYS YOU
CAN GET THAT THESE INCREASE
INSIDES IS MEASURING YOUR BLOOD
PRESSURE YES GLYCATED HEMOGLOBIN
WHICH IS A. ONE C. A MEASURE OF
EARLY DIABETES. LIPID LEVELS
YOUR WAIST TO HIP RATIO ALBUMIN
EXETER THESE ALL CLINICAL-
BIOLOGICAL WAYS OF MEASURING
ALICE STATIC LOW AND WHEN THEY
DID THE STUDIES THEY FOUND THAT
BLACKS AT HIGHER OUT OF A STATIC
LOAD AND WIPED. AND MORE
IMPORTANTLY FOR THE BLACK
POPULATION WHEN THEY LOOK AT
HISPANICS ASIANS WHITE SIX
CETERA BLACKS WITH THE ONLY ONES
TO HAVE BLACK FEMALES HAVE
HIGHER I WAS STATUS QUO. THE
BLACK. MALES I WAS THAT. WE LOOK
AT YOU ESTIMATE IN MATTEL RATES
BY RACE AND ETHNICITY. WE CAN
SEE THAT FOR AFRICAN AMERICANS
MATERNAL RATE IS TWO TO THREE
SOMETIMES FOUR TIMES HIGHER.
THAN HISPANIC IN. A WHITE
POPULATIONS IN THE SAME FOR
INFANT MORTALITY. AND THIS GOES
ON YES AS THE- SOCIAL INCOME
IMPROVES WITH THE JOB STATUS
IMPROVES. THE INFANT MORTALITY
AND MATERNAL RATES GO DOWN BUT
WHEN WE COMPARE BLACKS TO THE
SAME CLASS WE STILL SEE EVEN IT
UP INCOME- OF BLACK MOTHERS AND
WHAT NOT THIS DISPARITIES SO
RACES INDEPENDENT FACTOR AND I
THINK IT HAS TO DO WITH THAT
ALICE STATIC LOAD. IN CHRONIC
INTERMENT STRESS THAT BLACK
WOMEN GO THROUGH. HERE IN SAN
DIEGO COUNTY. NINE TWO ZERO
THREE SEVEN ROYAL. NINE ONE NINE
ONE FIVE IS HE SAN DIEGO A BABY
BORN IN THOSE ZIP CODES HAS A
LIFE EXPECTANCY AT BIRTH OF
EIGHTY FIVE YEARS IN EIGHTY
YEARS. AT 921-149-2115 IS THE
AREA WHERE I PRACTICE MEDICINE
ITSELF THE SAN DIEGO AND THE
LIFE EXPECTANCY AT BIRTH FOR A
BABY BORN AND THAT ERROR IS
SEVENTY NINE AND SEVENTY SEVEN
YEARS. JUST BECAUSE WHERE YOU
BELONG SO PLACE. HAS A VERY
SIGNIFICANT CONTRIBUTED TO YELP. IF WE LOOK AT RACE. AND
LONGEVITY THE OVERALL H. OF
LONGEVITY IN THE UNITED STATES
AND TWENTY SEVENTEEN TO SEVENTY
EIGHT POINT SIX HOWEVER IF WE
LOOK AT ASIANS WHO WAS EIGHTY
SIX POINT FIVE HISPANICS EIGHTY
TWO POINT EIGHT WHITE SEVENTY
EIGHT POINT NINE NATIVE AMERICAN
SEVENTY SIX POINT NINE IN BLACK
SEVENTY FOUR POINT SIX SO ALL
MINORITIES ARE NOT THE SAME SO
YOU MAY ASK WHY ARE BLACKS AND
NATIVE AMERICANS HELLO. I WANT
TO GO BACK TO THAT HISTORY K.
THAT COLLECTIVE TRAUMA THAT TOOK
PLACE IT'S PUT THAT TRAUMA IN
ALICE THAT EXPLODE HAS BEEN
GOING ON MUCH LONGER IN THOSE
COMMUNITIES THEN IN THE HISPANIC
COMMUNITY. WHAT'S TAKING PLACE
TODAY IN WHAT WE SEE IN THE
HISPANIC COMMUNITY WE'RE
BEGINNING TO SEE CHANGES IN
THOSE NUMBERS IT IS GETTING
WORSE BECAUSE OF THAT OUT
NEGATIVE ALLOSTERIC LOW THIS
TAKING PLACE THERE. IN IN
SUMMARY HOW DOES THE INTERACTION
OF GENES AND ENVIRONMENT TAKE
PLACE. ON ON THE REF WE'RE
TALKING ABOUT ESTIMATE
CONTRIBUTION TO DISEASE WE SAY
ABOUT 25% MAYBE BIOLOGY
LIFESTYLE GREATER THAN 50%
ENVIRONMENT 12% IN THE MEDICAL
CARE 10% SO 10% YET WE SPEND 90%
OF OUR MONEY ON MEDICAL CARE.
AND SO WE PROBABLY NEED TO FOCUS
MORE ON LIFESTYLE. AND LIFESTYLE
ITSELF. IS INFLUENCED BY OUR
ENVIRONMENT INTERACTS WITH OUR
GENES SO IT'S EASY TO SAY FOR
SOMEBODY IN LA HOYA I WANT YOU
TO JOG YOU'RE A PERSONAL TRAINER
- DO TWO LAPS OF SWIMMING VERSES
ITSELF THE SAN DIEGO IT'S MUCH
MORE DIFFICULT THE ENVIRONMENT
NOT MAY NOT BE SAFE SO YOU HAVE
ENVIRONMENT INFLUENCES ARE YOUR
ABILITY TO EXECUTE A HEALTHY.
LIFESTYLE AND THEN YOU THROW THE
EPIGENETICS IN THERE WHICH IS.
NOT THAT THERE'S A- NIGGLE GENE
MAKE IN US HYPERTENSIVE. YES THE
ENVIRONMENT AND RACISM AND
STRUCTURAL ISSUES THAT WE'RE
DEALING WITH. LEADING TO A
MODIFICATION OF GENE EXPRESSION
RATHER THAN ALTERATION IN THE
CODE ITSELF. AND THIS IS JUST TO
SHOW YOU THE IMPACT OF THE
SOCIAL DETERMINANTS OF HEALTH.
THIS IS SAYING THAT IN TWENTY
NINETEEN. THE LIFE EXPECTANCY OF
WHITE WAS SEVENTY EIGHT POINT
EIGHT YEARS HISPANICS EIGHTY ONE
POINT EIGHT YEARS AND BLACKS
SEVENTY FOUR POINT FIVE YEARS
WITH THE ONSET OF CODE VIA I
THINK THE LIFE EXPECTANCY FOR
TWENTY TWENTY WAS THE FIRST SIX
EIGHT MONTHS. THERE WAS A
DECREASE FOR THE FIRST TIME IN
DECADES LOCKED THE LIFE
EXPECTANCY FOR AMERICANS HOWEVER
THE LOS FOUR WHITES WAS ONLY
POINT EIGHT YEARS THE LOSS FOR
HISPANICS WAS ONLY ONE POINT
NINE YEARS IN THE LOS FOUR
AFRICAN AMERICANS WAS TWO POINT
SEVENTY. SO IN SUMMARY. WHY DID
NOT COUNTY AND OTHER COUNTIES TO
CLEAR RACISM A PUBLIC HEALTH
CRISIS. AS A RESULT OF HISTORIC
AND CURRENT RACISM BIAS
DISCRIMINATION RACE AND
ETHNICIT ARE SIGNIFICANT
CONTRIBUTORS TO MOST OF THE
SOCIAL DETERMINANTS OF HEALTH
WHICH INCLUDE STE YOUR
SOCIOECONOMIC STATUS THAT HELPS
YOU WITH EMPOWERMENT IN
INFLUENCE WHERE YOU LIVE. YOUR
JOB SATUS DO YOU HAVE ACCESS
TO- HEALTH IN QUALITY HEALTHCARE
. DO YOU HAVE ACCESS TO A
QUALITY HEALTHY FOOD AND OUR AYE
YOU'VE BEEN EXPOSED TO MORE
TOXINS IN THE ENVIRONMENT. THANK
YOU. THANK YOU VERY MUCH DOCTOR
HOOD AS USUAL- YOU HAVE. TAKING
US TO CHURCH SCHOOL AND ALL OF
THAT IN ONE I. ALWAYS ENJOY
LEARNING AND LISTENING FROM YOUR
VAST- WEALTH OF KNOWLEDGE YOUR
PASSION TO NOT ONLY EDUCATING-
THOSE OF US IN THE MEDICAL
PROFESSION BUT THOSE OF US IN
THE COMMUNITY BUT ALSO YOUR
PATIENCE- OVER THE DECADES THAT
YOU'VE BEEN PRACTICING MEDICINE-
DEFINITELY BEEN NOTICED AND YOU
KNOW WE ARE VERY GRATEFUL AND-
TO HAVE YOU HERE WITH AND SAN
DIEGO COMMUNITY- THAT WAS AN
AMAZING HISTORY LESSON. JUST
REMIND US THAT WHERE WE ARE
TODAY DID NOT HAPPEN OVERNIGHT
THAT THIS'S BEEN UNFORTUNATELY
EMBEDDED AND AMERICAN HISTORY
FOR GENERATIONS AND GENERATIONS
AND IF WE DO NOT TRULY BECOME
INTENTIONAL ABOUT TALKING ABOUT
THEM AND DEALING WITH THEM. THEN
WE WILL BE DOOMED TO CONTINUE TO
REPEAT HISTORY OVER AND OVER AND
OVER AGAIN. IT'S ALWAYS AN
INTERESTING TO ME HOW PEOPLE
LIKE TO. BUT CERTAIN MEDICAL
CONDITIONS ON GENES OR GENETICS-
WITHOUT RECOGNIZING THAT MANY
PEOPLE WHO COME HERE THEIR
HEALTH OUTCOMES AND THEIR HEALTH
CONDITIONS OFTEN CHANGE VERSUS
THOSE IN THEIR NATIVE COUNTRY TO
THEIR NATIVE LANDS. AND IT WAS A
FEW WEEKS AGO I HAD TO REMIND
SOMEONE ON A DIFFERENT COMMITTEE
THAT I MIND THAT IT'S NOT THE
GENES OF AFRICAN AMERICANS AND
NATIVE AMERICANS BECAUSE WHEN
YOU LOOKAT- THOSE WHO LIVE IN
AFRICA YOU REMEMBER. WHAT THE
NATIVE AMERICANS INITIALLY EIGHT
IT WAS FROM THE LAND IT WAS THAT
THE HEALTHY VEGETABLES AND
FRUITS BUT IT- BUT WHEN YOU ADD
THE STRESS AND THE POOR
CONDITIONS AND THE POOR DIETS
AND- THE FOOD IN A CERTAIN
COMMUNITIES THAT. OVER TIME
WHERE YOU GET THE HIGHER RATES
OF DIABETES OBESITY HYPERTENSION
COPD ASTHMA AND ALL OF THAT SO
THANK YOU SO MUCH FOR REMINDING
US HOW WE GOT HERE- SO THAT WE
CAN BE VERY INTENTIONAL ABOUT
MAKING SURE THAT WE DO NOT STAY
HERE. WE'RE GOING TO MOVE TO OUR
NEXT PRESENTER. NEXT I AM VERY
HONORED WE HAVE THE C. E. O. AND
PRESIDENT OF CHARLES R. DREW
UNIVERSITY OF MEDICINE AND
SCIENCE DR DAVID M. CARLISLE.
