Dr. Anthony Iton's slides from the Center for Health Journalism webinar, "How Our Environment Gets Under Our Skin" 10.9.18 More info: https://www.centerforhealthjournalism.org/content/master-class-reporting-health-policy

1. How The Environment Gets
Under Our Skin
USC Health Journalism Webinar
October 9, 2018
Tony Iton, M.D., J.D., MPH
The California Endowment

2. Does Your Zip Code
Matter More Than
Your Genetic Code ?

6. Life expectancy by census tract
6

9. Life Expectancy by Poverty Group 2000-2003
Alameda County
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
LifeExpectancy(Years)

10. BARHII Life Expectancy and Poverty by Tract
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
LifeExpectancy(Years)
Bay Area Poverty vs. Life Expectancy

11. Cost of Poverty in San Francisco
Bay Area
Every additional $12,500 in
household income buys one year
of life expectancy
 (Benefit appears to plateau at household
incomes above $150,000)
 Similar gradients in Baltimore, NYC,
Philadelphia, Hennepin County (Minneapolis-
St. Paul), Colorado, California, AND
Cuyahoga County ($6304/year of life)

13. Is This All Just Chance?
Why Don’t They Just Move?

14. “It is necessary that properties shall
continue to be occupied by the same
social and racial groups”- Federal
Housing Administration Underwriting Manual
1938 in recommending racially restrictive
covenants.

22. Allostasis, meaning literally "maintaining
stability (or homeostasis) through
change" was introduced by Sterling and
Eyer to describe how the cardiovascular
system adjusts to resting and active
states of the body. This notion can be
applied to other physiological mediators,
such as the secretion of cortisol as well
as catecholamines.
The concept of "allostatic load" was
proposed to refer to the wear and tear
that the body experiences due to
repeated cycles of allostasis as well as
the inefficient turning-on or shutting off
of these responses.
-Bruce McEwen and Teresa Seeman in collaboration with the
Allostatic Load Working Group.

23. When the external becomes internal:
How we internalize our environment
Allostatic Load
Inadequate
Transportation
Long
Commutes
Housing
Lack of social
capital
High
Demand-
Low Control
Jobs
Lack of
access to
stores, jobs,
services
Crime
Stress
Stress
Stress
Stress
Stress
Stress
Racism
Stress

24. DiseaseBehavior
Neglected
Communities
Policies
& Practices
Death
Biased
Beliefs
(Isms)
Medical Model (individuals)Socio-Ecological (society)
Emergency
Rooms
ClinicsHealth
Education
Power
& Leadership
Policy &
Partnerships
Change
the
Narrative