Reflections on Kindness in Healthcare Institute of Medicine of Chicago 2013 Awards Ceremony

Transcription

1 Reflections on Kindness in Healthcare Institute of Medicine of Chicago 2013 Awards Ceremony David Goldberg, MD Division of General Internal Medicine John H. Stroger, Jr. Hospital of Cook County

2 Photo by Sandra Steinbrecher

3 Disparities in Fire Injury and Overdose Deaths RR of Fire Injury for African Americans: 2.8 (95% CI ) GR Istre, NEJM, % of opiate related deaths G Scott, J Urban Health, 2007

4 Photo by Sandra Steinbrecher

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7 Cook County Hospital Waiting Room Mural by Henry Simon Cook County Hospital, Exterior Ornamentation

8 Men All-Cause Mortality: Year Olds 1980, 1990, 2000 Probability of Dying Y2000 W-US 0.20 AA-US 0.33 AA-Chi 0.50 Women W-US 0.12 AA-US 0.21 AA-Chi 0.32 AT Geronimus, Am J Pub Health, 2011 Black bar White bar Gray bar

9 Y2000 SMR and Excess Mortality Rates: Three Urban African American Areas Site SMR Excess Mortality Rate (per 100,000) Men HIV Homicide Cancer Cardiovascular Chicago Detroit New York Women Chicago Detroit New York SMR = Standardized Mortality Ratio % African American: Chicago 90%, Detroit 86%, New York 76% Poverty Rate: Chicago 46%, Detroit and New York 35% AT Geronimus, Am J Pub Health, 2011

10 New York Times, 2013 Homicides in Chicago

11 Trauma Center Desert in Chicago Evaluation of the IDPH Trauma Registry ,744 GSW patients during the study period, 4782 (41%) were shot more than 5 miles from a trauma center 23% increased odds of death from GSWs beyond 5 miles from a trauma center Crandall, AJPH, 2013

12 Food and Trauma Center Deserts Place Matters for Health in Cook County, 2012 Crandall, AJPH, 2013

13 Foreclosure Filings and Completions 2009 In 2009: 23,200 filings, 2009: 8500 home foreclosures 8,500 homes lost REO: Real Estate Owned (bank owned properties) National People s Action

14 Chicago Community Areas with the Highest Breast Cancer Mortality Rates Mortality Rate Ratio Black:White Ratios for Breast Cancer Mortality New York City, US and Chicago, New York City US Chicago Year D Ansell, Cancer Causes Control, 2008

15 Lack of Primary Care and Breast Cancer Mortality Minutes of the CCHHS BOD, May 2007 D Ansell, Cancer Causes Control, 2008

16 Lack of Primary Care and School Transitions Minutes of the CCHHS BOD, May

17 School Closings and Food Insecurity 2012 Data Yale Elementary, Englewood Englewood Food Insecurity Rate: 40% Chicago Citywide Rate: 18% Chicago Food Depository

18 Economic Impact of the Recession Unemployment Chicago Workforce Investment Council, 2012 $58,000 Median Household Income DuPage Federation on Human Services Reform Poverty Extreme Poverty $56,000 $54,000 $52,000 $50,000 $48, % 9% 4% Social Impact Research Center at Heartland Alliance for Human Needs and Human Rights, 2012

19 Trend in CCHHS Budget Adjusted for Health Care Inflation 5% 0% -5% * -10% -15% -20% -25% -30% Year to Year Change Cummulative Change Cook County Budget Documents

20 Trend in CCHHS Budget Adjusted for Health Care Inflation 3.4% of countywide health spending 5% 2.5% of countywide health spending 0% -5% * -10% -15% -20% -25% -30% Year to Year Change Cummulative Change Cook County Budget Documents

21 CCHHS: Productive Contributor to Regional Health Care Proportion of Estimated Cook County Health Service Delivery 2005/6 30% 25% 20% 15% Gonorrhea Chlamydia Estimate of CCHHS s Proportion of Countywide Health Expenditures in 2005: 3.4% 10% 5% < 1500 gm < 2500 gm 0% ED Visits Visits HIV Primary Care DM Primary Care Patients in Primary Care Tuberculosis STDs Newborn Deliveries Cases Neonatal Care Cancer Diagnoses D Goldberg, J Healthcare Poor Uninsured, 2010

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23 CCHHS Remains a Productive Contributor to Regional Health Care: % 8% 6% 4% 2% 0% Estimate of CCHHS s Proportion of Countywide Health Expenditures in 2011: 2.7% Data from April 1, March 31, 2012 IDPH, IL Hospital Report Card

24 $7,000 Public Health System Budget Comparisons: Operating Budgets, 2009 $6,000 In Millions $5,000 $4,000 $3,000 $2,000 $1,000 $0 Range of $482M (Oakland) - $6,037M (New York City)

25 $1,200 Public Health System Budget Comparisons: Per Capita Calculation, 2009 $1,000 $800 $600 $400 $200 $0

26 Kindness and Healthcare Relationships: Meaningful Us

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28 Train Station, Walter Ellison, 1935, Chicago Art Institute of Chicago Oil on Cardboard