WILL BE PRESENTING VIRTUALLY.
PRESENTLY SERVING SINCE TWO
THOUSAND ONE AS THE PRESIDENT
AND CHIEF EXECUTIVE OFFICER OF
CHARLES R. DREW UNIVERSITY OF
MEDICINE AND SCIENCE IN THE
WATTS WILLOWBROOK AREA OF LOS
ANGELES COUNTY. DR CARLISLE IS A
PUBLISHED AUTHOR AND HEALTH
POLICY. QUALITY OF CARE. MEDICAL
EDUCATION DIVERSITY AND
ELIMINATING HEALTH DISPARITIES.
A BOARD CERTIFIED INTERNAL
MEDICINE SPECIALIST ITS CLINICAL
WORK HAS ALWAYS REVOLVED AROUND
CARING FOR THE UNDERSERVED.
PRESIDENT CARLISLE SERVED AS
DIRECTOR OF THE OFFICE OF
STATEWIDE HEALTH PLANNING AND
DEVELOPMENT FOR ELEVEN YEARS
FROM TWO THOUSAND TO TWO
THOUSAND AND ELEVEN. UNDER HIS
LEADERSHIP THE OFFICE RELEASED
ITS FIRST EVER HEALTH
DISPARITIES REPORT. I'M SO
PLEASED TO PRESENT OUR NEXT
PRESENTER DR DAVID CARLISLE.
THANK YOU VERY MUCH- NUMBER DR
WHATEVER IT IS AN HONOR TO BE
HERE AND- I AM LOOKING FORWARD
TO JOURNEY MUST ALWAYS WITH YOU
. I DON'T WANT TO RENEW-
GREETINGS FROM ANYONE IS CHARLES
R. DREW UNIVERSITY MADISON
SCIENCE. OF OUR TRUSTEES OUR
STAFF ARE BADLY. ESPECIALLY OUR
STUDENT BODY. COME FROM LOS
ANGELES COUNTY. WHAT WHAT SIDE.
I THINK WE'RE SURE YES OKAY SO-
BUT ALSO IN ORDER TO FOLLOW- MY
GOOD FRIEND A COLLEAGUE A DOCTOR
ED WELL KNOWN. FOR CAREER AS
WELL AS DR RIGHT RIGHT- SOMEBODY
THAT I. A JOB IS. TALK ABOUT
ARMS DETERMINANTS AND I WILL FOR
PRESENT ME OUT THERE ARE GOING
TO A CONCERT TO. WE USE ON OUR
TO CHARLES ARE. AS A METAPHOR.
AND THEN WRAP IT UP I WAS
TALKING ABOUT HOW TO. BERMAN THE
CODE I BECAUSE. ONCE OUT WITH A
- SO. IT'S CALLED A GARDENER'S
YES- MY GOOD FRIEND TO CALL- AND
IT'LL DR JONES. SORRY TAIL IS
REALLY INSTILL ABOUT TURNS WHAT
IS ALSO ALREADY. SO THERE IS A
GARDENER. HERE'S TO PLAY
IMPATIENS INTO POWER ARE. AND-
ON ONE OF OUR SHOULD RENOVATION
. IN THE BOX YOU CAN PATIENTS.
FOR SOME REASON AN OLDER EVERY
YEAR RIGHT A PATIENTS RIGHTS.
INVASIONS DENT. SORT OF LIKE
READING MORE AND MORE AND MORE.
IT WAS UNTIL SHE DECIDED TO SHE
WANTED THE ON MARCH IS GOING TO
REPLACE PENTAGON'S WITH RED.
THAT SHE THOUGHT REALIZE SOME OF
- WRONG BECAUSE THE
PRESENTATIONS TO NEVER AND
THRIVE. AND SHE DISCOVERED THAT
THE PASTORAL. I SAW. RETURN OF
THESE QUALITY REDUCE OF SORT AS
WELL THE FRONT ROCK AND CLAY SO. SHE PROTECTING INVENTIONS AND
THEY DID WELL AS AS WELL SO
THAT'S A GARDASIL INITIAL YOU AN
EXAMPLE THE SERGEANTS ACTORS THE
DIFFERENCE CAN IMPACT THE HEALTH
OF EMISSIONS AND CERTAINLY.
PEOPLE AS WELL. SO IS A CONCERT
- PEOPLE TWO THOUSAND TWENTY OR
- LAS AND THERE ARE BODIES MAY
CATTLE. SO DETERMINES- ACT
QUALITY ECONOMIC STABILITY. SO
CONTACTS NEED AND ALL OF OUR AND
OKAY- ASK AND- WE'RE GONNA BE
TALKING ABOUT THIS FOR- AND I'M
TO SEE YOU AS A MATTER OF. US.
RECOGNIZES WHAT AROUND YES DON'T
KNOW. WHAT'S POST NINETEEN
SIXTY. SHOWING THE NATIONAL
TROOPS ON THE STREETS OF LOS LOS. THE STORY THAT JUST A FEW
MONTHS AGO THAT ARE HAS READ. TO
THOUSAND BOSTON. THIS AMERICAN
INFORMATION. TO RELIEVE THE
EXHAUSTED AND MARK LUTHER KING
COMMUNITY CENTER WELL CROSS
STREET CHARLES RIVER BECAUSE
THAT ONE HUNDRED THIRTY AWESOME
WE'LL SEE MORE NINETEEN. THAT
OTHER ARE NO IT. SO NATIONAL
GUARD TOOLS. ABOUT OUR STUDENTS
ARE URGING AND SCIENCE WE ARE
SUPPOSED OUR TO BECAUSE WERE OUR
IN THE RIGHT AFTERMATH OTHERWISE. WE WERE FOUND BECAUSE OF
WHAT'S LAST AND THE EXIT OF THE
COMMUTER OFF HAS EXPERIENCED
RUNNING THE THING AFTER AND
TWENTY CENTURY ARTISTS ARE
RICHARD. NUMBER THREE VALUE AT A
UNIVERSITY IN THE COUNTRY OUR
STUDENTS BENEFITING DIRECTLY
FROM BEING IN A ROLE TO SEE HERE
. REGULARLY IN THE TOP 10% IN
GRADUATE EARNING POWER ACROSS
THE STATE OF CALIFORNIA OR THE
UNITED STATES. SEE YOU IS AN
ASSORTMENT OF BLACK GRADUATE
INSTITUTION. WE ALSO HAVE- NOT
DIVERSITY SCHOOL TEAM OR- AS
WELL AS- OUR PRESENTATION TO.
ALSO AT A THE GROUND SERVICE
DIVISION AS WELL WE DON'T THOSE
ONE OF THOSE STUDENTS 50 DEGREES
PROGRAMS IN MEDICINE NURSING
UNDERGRADUATE. AND OTHER
PROGRAMS INCLUDING THE FIRST
POSITION IN PROGRAM. IT WAS A
DIFFICULT. AND WE ARE IN H.
FUNDED RESEARCH. PROGRAM OUR
MISSION IS TO CULTIVATE DIVERSE
ALL LEADER ARE DEDICATED TO DOES
NOT AUTOMATICALLY. FOR
UNDERSERVED. SENATOR RESEARCH
COMMUNITIES ARE. AND AND- THIS
IS ARE WE STRIVE SHE VISION. BOB
ROLE IN THE WORLD WITHOUT-
DISTURBS. C. MOBILE. IN
SOUTHWEST ANGELES. CALLED
SERVICE MY AREA SIX OR SAUCE AND
IT'S THEREARE EIGHT WINNERS LOS. JUST WANTED TO DO SHOWING. SAN
FRANCISCO CITY POPULATION
SEATTLE HONOLULU. WASHINGTON DC
. SACRAMENTO SENATOR SENATOR
EVEN THE WORLD CITY ASKED THE
SMALL. POPULATION OF SOUTH
AUSTIN ADULTS MEADOWS OVER
BOSTON I DID THAT FOR REASON.
