What's killing Baltimore? Health Department on a quest to find out

Baltimore Health Department wants to involve communities in improving health outcomes

May 09, 2011|By Oxiris Barbot

Fourteen thousand eight hundred and eighty-seven.

That's the number of years of potential life lost before age 75 per 100,000 Baltimore City residents last year. It's one of the most striking statistics presented by the Robert Wood Johnson Foundation's second annual County Health Rankings Report for Maryland. As it did last year, Baltimore City ranked 24th of the 24 Maryland jurisdictions.

Though this ranking is disappointing, it presents an opportunity to look more closely at the factors that affect health outcomes — such as the number of years of life lost. While the figure for Baltimore was 2.6 percent better than last year's value, it's still twice that of the state as a whole. This number, reflecting all the people who died before their time in the last year, gives urgency to the work we do.

This information, in conjunction with the Health Disparities Report Card we released last year, provides a critical assessment of the city's health status. Both reports incorporate "social determinants of health" — factors related to areas such as housing, transportation, alcohol- and tobacco-selling establishments, and education that provide an additional means of gauging community health. Taken together, these reports illustrate that where we live, work and play are as important in making us sick as they are in making us healthy.

These reports also remind us that continuing to address challenging health outcomes from a traditional medical or public health approach is like spitting in the wind. Mayor Stephanie Rawlings-Blake and I agree that a cross-sector approach in addressing these health issues is critical. Baltimore's health inequities didn't develop overnight, and I would argue that they were accelerated by the historical social and economic challenges faced by the city.

To that end, today the Baltimore City Health Department is releasing "Healthy Baltimore 2015," which articulates the city's priorities for improving our health outcomes and provides an organized framework for institutions, communities and other partners to build on. The plan makes clear that we all play a role in improving the health of our city. Most importantly, it provides clear measures for determining our success.

Implementing Healthy Baltimore 2015 begins with the release of this year's Neighborhood Health Profiles. One of the health department's critical functions is to ensure that communities have access to the most up-to-date data regarding health outcomes in their neighborhoods so they can take action. This year's Neighborhood Health Profiles will contain more information on social determinants of health.

For example, residents will be able to see the percentage of single-parent households in their community, the percentage of households without a vehicle, and levels of school absenteeism, adult educational attainment, and liquor outlet density, just to name a few.

Senior health department leaders will also be visiting communities around the city to talk about their Neighborhood Health Profiles and learn what community members' priorities are. I see this as a central role of the health department — helping communities make connections about how their health status is influenced by where they live, work and play.

Everyone has a role to play. There are at least three ways in which communities, individuals and institutions can contribute to the success of Healthy Baltimore 2015. One way is to help us get out our prevention messages in as many diverse venues as possible. For example the court system is showing our infant Safe Sleep educational video, targeted at reducing infant mortality, to potential jurors during jury duty. Our website (www.baltimorehealth.org) is also a great resource for health information.

Second, help us facilitate new ways to make it easier for Baltimoreans to opt for healthier choices. One easy way to do this is to make condoms available where you live and work. (I did — there are two fishbowls of them in our lobby.)

Finally, everyone in the community can become an advocate for change. Tired of hearing about the problem of childhood obesity? Then do something about it. Push local store owners to offer fresh fruits and vegetables. Demand changes that make it easier for people to exercise where they live and work.

I have met with all of the CEOs of the city's hospitals, as well as many of the leaders within the world-class academic institutions we are fortunate to have in this city. They all agree that in a city with such resources, our health outcomes can and should be better. They have all pledged their support in this process.

To this end, Mayor Stephanie Rawlings-Blake has directed agency heads to identify senior leaders within each organization to be part of a cross-agency health task force. This group will ensure we are all working together to improve health outcomes. I encourage business, education and philanthropy leaders to follow suit. Healthy Baltimore 2015 will be the measuring stick by which we all evaluate our success in working together to improve health.

Dr. Oxiris Barbot is commissioner of health for Baltimore City. Her email is health.commissioner@baltimorecity.gov.

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