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Miami-Dade County Health Department

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Linking social unrest with social determinants of ill health


City health departments are increasingly linking social unrest, such as last year’s Baltimore riots, with such social determinants of ill health  as living in places with peeling lead paint and other pollution,  the sort of crumbing infrastructure that led to the Flint, Mich., lead-in-water disaster, thin or nonexistent public transportation, substandard school and low-paying jobs

Freddie Gray, whose death in police custody led to the Baltimore riots, grew up in a West Baltimore row house polluted with lead-paint chips.

LaMar Hasbrouck, M.D., executive director of the National Association of County and City Health Officials, told Modern Healthcare:

“There’s been kind of a resurgence in looking at something called a ‘health-in-all-policies’ approach (that) convenes folks together and looks at the health aspects of other sectors. So if it is transportation, if it’s housing, if it’s employment, (the strategy) looks at how all those things fit together in creating a healthy environment.’

Lillian Rivera,  M.D., administrator for the Miami-Dade County Health Department, told the publication that she sees, in Modern Healthcare’s words, “programs to address the social determinants of health becoming central to public health departments in the same way that disaster preparedness and bioterrorism response units became crucial to public safety departments after 9/11.”


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