BOSS WITH UNDER THREE OF PEOPLE
OKAY SMALLER. IN SOUTH BOSTON
AND- YEAH MEDICAL SCHOOLS ARE
THERE. TO I THINK THE ANSWER IS
FOR. HOW MANY HOSPITALS ARE ALSO
. PROBABLY TWELVE MAJOR HOSPITAL
AND- MADE ALMOST TWENTY MAR ALSO. IT IS FASCINATING TO COMPARE
THE PROS PROBLEMS SO RESOURCES
AWESOME THAT'S OUR LARGER
POPULOUS OF SOUTH BOSTON. THIS
WHY WE LOOK THE KEY JADHAV CONS
- LOS ANGELES. PEOPLE INTO THE
BIGGEST COUNTY OF. COULD TWENTY
FIVE SO OF THE ENTIRE L.
POPULATION IS DOUBLES. TWENTY
SIX RESIDENTS ARE SAYING. WHAT
3% I SOLICITATION AND. JORDY
NELSON. ALSO ALARMINGLY MOST
UNFORTUNATE IN HIS REPORT. WHEN
YOU LOOK AT ALL OF YOUR OUTCOMES
ACROSS TWENTY MEASURES. THE
REPORT. HE WAS WARY SAUDIS
ALREADY WORSE ON ABOUT THREE
MEASURES. THIS WELL AS FAR SIX
TOP LOS ANGELES OKAY COMMITTEE
MEASURES WERE WORSE FOR TWELVE
YEARS ENTIRELY DISPROPORTIONATE
TO WHAT YOU'D EXPECT GIVEN THE
SIZE OF THE POPULATION THERE WAS
ONLY ONE MEASURE. YEAH AND I WAS
VERY WHICH I EXPLAIN TUESDAY. I
HE'S ALSO WITH HERBAL. AND- L.
A. COUNTY IS THE R. FORCES
CALLED BLOCKED IN ALL. OF CAN
OUTCOMES SAUCE AS WORSE CANCER.
SO FAR NO. SPAS HOUSING IS ABOUT
. RIGHT HOUSING IS. IT'S.
TRANSPORTATION MOSTLY ARE
WORKING AND ONE OF WHICH MEANS
THEY COULD TAKE TIME OFF
COULDN'T STAY HOME FROM DURING
OUR CODE PADDOCK YOUR CALL IS
FOR THE SENATE ETCETERA CENTER
AND WE LOOK AT THE SOURCE
INTERNET YOU CAN SEE ON MAP THE
CODE I OF US RESEMBLE HOUSING WE
NEED TO INCREASE PRESSURE CODE.
AT WORK. GENERATIONAL HOUSING
MEANS THAT YOUNG PEOPLE WERE
MORE LIKE TO BE AFFECTED. ARE
LEADING WATER AROUND HER RESULT
IN ONE. IN THE SAUCE. WHEN YOU
LOOK AT THE FOOD AS WELL. PEOPLE
DON'T GET HIGH QUALITY. LONG
FOOD IT ALL INCREASE THE ON ALL
THESE AND THAT CAUSES MORE CO
NINETEEN OUT WE. ARTICLE IN OUR
AVAILABLE. THAT MEANS THERE'S TO
GO TO MARKET IS ALL SITTING NOW
. WE ARE GETTING ASKED
CELEBRITIES. ZOMBOSS THE PEOPLE. I'M JUST GOING ACTUALLY IT IS
DECREASED TRUST IN OUR URBAN
POPULATIONS. IN ATLANTA HOUSE
WELL NO SURPRISE BECAUSE THERE'S
CRITICISM OR- MINIMUM IN RB.
OKAY WE HAVE ONE POSSIBLE.
TWENTY THE CITY OF AUSTIN.
THERE'S ALSO HERE ACT ONE COULD
PROBABLY TERM THIS TO MEAN THAT
OKAY SYSTEM IS NOT RISK. TO THE
NEWS POPULATION. IN FEELS WAY
HELLO YOU FEEL ABOUT IT ALL
SYSTEM THEY DON'T TRUST OF
NURSES AND THEY DON'T COME. AND
THEY DON'T GET A BASKET RESULT
IS MORE CASES ACROSS NINETEEN
MORALLY. THIS IS WHY SEE YOU.
OPENED GOOD JOSH WHAT ARE PART
THE ONLY COUNTY. STE WE NEED TO
TEST AN INDIVIDUAL'S ACTIONS
SAID AND ROUTING THE FIELD
DURING BOWL ACTIVATION WORK THE
MEASURE WAS OUR NUMBERS INCREASE
. REALIZED THAT HE'D WERE THE
TASK HIM LAST ONLY LOOK BY THEM
NOT ONLY IS OF THE SAME LANGUAGE
THAT. BUT WHAT IS YOUR WITH AN
AWESOME. RIGHT WE'RE GOING TO IN
THE AND SHOPPING CENTERS IN FACT
IT IS SO INTERESTING. WITH THE
COMMUNITY THAT SADDAM SEEKS TO
ISSUE TRY AND HEALTH. INITIAL
ALL WHEN CONNECT WITH COMMUNITY
WHEN YOU ARE AGGRESSIVE REACHING
OUT AND SAYING WE ALREADY.
PEOPLE STARTED THE MINDS. ABOUT
AUTHORS. SO SEE YOU BASICALLY
HAVE. THE SAUCE FROM ALL IN THE
FOLLOWING WAY. I'M WE'RE
INCREASE EDUCATION ACCESS
CONSOLIDATED'S COMMITTEE.
BECAUSE OUR MAJOR WATER WE ARE
ECONOMIST I READ WAS RETURNING
TO THEM ALSO INCREASING OFFICE.
ALL THESE. ALL THESE THINGS
RESULT IN THE IMPROVEMENT OF THE
SOCIAL COMMUNITY CONTEST WHICH
IS THE FINAL- SOCIALIST BERMAN
ABOUT. THESE LEVY- THE
CALIFORNIA IF YOU DON'T WORK
COMMISSION TO RECOMMEND THIS AND
IS OUR IS ALSO A LOS COMMUNITIES
LIKE THROW. AND BEYOND WELL OUR
OWN FOR YOUR ANTI TO. I DON'T
REALLY ORGANIZATION YOU DON'T
HAVE TO THE KING OF THE
COMMISSION. DIRECTLY THE SENATE
- I'M ALLOCATING MILLION DOLLARS
. TO ARE YOU. TO LAUNCH THE
SERVERS TO A YOUR CARE PROGRAM
AND PROGRAM TO SUPPORT SO
SANDALS AND COMMUTERS LIKE. AND
ADDRESS THE MORNING WERE ALREADY
THE SOCIAL FROM HOW. SO THERE
AND SAY THANK YOU VERY MUCH.
WEBER EVERY **** AND ALL
AMERICANS THESE ARE MEMBERS AND
OTHERS THANK YOU VERY MUCH.
THANK YOU SO MUCH KERR FOR
REASON- AND LET US KNOW. NOT
ONLY GO ON IN OTHER A OF IN
CALIFORNIA CPAS LAW SANDEL- BUT
ALSO LETTING US IN CHARGE DREW.
AS I DON'T KNOW HOW MANY ARE
AWARE OF THAT JULIE IN LAS
ANGELES- A FELLOW I. BLACK AND
UNIVERSITY GRAD MYSELF- CHARLES
DREW IS NEAR AND DEAR TO MY
HEART AND THE ONLY H. B. C. U.
IN CALIFORNIA AND I BELIEVE ON
THE WEST COAST AND SO WE'RE VERY
VERY FORTUNATE TO HAVE THE
UNIVERSITY ALL OF THE PHYSICIANS
AND TEACHERS THAT ARE TEACHING
OUR FUTURE. LEADERS WITHIN THE
MEDICAL PROFESSION- AND I REALLY
APPRECIATE YOU TAKING TIME OUT
OF YOUR BUSY SCHEDULE TODAY TO
COME AND PRESENT TO ASK. SO I
WAS MOVING TO THE LAST
PRESENTATION FOR THIS MORNING.
MEMBERS OF THE PUBLIC MAY NOW
CALL INTO OUR TOLL FREE NUMBER
FOR PUBLIC COMMENT. ONCE AGAIN
THE NUMBER IS. 877-692-8957 AND
THE PUBLIC ACCESS CODE IS. ONE
THREE ONE FIVE ONE EIGHT FIVE
ZERO. SO LASTLY WE HAVE THE
ACTING DIRECTOR OF PUBLIC HEALTH
SERVICES AT THE COUNTY OF SAN
DIEGO HEALTH AND HUMAN SERVICE
AGENCY DR ELIZABETH HERNANDEZ.
DR HERNANDEZ OVERSEAS PHS
OPERATIONS WHICH INCLUDES
TUBERCULOSIS CONTROL AND REFUGEE
HEALTH. REPAIRED NIS AND
RESPONSE MATERNAL CHILD AND
FAMILY HEALTH SERVICES
CALIFORNIA CHILDREN'S SERVICES
HIV SLASH AIDS STI AND HEPATITIS
AS WELL AS THE EPIDEMIOLOGY AND
IMMUNIZATION BRANCH. SHE
PROVIDES DIRECTION AND
OPERATIONAL LEADERSHIP IN THE
AREAS OF BUDGET DEVELOPMENT
FISCAL PROCESSES AND
ACCOUNTABILITY. CONTRACTING
QUALITY MANAGEMENT AND QUALITY
IMPROVEMENT BOARD LETTER
COORDINATION AND HUMAN RESOURCES
I THOUGHT. THE PHS DEPARTMENT
CONSISTS OF OVER SIX HUNDRED AND
SEVENTY EMPLOYEES AND A BUDGET
OF OVER THREE HUNDRED MILLION
DOLLARS SERVING A COUNTY OF
ALMOST THREE POINT FOUR MILLION
RESIDENTS. I AM SO APPRECIATIVE
OF HER JOINING US TODAY AND I
WILL NOW TURN THE FLOOR OVER TO
DOCTOR ELIZABETH HERNANDEZ.
