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Evidence to Support Pro-Health Policy Making and Planning

As part of the Galveston Health in All Policies Initiative, CEHD recognized that creating an evidence base would be essential to promoting pro-health policies and planning.Creating an evidence base began with identifying critical post-disaster influences on health. Work initially focused on demonstrating the extent of the island’s food desert, as well as key demographic features such as rates of poverty, access to transportation, access to daycare, and other issues.

The CEHD began by creating local maps related to health issues using Geographic Information Systems (GIS). The Center adapted a health impact assessment tool called the Healthy Development Measurement Tool (HDMT), developed by the San Francisco Department of Public Health, which brings the principles of healthy and equitable development to city planning. This tool consists of 125 indicators across 6 elements that make up a healthy city: environmental stewardship, sustainable and safe transportation, social cohesion, public infrastructure/access to goods and services, adequate and healthy housing, and a healthy economy. The impact of these indicators on health are represented through geospatial maps of the area, and the tool is supported by an extensive collection of online resources, including the evidence base for each indicator as well as common development goals and policy responses for cities based on the findings.

Much of the East End of Galveston is a food desert, a problem exacerbated by poor access to transportation following Hurricane Ike. More than 23 million people in America live in food deserts, which are areas without ready access to fresh, healthy, and affordable food. Food deserts contribute to poor nutrition and can lead to increased chronic disease as well as susceptibility to the health effects of exposure to toxins such as lead.

Efforts have focused on mapping community health indicators of highest priority to community partners, such as reducing food deserts; increasing access to affordable child care; ensuring adequate green space; affordable and healthy housing; reducing environmental toxins and pollutants; and supporting physical activity. Special attention is being placed on issues of health inequities, including potential disproportionate impacts of interventions on less advantaged groups, especially since inequities become more pronounced in a post-disaster context.

The CEHD now has over 150 GIS maps of Galveston related to social determinants of health, which have been used for research in many of the projects.

 

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The Role of Academic Medicine in Addressing Social Determinants of Health

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