THANK YOU SO MUCH ASSEMBLY
MEMBER DR WEBER. REALLY
APPRECIATE THE OPPORTUNITY
SPEAKS WITH YOU TODAY- AS THE
OTHERS SPEAKERS I'M HERE TODAY
TO TALK ABOUT THE SOCIAL
DETERMINES OF HEALTH AND TO
PROVIDE A LOCAL PERSPECTIVE IN
SAN DIEGO COUNTY- AND FROM
PUBLIC HEALTH PERSPECTIVE AS
WELL. I'D LIKE TO BEGIN- AS THE
OTHERS SPEAKERS IN TERMS OF WHAT
ARE THE SOCIAL DETERMINANTS OF
HEALTH- I THINK THE OTHER
SPEAKERS ALSO. SPOKE ABOUT THIS
VERY WELL AND SO I'M NOT GOING
TO GO INTO THE DIFFERENT
ELEMENTS OF THE SOCIAL
DETERMINANTS OF HEALTH. AND WE
ALL KNOW THAT IT IMPACTS
RESILIENCY WE KNOW THAT IMPACTS
HEALTH EQUITY- BUT A PUBLIC
HEALTH PRACTICE WE GET TO ASK
THE QUESTIONS OF WHY DO CERTAIN
HEALTH. OUTCOMES EXIST. AND MORE
AND THE MORE WE ASKED THAT
QUESTION THE MORE WE ASK WHY WHY
WHY AND WE END UP PEELING IT
BACK TO YOU SOCIAL DETERMINANTS
OF HEALTH AT PLAY. AND AGAIN
THIS INCLUDES EDUCATION JOB
STATUS FAMILY SOCIAL SUPPORT THE
OTHER COMPONENTS THAT WE TALKED
ABOUT BEFORE. AS WE LOOK AT THE
EXAMPLES OF SOCIAL DETERMINES OF
HEALTH WE SEE THAT NOT EVERY
PERSON HAVE THE SAME CONDITIONS
AND THESE CONDITIONS EXPLAIN IN
PART WHY SOME INDIVIDUALS ARE
HEALTHIER THAN OTHERS AND WHY
INDIVIDUALS ARE MORE GENERALLY
ARE NOT AS HEALTHY AS IT COULD
BE. THE NATURE OF OUR WORK IN
PUBLIC HEALTH RELIES HEAVILY ON
SOCIAL DETERMINANTS OF HEALTH.
MOST OF MY PRESENTATION WILL
FOCUS ON HOW THE COUNTY USES A
COLLECTIVE IMPACT APPROACH TO
MEASURE AND IMPROVE SOCIAL
DETERMINES OF HEALTH AND
INCREASE HEALTH AWARENESS. IN
OUR COMMUNITIES THROUGH A HEALTH
EQUITY LENS. WE START WITH THE
THREE FOUR FIFTY MODEL BASED ON
THE WORLD HEALTH ORGANIZATION
THREE FOUR FIFTY MODEL THE
COUNTY FOCUSES ON THREE
BEHAVIORS. THIS INCLUDES POOR
DIET LACK OF EXERCISING AND
SMOKING AND WE'VE LEARNED FROM
THE OTHER SPEAKERSTHAT SOCIAL
DETERMINANTS OF HEALTH DIRECTLY
IMPACT THE THREE BEHAVIORS.
THESE THREE BEHAVIORS LEAD TO
FOR CHRONIC DISEASES CANCER
HEART DISEASE STROKE TYPE TWO
DIABETES AND LUNG DISEASE WHICH
CONTRIBUTE TO MORE THAN HALF OF
THE DEATHS IN SAN DIEGO EACH
YEAR. CHRONIC DISEASES MAKE UP
THE EIGHT OF THE TEN LEADING
CAUSES OF DEATH IN SAN DIEGO
COUNTY IN FACT IN THE YEAR OF
200063% OF DEATHS IN SAN DIEGO
COUNTY WERE DUE TO THESE FOR
CHRONIC DISEASES. IF YOU LOOK
SPECIFICALLY AT THE SEVENTY NINE
ASSEMBLY DISTRICT WHICH INCLUDES
PARTS OF CENTRAL SOUTHEAST AND
NORTH CENTRAL REGIONS. THESE
REGIONS HAVE SIMILAR PERCENTAGES
IN TERMS OF DEATH WITH THE
EXCEPTION OF SOUTH REGION. IN
SOUTH REGION 67% OF DEATHS WERE
DUE TO THESE CHRONIC DISEASES.
MEANING THAT IN THE YEAR TWO
THOUSAND. TWO OUT OF THREE SOUTH
REGION RESIDENTS DIED AS A
RESULT OF ONE OF THE THREE FOUR
FIFTY DISEASES. BY TWO THOUSAND
NINETEEN THIS HAD DROPPED TO ONE
OUT OF TWO. WELL THIS IS NOT
STILL NOT GOOD ENOUGH I WOULD
LIKE TO SHARE HOW YOU BEGAN TO
MOVE THE NEEDLE ON THIS. AND WE
BEGIN WITH LOOKING AT OUR DATA.
IN ORDER TO CONTINUE TO GET TO
THE WHY. WE BEGAN TO CONDUCT
DEEPER DIVES INTO OUR DATA. OUR
COMMUNITY HOSTED TO STICKS UNIT
CREATED ONLINE COMMUNITY
PROFILES FOR PUBLIC USE. THESE
PROFILES AS YOU CAN SEE ON THE
SCREEN CAN BE ACCESSED ON OUR
INTERNET. FROM THE COLLECTIVE
IMPACT PERSPECTIVE MANY OF OUR
PARTNERS HAVE REACHED OUT TO US
TO RECEIVE THIS TYPE OF DATA.
AND NOW IT IS ONLINE FOR THEM TO
USE AT THEIR LEISURE. THE
PROFILES INCLUDE FIVE DASHBOARDS
EACH SHOWING THE DIFFERENT
LENSES OF HEALTH EQUITY. SUCH AS
GEOGRAPHY AND SOCIOECONOMIC
STATUS. RACE ETHNICITY AGE GROUP
GENDER. AND A SUMMARY SLIDE
SHOWING ALL FIVE LENSES IN ONE
SINGLE SLIDE. SO HOW THIS WORKS
IS THE USER SELECTS A HEALTH
CONDITION FROM A DROP DOWN LIST.
AS WELL AS THE OUTCOME AND YOU
CAN SEE THAT'S OPEN FOR IN
PURPLE. WELCOME COULD BE DEATH
HOSPITALIZATION EMERGENCY
DEPARTMENT SKILLED NURSING
INPATIENT TREATMENT AND PHYSICAL
REHAB. THE RATES ARE DISPLAYED
ON THE DASHBOARD AND IF YOU
HOVER OVER THE GEOGRAPHIC AREA A
POP UP WILL DISPLAY THE
GEOGRAPHIC AREA THE RATES AND
THE COUNT OF THE DISEASE. FOR
EXAMPLE ON THIS SLIDE ASTHMA IS
A CONDITION WITH THE OUTCOMES OF
EMERGENCY DEPARTMENT DISCHARGES.
THE LIGHT BLUE SHOWS LOWER RATES
FOLLOWED BY DARKER AREAS FOR
HIGHER RATES. HERE CENTRAL AND
EAST REGIONS HAVE THE HIGHEST
RATES. HERE'S ANOTHER EXAMPLE.
OF ANOTHER CONDITION CHRONIC
LOWER RESPIRATORY DISEASE HERE
AGAIN EAST REGION CONTINUES TO
SHOW THE HIGH STREET FOLLOWED BY
CENTRAL. THIS SYSTEM ALLOWS US
TO DO A DEEPER DIVE ON ANY
REGION THIS EXAMPLE SHOWS- A
DEEPER DIVE IN CENTRAL REGION
AND WE CAN SEE THAT SOUTHEASTERN
SAN DIEGO HAS THE HIGHEST RATE
AMONG THE SUBREGIONAL AREAS IN
THE AREA OF CHRONIC LOWER
RESPIRATORY DISEASE. FIVE I
SHARED EARLIER WE CAN ALSO
FILTER THE DATA BY GENDER THIS
SLIDE SHOWS HEART DISEASE AS THE
CONDITION AND DEATH AS THE
OUTCOME. WE CAN SEE FROM THIS
SLIDE UP THE DEATH THE DEATH
FROM HEART DISEASE IS HIGHER
AMONG MEN AND WOMEN IN ALL SUB
REGIONAL AREAS IN CENTRAL SAN
DIEGO. HOWEVER THE RATES FOR
BOTH MEN AND WOMEN WERE HIRE IN
SOUTHEASTERN SAN DIEGO THEN THE
REGION OR THE COUNTY AS A WHOLE. THIS DASHBOARD SHOWS ASTHMA
RATES AND LEMON GROW BY ALL
LENSES OF HEALTH EQUITY. BASED
ON THIS DATA WE CAN SEE THAT
UNCONTROLLED ASTHMA RATES ARE
HIGHEST AMONG AFRICAN AMERICAN
CHILDREN. THIS WAS JUST A QUICK
SNAPSHOT OF THE ONLINE PROFILES
THAT WE HAVE FOR OUR AND THE
ALL TO TAILOR INTERVENTIONS
INTERVENTIONS AND SERVICES TO
PACIFIC POPULATIONS. SO HOW DOES
THE COUNTY USE THIS DATA TO
BEGIN TO MOVE THE NEEDLE FROM
THE BEGINNING. IT WAS CLEAR THAT
WE NEED A STRATEGY TO PROMOTE
BETTER HEALTH. HOWEVER AS A
BLUEPRINT FOR LIVE WELL SAN
DIEGO TOOK SHAPE WE ALSO REALIZE
IT WAS GOING TAKE MORE THAN A
SINGULAR AIM TO ADDRESS THE
ISSUES WE'RE SEEING IN OUR
REGION. AS A RESULT THE BOSTON
DIEGO HAS THREE COMPONENTS
FOCUSING ON THREE ELEMENTS OF
WELL BEING HEALTHY. SAFE SAFETY
AND QUALITY OF LIFE OR BUILDING
BETTER HEALTH LIVING SAFELY AND
THRIVING RESPECTIVELY. ALL
COUNTY SAN DIEGO'S PROGRAMS
PRACTICES POLICIES AND
INTERVENTIONS SUPPORT LEVEL SAN
DIEGO. THE THREE COMPONENTS
BUILDING BETTER HEALTH LIVING
SAFELY IN THRIVING AND BODY THE
VISION OF LEVELS AND DIEGO WHICH
INCLUDES SPECIFIC STRATEGIES AND
INDICATORS TO TRACK OUTCOMES.
THE STRATEGIC APPROACHES WHICH
ARE NOTED IN GREEN INCLUDE
BUILDING A BETTER SERVICE
DELIVERY SYSTEM SUPPORTING THE
POSITIVES CHOICES PRESERVING
POLICIES SYMPTOM AND
ENVIRONMENTAL CHANGE AND
IMPROVING THE CULTURE FROM
WITHIN. SUCCESS IS MEASURED
THROUGH FIVE AREAS OF INFLUENCE
AND TEN INDICATORS THESE TEN
INDICATORS AND BLUE ARE
COMPONENTS OF SOCIAL
DETERMINANTS OF HEALTH. WITH
OVER FIVE HUNDRED RECOGNIZE
LEVEL PARTNERS ACROSS FOUR
SECTORS GOVERNMENTS BUSINESSES
SCHOOLS AND FAITH AND COMMUNITY
BASED ORGANIZATIONS DOING WHAT
THEY DO BEST ACHIEVE COMMON AND
MUTUAL GOALS. SO NOW THAT WE
HAVE A VISION AND A FRAMEWORK
YOU RELIED ON THE POWER OF
COLLECTIVE IMPACT WHICH INCLUDES
FIVE COMPONENTS A COMMON AGENDA.
SHARED MEASUREMENTS MUTUAL
REINFORCING ACTIVITIES
CONTINUOUS COMMUNICATION AND
BACK ONE SUPPORT. LEVEL SAN
DIEGO USES A COLLECTIVE IMPACT
STRATEGY ACHIEVING A HEALTHY
SAFE AND THRIVING SAN DIEGO
COUNTY INVOLVES EVERYONE WORKING
TOGETHER TOWARDS THE SAME VISION
HERE WE APPLY THE FIVE
CONDITIONS OF COLLECTIVE IMPACT.
NUMBER ONE COMMON AGENDA THIS IS
OUR LEVEL SAN DIEGO FRAMEWORK
THAT YOU SAW IN EIGHT INDIA
TRIANGLE. NUMBER TWO SHARED
MEASUREMENTS FIVE AREAS OF
INFLUENCE AND THE TOP TEN
INDICATORS THE SOCIAL DETERMINES
OF HEALTH. NUMBER THREE MUTUALLY
REINFORCING ACTIVITIES FOCUSED
ON FOCUSING ON ON RECOGNIZING
OUR PARTNERS. FOR CONTINUOUS
COMMUNICATION WHICH FOCUSES ON
VARIOUS EVENTS CONTRACTS TELLER
BRIEFINGS. A NUMBER FIVE
BACKBONE ORGANIZATION HELPS
MOBILIZE COORDINATE AND
FACILITATE WHICH IS THE COUNTY'S
ROLE IN THIS COLLECTIVE IMPACT
IN SIMPLEST TERMS WE CAN DO MORE
TOGETHER THAN WE COULD EVER DO
ALONE WE CAN DO DIFFERENT THINGS
THINGS EACH OF US IS BEST AT
WHAT CONTRIBUTING TO THE SAME
POSITIVE CHANGE. WE CAN
STRUCTURE HOW WE'D THE WE DO
THINGS TO DROP A RESEARCH AND
BEST PRACTICES LEVERAGE EACH
OTHER'S EFFORTS AND MEASURE OUR
INDIVIDUAL CONTRIBUTIONS AS WELL
AS OUR CUMULATIVE IMPACT. I'D
LIKE TO NOW FOCUS ON SHARED
MEASUREMENTS AND AGAIN ANOTHER
ALL MINE RESOURCE FOR US TO USE
. COMMUNITY COLLABORATION AND
DATA ARE THE KEY COMPONENTS OF
LEVEL SAN DIEGO. THIS IS ANOTHER
RESOURCE FOR THE PUBLIC AND I
LEVEL PARTNERS ON OUR LIVE WELL
SAN DIEGO WEBSITE WE HAVE WHAT
WE CALL IMPACT REPORTS. AND THEY
ARE CATEGORIZED UNDER THE FIVE
LOSE INFLUENCE FIVE AREAS OF
INFLUENCE AND FUTURE DATA ON THE
TENT DETERMINANTS OF HEALTH.
THESE REPORTS CAN BE ACCESSED BY
ANYONE AND REALLY FILTERED BY
CITY. THIS ONE ON THE SLIDE
FEATURE SAN DIEGO COUNTY WITH
THE LIFE EXPECTANCY OF EIGHTY
TWO POINT SEVEN YEARS. IN
NINETEEN SIXTY THE U. S. LIFE
EXPECTANCY AT BIRTH WAS SIXTY
NINE POINT SEVEN YEARS THIS HAS
RISEN TO SEVENTY EIGHT POINT
SEVEN YEARS IN TWO THOUSAND TEN.
AND SLIGHTLY HIGHER AT AT
SEVENTY EIGHT POINT EIGHT YEARS
IN TWO THOUSAND NINETEEN. IN SAN
DIEGO A BABY BORN IN TWO
THOUSAND TEN WAS EXPECTED TO
LIVE SEVENTY SIX POINT SEVEN
YEARS. AND THIS LIFE EXPECTANCY
HAS SINCE RISEN BY SIX TO EIGHTY
TWO POINT SEVEN YEARS AND TWO
THOUSAND NINETEEN IN SAN DIEGO
COUNTY. WELL LIFE EXPECTANCY IS
INCREASING ACROSS THE BOARD
THERE IS VARIATION AND ESTIMATES
BY COMMUNITIES WITHIN THE SAN
DIEGO COUNTY REGION. AS
MENTIONED EARLIER PEOPLE ARE
LESS LIKELY TO LIVE LONGER IF
THEY'RE ECONOMICALLY
DISADVANTAGE GET LITTLE EXERCISE
LOOK LIKE ACCESS TO HEALTH CARE
. AS YOUR BEFORE A BABY BORN IN
SAN DIEGO COUNTY IN TWO THOUSAND
NINETEEN HAS A LIFE EXPECTANCY
OF EIGHTY TWO POINT SEVEN YEARS
BUT WITHIN THE COUNTY THERE IS
CURRENTLY A GAP IN LIFE
EXPECTANCY BETWEEN SOME
COMMUNITY. IF WE MOVE TO THE
SOUTH IN CHULA VISTA. THE LIFE
EXPECTANCY DECREASES BY SIX
YEARS ALONG WITH EDUCATION AND
INCOME. SHOWING THE IMPORTANCE
OF SOCIAL DETERMINANTS AND A
CLEAR HEALTH DISPARITY FROM THE
ZIP CODE PERSPECTIVE. THIS DATA
HELPS DIRECT SERVICES TO AREAS
WE HAVE. UNDER RESOURCE OVER
TIME. IF WE GO BACK TO THE THREE
FOUR FIFTY FRAMEWORK WE CAN SEE
THAT USING THE COLLECTIVE IMPACT
MODEL THE PROPORTION OF DEATHS
DUE TO FOR THE FOR CHRONIC
DISEASE AND DIEGO COUNTY DROPPED
FROM 63% IN 2000250% IN TWO
THOUSAND NINETEEN. DESPITE A
DECREASE IN THE THREE FOUR FIFTY
CHRONIC DISEASES. DISEASE IS
STILL THAT HELD 450% OF ALL
DEBTS IN SAN DIEGO COUNTY. THIS
GRAPH SHOWS A DOWNWARD TREND
AMONG ALL REGIONS BUT AGAIN.
WITH SOME REGIONS PERFORMING
BETTER THAN OTHERS. LOOKING
SPECIFICALLY AT CENTRAL REGION
THE PROPORTIONATE STUDENT THREE
FOUR FIFTY CHRONIC DISEASES AND
CENTRAL REGION DROPPED FROM 61%
22000251% IN TWO THOUSAND
NINETEEN. AMONG THIS REGION SUB
REGIONAL AREAS SOUTHEASTERN SAN
DIEGO HAS THE HIGHEST PERCENT OF
DEATHS DUE TO THREE FOUR FIFTY
CHRONIC DISEASES AT FIFTY THREE
PERCENT. IN TWO THOUSAND
NINETEEN. IN THE SOUTH REGION
THE PROPORTION THAT STILL THREE
FOUR FIFTY CHRONIC DISEASES
DROPPED FROM 67% IN 2000251% IN
TWO THOUSAND NINETEEN. AND AGAIN
IF YOU DO A DEEPER DIVE SOUTH
BAY HAS THE HIGHEST PERCENTAGE
OF DEATHS DUE TO THREE FOUR
FIFTY CHRONIC DISEASES AT 53% IN
TWO THOUSAND NINETEEN. AGAIN
SHOWING DISPARITIES BETWEEN
REGIONS AND EMPHASIZING THAT
PLACE DOES MATTER. WE REALIZE
THAT THERE'S LOTS MORE WORK TO
BE DONE THE COUNTY IS LASER
FOCUSED ON CONTINUING TO MOVE
THE NEEDLE IN ON HEALTH AND ALL
COMMUNITIES. THIS BEGINS WITH
OUR BOARD OF SUPERVISORS WHO
HAVE PUT FORTH A BOLD FRAMEWORK
FOR A FUTURE. THE FRAMEWORK
PRIORITISES COMMUNITIES A
POPULATION SAN DIEGO THAT HAVE
BEEN HISTORICALLY LEFT BEHIND.
THROUGH THIS FRAMEWORK THE
COUNTY IS FOCUSED ON RACIAL
JUSTICE. HEALTH EQUITY ECONOMIC
OPPORTUNITY ENVIRONMENTAL
PROTECTION GOVERNMENT
TRANSPARENCY AND CLIMATE CHANGE
TO NAME A FEW. WITH THAT THE
COUNTY HAS CREATED AND INVESTED
IN NEW DEPARTMENTS SUCH AS THE
OFFICE OF ENVIRONMENTAL AND
CLIMATE JUSTICE THE OFFICE OF
EQUITY AND RACIAL JUSTICE AND
THE DEPARTMENT OF HOME SOLUTIONS
AND EQUITABLE COMMUNITIES. ALSO
JUST RECENTLY THE COUNTY HAS PUT
FORTH AN AUDACIOUS FRAMEWORK FOR
ENDING HOMELESSNESS WHICH
INCLUDES FIVE STRATEGIC DOMAINS
RANGING FROM FOCUSING ON ROOT
CAUSE PREVENTION. TO PROVIDING
REAL TIME PERMIT HOUSING AND
SUPPORT. ADDITIONALLY WE
CONTINUE TO TAILOR OUR SERVICES
AND INTERVENTIONS BASED ON
HEALTH PLACES INDEX AS DR- HUNT
SPOKE EARLIER. INVESTING IN
AREAS THAT HAVE THE LEAST
HEALTHY CONDITIONS OR SOCIAL
DETERMINES OF HEALTH. THIS WAS A
KEY DRIVER IN OUR CODE TO
RESPONSE STRATEGY ALONG WITH A-
LONG SUPPORT OF COMMUNITY
COLLABORATION. AND HAS ALLOWED
US TO SAVE LIVES AND ACHIEVE A
HIGH VACCINATION RATE IN OUR
COUNTY. ALSO FROM A THREE FOUR
FIFTY PERSPECTIVE WE CONTINUE TO
DEVELOP AND IMPLEMENT TOBACCO
CONTROL POLICIES AND PARTNER
WITH OTHER MUNICIPALITIES TO DO
THE SAME. SIX DIFFERENT TOBACCO
PREVENTION POLICIES WERE ADOPTED
ACROSS THE COUNTY AND CITY
LEVELS. SAN DIEGO COUNTY AND
CITIES OF ESCONDIDO AND SAN
MARCOS PASS ORDINANCES TO
ESTABLISH SMOKEFREE OUTDOOR
DINING. THE CITY OF LAMESA
PASSED AN ORDINANCE TO ESTABLISH
FOR SMOKE FREE OUTDOOR PUBLIC
PLACES WELL THE CITY OF SANTEE
TOOK ACTION TO ESTABLISH SMOKE
FREE PARKS SMOKE FREE TRAILS
THIS IS AN EXCELLENT EXAMPLE OF
COLLECTIVE IMPACTS. AND FINALLY
WE'RE BEGINNING TO LAUNCH AN
IMPLICIT BIAS TRAINING FOR
HEALTH CARE PROVIDERS IN ORDER
TO DECREASE INFANT MORTALITY
RATES AMONG AFRICAN AMERICAN
INFERENCE. WE KNOW ABOUT THIS
DISPARITY. AND THE BLACK AND
HEALTH PROGRAM HAS BEEN AROUND
FOR OVER THIRTY YEARS AND
CONTRIBUTED TO THE POSITIVE
OUTCOMES OF AFRICAN AMERICAN
INFANTS AND EAGLE COUNTY. THE
INFANT MORTALITY RATE HAS
DECLINED OVER THE PAST TWENTY
YEARS IN THIS COUNTY. AND TWO
THOUSAND THE RATE WAS FOURTEEN
POINT FIVE PER ONE THOUSAND LIVE
BIRTHS IN TWO THOUSAND EIGHTEEN.
THE RATE DECREASED TO EIGHT
POINT SEVEN. STILL MORE NEEDS TO
BE DONE. THESE ARE JUST SOME OF
THE NEWER EFFORTS AROUND
ENSURING EQUITY WITHIN THE
SOCIAL DETERMINANTS OF HEALTH.
IN CONCLUSION. WE HAVE A LOT
MORE WORK TO DO. AND WE WILL
CONTINUE TO USE DATA INFORMED
EVIDENCE SCIENCE PEOPLE A
COMMUNITY POWER AS WELL AS
HEALTH EQUITY FOR THE BETTERMENT
OF OUR COMMUNITIES THANK YOU
AGAIN FOR THE OPPORTUNITY. THANK
YOU SO MUCH FOR THAT
PRESENTATION DR HERNANDEZ. NOW
SOMETIMES WHEN YOU TALK ABOUT
THINGS FROM A VERY BROAD-
PERSPECTIVE PEOPLE DON'T REALIZE
WHAT'S GOING ON IN THEIR OWN
BACKYARD. AND SO IT WAS VERY
IMPORTANT FOR ME TO HAVE SOMEONE
LIKE YOU TO COME AND PRESENT TO
SAY. THAT YES WE HAVE THESE
ISSUES HERE RIGHT HERE IN SAN
DIEGO COUNTY SIGNIFICANT
DISPARITIES BASED OFF OF WHAT
YOUR ZIP CODE IS- THAT WILL
DETERMINE WHAT HEALTH CONDITIONS
YOU HAVE YOUR QUALITY OF LIFE
AND UNFORTUNATELY AS WELL YOUR
LIFE EXPECTANCY. I'M ALSO VERY-
PLEASED TO SEE ALL THAT THE
COUNTY HAS BEEN DOING ESPECIALLY
WITHIN THE LAST FEW YEARS. I DO
PRACTICE ON MY COLLEAGUES ABOUT
WHAT. IS THE COUNTY OF SAN DIEGO
DID DURING THE- THE CODE FAX
THEME PANDEMIC WITH THE
VACCINATIONS AND THE TESTING.
AND THE COMMUNITY PARTNERSHIPS
THAT UNIFORM TO MAKE SURE THAT-
NO ONE NO COMMUNITY WAS LEFT
BEHIND IN TERMS OF TESTING. AND
THE ABILITY TO GET VACCINATIONS
ALONG WITH EDUCATION AND STYLE.
I AM LOOKING FORWARD TO SEEING
WHAT THE DATA WILL SHOW AS YOU
CONTINUE TO- IMPLEMENT- EVIDENCE
BASED PROGRAMS AND PROJECTS IN
VERY TARGETED AREAS BASED OFF OF
THE DATA THAT YOU HAVE. TO SEE
WHAT THE OUTCOME WILL BE TO SHOW
THAT WHEN YOU ARE INTENTIONAL
ABOUT THE PROGRAMS THAT YOU'VE
PLACED IN THE FUNDING- THAT YOU
CAN HAVE- POSITIVE OUTCOMES THAT
ARE VERY BENEFICIAL AND- SHOWN
BY DATA IMPROVES HEALTH OUTCOMES
AND LYFT EXPECTANCY SO THANK YOU
SO MUCH FOR THAT- AMAZING
PRESENTATION ON WHAT WE'RE DOING. RIGHT HERE IN SAN DIEGO COUNTY
. SO THAT CONCLUDE OUR PRISON TO
MORNING. I WANT TO THANK ALL OF
OUR PANELISTS WHO PARTICIPATED
AND MADE THE TIME TO BE HERE
TODAY. WE ARE SO VERY FORTUNATE
TO HAVE YOU IN THE ROLES TO
AMPLIFY THE IMPORTANCE OF THE
SOCIAL DETERMINANTS OF HEALTH.
YOU HAVE BEEN A WEALTH OF
RESOURCE TO ME AND TO MY OFFICE
AND I LOOK FORWARD TO CONTINUING
TO WORKING WITH EACH OF YOU AND
THIS COMMITTEE. THANK YOU AGAIN
. WE WILL NOW OPEN THE MEETING
UP FOR PUBLIC COMMENT. WE WILL
FIRST TAKE IN PERSON COMMENTS
YOU MAY WALK UP TO THE PODIUM TO
SPEAK AND YOU WILL BE ALLOWED IT%
A LOT IT NINETY SECONDS. MY
STAFF WILL BE KEEPING TIME AND
WILL ALERT YOU WHEN YOU HAVE
THIRTY SECONDS REMAINING. AND SO
AT THIS TIME IF WE HAVE ANYONE
WHO WOULD LIKE TO GIVE ANY
PUBLIC COMMENTS AND THE
AUDIENCE. YOU CAN COME UP TO
THIS PODIUM HERE. OKAY I'M
VIRGINIA HALL I'M THE PRESIDENT
OF THE GROSSMONT HEALTHCARE
DISTRICT. AND I'D LIKE TO- JUST
RECOGNIZE YOU FOR WHAT YOU'RE
DOING HERE I THINK IT'S GREAT. I
THINK- YOU KNOW I'M LOOKING AT
THE DATA AND- SOME THINGS HAVE
BEEN BROUGHT TO LIGHT BUT I DO
LOOK AT THE FOR. THE LAST FIFTY
FIVE YEARS I'VE EXPERIENCED A
LOT OF THE HISTORY THAT THEY
TALKED ABOUT. AND I HAVE SEEN
IMPROVEMENTS BUT THERE IS
OBVIOUSLY MORE WORK TO BE DONE-
OBVIOUSLY WE WOULDN'T EVEN
PROBABLY BE HERE WHICH IS. VERY
IMPORTANT. AND SO THE ONE THING
THOUGH THAT I THINK IS REALLY
IMPORTANT THAT WE NEED TO REALLY
LOOK AT. IS EDUCATION AND THE
YOUNG ELEMENTARY SCHOOLS.
EDUCATING THEM ON THE IMPORTANCE
OF THEIR HEALTH. AND THE
IMPORTANCE OF NUTRITION. AND
SEEING A QUALITY ACROSS THE
EDUCATIONAL ALL THE SCHOOLS IN
SAN DIEGO. BECAUSE THAT REALLY
IS GOING TO BRING THE- YOU KNOW
THE IMPORTANCE OF LIKE DRUG AND
ALCOHOL. ADDICTION AND SO REALLY
THAT IS WHERE YOU REALLY NEED TO
FOCUS A LOT OF YOUR ATTENTION IS
ON THE EDUCATION IN THE EARLY
YEARS. THANK YOU. THANK YOU SO
VERY MUCH FOR THAT COMMENT I
AGREE WHOLEHEARTEDLY THAT WE
NEED TO MAKE SURE THAT WE ARE
STARTING FROM A VERY YOUNG AGE
AND EDUCATION AND ALSO MAKING
SURE THAT THE ENVIRONMENT THAT
ARE USED TO LIVE IN ARE
CONDUCIVE TO AT HEARING TO THE
THINGS THAT WE ARE TEACHING THEM
IN SCHOOL SO WHEN WE'RE TEACHING
THEM ABOUT HEALTHY EATING AND
HEALTHY NUTRITION. THAT THEY
DON'T GO HOME AND AREAS WHICH
ARE FOOD DESSERTS AND WINE OR
TEACHING THEM ABOUT THE DANGERS
OF TOBACCO AND ALCOHOL THAT THEY
DON'T HAVE TO WALK BY- STORES
WHICH ADVERTISE CIGARETTES AND
ALCOHOL USE EVERY BLOCK ON THE
WAY HOME SO I AGREE THAT WE
DEFINITELY NEED TO TEACH IT AND
MAKE SURE THAT THE ENVIRONMENT
THAT THEY'RE LIVING AND ARE NOT
COUNTERPRODUCTIVE TO WHAT WE'RE
TRYING TO TEACH THEM AND HEALTH
CARE SETTINGS AND ALSO IN SCHOOL
THANK YOU SO VERY MUCH FOR THAT.
THAT COMMENT. HI GOOD MORNING-
THANK YOU DR WEBER FOR HAVING
HAVING US AND FOR INVITING ME
SPECIFICALLY IT WAS- EXCELLENT
INFORMATION DOCTOR HOOD THE
HISTORICAL DATA WAS. AWESOME I
MEAN IT WAS MY MOUTH WAS OPEN
BECAUSE OF SOME OF THE DATA THAT
YOU PULLED UP SO THANK YOU VERY
MUCH FOR THAT. WHICH NEEDS TO GO
DEEPER INTO THE COMMUNITY- MY
NAME IS BARRY POLLARD I RUN THE
URBAN COLLABORATIVE PROJECT AND
WE FOCUS IN ON. SOUTHEASTERN SAN
DIEGO. AND SO I'M GOING TO BRING
THE TOPIC BACK DOWN TO WHERE I
LIVE. AND ALTHOUGH THE COUNTY IS
DOING A REMARKABLE JOB ON A
COUNTY WIDE I WOULD REALLY LIKE
TO SEE MORE ACTIVITY IN THE
CENTRAL REGION. I'M ALSO THE CO
LEADER OF THE CENTRAL REGION SO
BARBARA JIMENEZ AND I ARE
WORKING ON THAT. WITH THE END
RESULT OF LOOKING AT WHAT THE
COUNTY AND THAT. TYPE OF- MODEL
THAT'S BEEN USED TO ADDRESS I
THINK WE NEED TO LOOK AT IT. I
THINK OF WHAT WE'RE LOOKING AT
IS THE OLD STANDARD DEFINITION
OF INSANITY AND KEEP. DOING THE
SAME THINGS. AND EXPECTING
DIFFERENT RESULTS. FELL THAT'S
WHY I MENTIONED THAT IT WAS VERY
REFRESHING TO HEAR FROM THE
STATE LEVEL. THAT WE WERE
STARTING TO FOCUS IN ON THESE.
DISPARITIES BECAUSE THEY HAVEN'T
REALLY CHANGED. SO THAT'S WHAT
WE DO IN SOUTHEASTERN SAN DIEGO
AND WE'RE GOING TO CONTINUE TO
STILL TO LOOK AT THAT WITH THE
SUPPORT OF YOUR OFFICE CONTINUED
SUPPORT- AND THANK YOU AGAIN FOR
BRINGING THIS YEAR- I WITH THIS
INFORMATION AND THIS TO GET INTO
THE COMMUNITY IN SOUTHEASTERN
SAN DIEGO BECAUSE EVERYTHING
THAT WAS SAID TODAY WAS
EXCEPTIONALLY- VALUABLE. THANK
YOU. THANK YOU SO MUCH FOR THAT
INFORMATION WE WILL DEFINITELY
LOOK AND TO SEE WHETHER OR NOT
BECAUSE IT'S BEING LIVESTREAMED
RIGHT NOW. IF THERE IS A CODE
THAT PEOPLE CAN GO BACK AND TAKE
A LOOK AT THIS HEARING- ONE OF
THE GOOD THINGS THOUGH IS THAT
TWO OF OUR PRISONERS ARE RIGHT
HERE THEIR JEWELS OF OUR
COMMUNITY. AND I KNOW DOCTOR
HEAD HAS A VERY STRONG FOOTPRINT
AND IN SOUTHEAST SAN DIEGO. AND
OUR DOCTOR HERNANDEZ HAS A
COMMITMENT AS WELL TO MAKING
SURE THAT THAT WE DO SEE-
EDUCATION CHANGE AND ALL OF OUR
COMMUNITIES BUT WE WILL
DEFINITELY CHECK TO MAKE SURE.
THAT WE WILL BE ABLE TO PROVIDE
THIS HEARING- AFTER IT IS
COMPLETED TO OTHERS WHO ARE
UNABLE TO LIVE TODAY. THE
MORNING ALL GOOD MORNING DOCTOR
GOVERNOR MICHAEL EMERSON. BOARD
MEMBER CRESSMAN HEALTH CARE
DISTRICT. IT COMMENT VERY
INTERESTING- ONE OF THE COMMENTS
THAT I TAKE AWAY THIS MORNING
NELLIS ROHANI. ROCK CORRECT
RECORDS. COMMENTS ABOUT BILLIN
ARE WRITING PRESCRIPTIONS FOR
SOCIAL DETERMINANTS. I THINK
THAT WOULD BE A GOOD-
DEVELOPMENT FOR THE ICD CAN'T
TEN CODES SO THAT WE COULD GET
BILLING FOR THE SOCIAL
DETERMINANTS FROM THE STATE. AND
CRRENT DATA FOR EPIDEMIOLOGY-THEY COULD BE VERY IMPORTANT TO
PURSUE THOSE ANGLES FOR FUNDING
AND QUICK ACCESS TO REAL CURRENT
DATA SO WE CAN MAKE QUICK
DECISIONS ON WHAT WE NEED TO DO.
THANK YOU VERY MUCH FOR BEING
HERE TODAY. WHAT SUCCESS TO YOU
THANK YOU THANK YOU VERY MUCH
FOR THOSE SUGGESTIONS AND
COMMENTS. GOOD MORNING GOOD
MORNING THANK YOU DR WEBER FOR
THIS OPPORTUNITY MY NAME IS
JENNY BRUCE ON THE COMMUNITY
OUTREACH LIAISON FOR THE BLACK
INFANT HEALTH PROGRAM. IT WAS SO
REFRESHING TO HEAR THAT THIS
DISPARITY JUST CONTINUES TO BE
BROUGHT TO THE FOREFRONT BECAUSE
OFTEN TIMES IT SWEPT UNDER THE
CARPET WILL NOT REALLY
DISCUSSING IT. IS SO WHEN WE DO
TALK ABOUT IS LIKE OH THAT'S AN
ISSUE IN OUR COMMUNITY SITE
THANK YOU FOR THAT THAT IT WOULD
BE SO IMPORTANT TO YOU AND TAKE
YOUR- PANELISTS THEN. TO DOCTOR
HOOD INTO DOCTOR HERNANDEZ THAT
WE CONTINUE TO TALK ABOUT THIS
BECAUSE THERE'S ALWAYS ONE
PERSON IN THE ROOM WHO WOULD
NEVER RAISE THEIR HAND TO SAY I
DON'T KNOW THAT WAS AN ISSUE. IT
CONTINUES TO BE AN ISSUE AND HAS
BLACK GIVEN HEALTH HAS BEEN IN
SAN DIEGO FOR THIRTY YEARS WE
CONTINUE TO HEAR HER. PREGNANT
AND MOTHERING BLACK WOMEN SAY I
DON'T KNOW THIS WAS A PROGRAM I
DON'T KNOW THIS WAS AN ISSUE. SO
IT'S GONNA TAKE THINGS LIKE THIS
AND CONVERSATIONS JUST LIKE THIS
CANDID OPEN WIDE CONVERSATIONS
TO CONTINUE TO BRING THIS ISSUE
TO THE FOREFRONT SO I THANK YOU
I THANK YOU I THANK YOU BECAUSE
WE CAN'T TALK ABOUT IT ENOUGH IN
ORDER FOR IT TO. REALLY AREN'T
MATTER IN OUR COMMUNITY AND TO
SAY ON OUR COFFEE TABLES IN OUR
HOMES TO SAY THIS. IS AN ISSUE
SO THANK YOU. I THANK YOU VERY
FOR YOUR- IN YOU FOR YOUR WERE
WITH. THE BLACK INFANT HEALTH
PROGRAM HERE IN SAN DIEGO COUNTY
YOU ALL DO AMAZING WORK AND I
AGREE. THAT WE NEED TO- HELP GET
THE WORD OUT- WHEN I WAS PRIOR
TO JOINING THE ASSEMBLY WHEN I
WAS PRACTICING AND I HAD MY OWN
OB PATIENTS. I WOULD DEFINITELY
MAKE SURE THAT ALL OF MY AFRICAN
AMERICAN FEMALE PATIENTS NEW
PATIENTS KNOW ABOUT THE BLACK
INFANT HEALTH PROGRAM- NOW I'M
NO LONGER PRACTICING IN MY ADULT
AROUND- BUT I MY OFFICE.
DEFINITELY WORK TO CONTINUE TO
GET THAT THAT WORD OUT ON A
LARGER SCALE POPULATION SO.
THANK YOU ALL SO MUCH FOR ALL
THAT YOU HAVE DONE AND THE
IMPACT THAT YOU HAVE MADE AND-
NOT ONLY THOSE WOMEN'S LIVES BUT
ALSO AND THEIR FAMILIES SIDES.
SO NOW WE WILL MOVE TO ANYONE
WHO HAS CALLED IN- MODERATOR DO
WE HAVE ANYONE ON Q. THANK YOU
WHEN ASSEMBLY TO COMMENT OVER
THE PHONE PLEASE PRESS THE WIDE
IT AND ZERO AT THIS TIME I
CURRENTLY HAVE. YOU ARE WORKING
RIGHT TWENTY PLEASE GO AHEAD. HI
TWENTY CAN I GET HEARD IN- THE
PHONE TO OF HEALTH MANY YEARS
AGO ON THE SERVER RIGHT PLEASE.
HOLD CALLING IN. HELLO WE HEAR
YOU. YOU'RE IN. ACTUALLY
INFORMATION AND HEARING GRADER
WITH A GOOD IN HERE TODAY I OF
SOME OF- THE NATIONAL AT OF
BEING. A LITTLE BIT OF TROUBLE
TO HOME TO THE CHILD. CALL THE
SIX THOUGHT. REALLY SURE I'LL
SAY IT. SIX DOCTORS. AND NO CAN
IT- WATER AND AIR EXERCISE IT
RESPECTFUL YOU ATTEND A PHONE
YOU ARE WILLING. YOUR MIND THE
YOUR WELL THEN AND CHARGING. ONE
WE NEED TO GET HER IN AMERICA
AND- ACT RATE OF ANY ERA GROUP-
AND IN LIGHT OF THE FACT THAT
6270% THE BLACK POPULAR AS WE-
THE CO. NINETY I THINK I FIND IT
FROM BEING SHARED. THANK YOU
AUTHOR AND FOR THROUGH THE REST
CENTERS AVAILABLE. H. R. SEVEN.
THREE CURRENTLY IN THE WEEK OF A
LOT. SESSION IF YOU SEEN OUR-
MANY. YOU KNOW I'S- YOU KNOW
AFFECTING THE AFRICAN AMERICAN
POPULATION FATHER MORE
DISPROPORTIONATELY ACROSS THE
BOARD WITH ALL MAXINE EVEN WHICH
IS A LITTLE INSTEAD OF RESEARCH
AND SEE WHAT'S HAPPENING. YOU
MIGHT IT'S POPULATION OF
PEOPLE'S AND- I JUST WANNA
REMIND EVERYONE THAT YOU WILL
HAVE NINETY SECONDS FOR YOUR
COMMENT OPERATOR WE CAN GO TO
THE NEXT CALLER. THANK YOU I
TWENTY ONE PLEASE GO AHEAD. HOW
ONE I JUST WANT TO SHARE A
LITTLE BIT OF SOMETHING READING
FOR AWHILE AND HE ARTICLE FROM
EARLIER THIS YEAR THE SCENE OF
THIS BECAUSE HE SAID HE AND
OTHER EXAMPLES OF HOW BLACK
PEOPLE HAVE BEEN TREATED AND IN
MANY CASES STILL ARE BEING
TREATED BY THE MEDICAL COMMUNITY
MAKES. PEOPLE SKEPTICAL. HE
EXPERIENCE WHAT PEOPLE CIVIL.
WERE PROVIDED SHE- BUT RECEIVE
IT MANY OF THEM AND WENT LINE OR
DEVELOPED OTHER EXPERIENCE
ISSUES. AND SO. THE REASON WHY.
THE OTTOMAN AMERICAN POPULATION-
IS DISPROPORTIONATELY. THE
ACCORDING RIGHT TRANSACTION SO
IT SEEMS TO ME THAT GIVEN THAT
YOU FOLKS- ARE REPRESENTED BY A
RECORD ARE SUPPOSED TO BE
REPRESENTING THE PEOPLE YOU
MIGHT WANT TO LOOK INTO. SOME OF
THESE ISSUES. RATHER THAN
BECAUSE- IF. THE POPULAR CARE
AND TRY TO PUT FORTH THESE
MANDATES WHEN BECOME CLEAR THAT
BELIEVE ARE SEEN ARE NOT WOULD
BE WANT AND THIS IS REALLY
ACROSS ALL ETHNIC GROUP. I IT'S
PROBABLY. EVEN WHY IT FORTY.
THOUSAND HERE IN THE SCHOOL. DID. READING FROM THE ALREADY HIGH
DELETED NOT- MEET THE DEADLINE
FOR THE CRUISE CALLING IN TO
COME ON THIS TO TURN OF HEARING
TODAY YOUR TIME IS COMPLETE. WE
CAN MOVE ON TO THE NEXT CALLER
AND I DO APOLOGIZE I FORGOT TO
MENTION WHEN YOU START SPEAKING
PLEASE STATE YOUR NAME AND WHERE
YOU'RE CALLING FROM AND YOU HAVE
NINETY SECONDS. ZERO NINE TWENTY
TWO. THE NEXT CALLER. THE
MANAGER ASSEMBLY MEMBER WARDENS
OF THE COMMITTEE ON BREAST RT
FOR THE CALIFORNIA ACADEMY OF
FAMILY PHYSICIANS WHO IS RUNNING
FOR GOVERNOR TO RESOLUTIONS. IN
ADDITION UNDERSTAND THAT WOULD
HOSPITALS FACTOR IMPACT OUR AND
THEN A CARE YOU. THEY ARE WHO
ALSO TODAY THAT THERE ARE
CERTAIN THERE'S AND- THAT EVEN
DON'T ALLOW DECADE THAT ONE'S
GONNA HOLDEN TO THE FOR HELP.
ACCORDINGLY C. A. R. P. CENTER
FANS PHYSICIAN AND PRACTICE JUST
GROWING FOR TO TERMINATE HOW.
YOU'RE GOING A FEW CARE. YEAH P.
PURPOSE FOR DIVERSE ABOUT. INTO
THESE THREE AND THAT'LL WHO
RESOURCE ENGLISH HER PROVISIONS
IN THE- CALIFORNIA FAMILIES
MEDIATOR SERVICES UNANIMOUS
THERE MANY IN CLOSING THE GAP
ANY SOCIETY HEALTH NEEDS.
FEDERAL HERE TODAY EVER THE
OPPORTUNITY TEHAMA. THANK YOU
SOME FOR YOUR- BOB ANYONE ELSE
IN THE- HE LIVES IN ROLE I HAD.
GOOD TALKING ON WANT YOUR IF YOU
WISH MY NAME IS JAY GOAL BE IN
BOTH. AND WAS VERY GLAD TO BACK
TO THE SPEAKER AT A THE OF
MOMENT BY TERMS OF THE BILL IN
MY WHERE LIVE AND THAT. YEAH MY
WELL MY YOU BYE BYE OF MY WHEN
SHE'S IN A PUBLIC LAST IN MY
SOKOL ARTICLES REGULARLY. THE
TWO MINUTES ALLOWING THE YOUR
YOUR HOW SO WE SEND AYE PER OF
OUR TIME IN THE BILL. SO I HAVE
FOR THE NEEDY IS. ARE YOU DOING
A WORK WITH POLICY. ARE IT BILL
HOW. WHICH WOULD ALLOW LEARNED
FROM IT. ANYWHERE WELL ACT
NATURE. BETTER THANK YOU SO MUCH
FOR YOUR COM I WHY OF THE WERE
WILL SPECIFIC FOCUS SO TO AND
HOUSING SOLDIERS KEY YOUR EYES
AND EARS FOR THAT WORKSHOP.
OPERATOR IS THERE ANYONE ELSE IN
THE QUEUE. CLEARER COMMENTATING
YOU AT THIS TIME. THANK YOU SO
MUCH WELL THAT CONCLUDES OUR
PUBLIC COMMENT AS WE CONCLUDE
THIS HEARING I WANT TO GIVE A
BIG THANK YOU AGAIN TO ALL OF
OUR PANELISTS. DR ROSHAN RADHA
KRISHNA DR RODNEY HOOD DR DAVID
CARLISLE AND DR ELIZABETH
HERNANDEZ WITHOUT YOUR VISION
EXPERTISE WE COULD NOT HOLD THIS
HEARING TODAY. I ALSO WANT TO
THANK OUR SIMPLY TECH TEAM THAT
MADE EVERYTHING RUN SO SMOOTHLY
TODAY I. THANK MY STAFF HERE IN
THE DISTRICT AND IN SACRAMENTO
AND I WANT TO GIVE US VERY
SPECIAL THANKS AND RECOGNITION
TO RAMEN CONTRAST. WHO IS THE
STAFF HERE DIRECTLY RESPONSIBLE
AND OVER THIS COMMITTEE AND I
THINK AGAIN THE GROSSMONT
HEALTHCARE DISTRICT FOR ALLOWING
US TO USE YOUR FOR SELLING. THIS
CONCLUDES THE FIRST HEARING OF
THE SELECT COMMITTEE ON THE
SOCIAL DETERMINANTS OF HEALTH.
BUT PLEASE WATCH OUT FOR FUTURE
HEARING DATES WHERE WE WILL
TACKLE EACH OF THESE ISSUES
INDIVIDUALLY AND IN MORE DEPTH.
KEEP IN MIND EVERYTHING IN YOUR
EVERYDAY ENVIRONMENT HAS AN
IMPACT ON YOUR PERSONAL HEALTH
ONE WAY OR ANOTHER. THANK YOU
AND PLEASE ENJOY THE REST OF
YOUR DAY.