Category Archives: California (CA) P

Jul 25 2013
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Sonoma Aims for Healthiest County in Calif. By Addressing Education, Poverty: Q&A with Peter Rumble

Peter Rumble, Sonoma County Peter Rumble, Sonoma County

In 2011, Sonoma County in California established the division of Health Policy, Planning and Evaluation (HPPE) in an effort to move the county up in the County Health Rankings, toward a goal of becoming the healthiest in the state by 2020. As the director of the division, Peter Rumble, MPA, has played a critical role in the development of numerous programs and policy efforts to help create opportunities for everyone in Sonoma County to be healthy. Rumble has worked on programs and policies that go beyond traditional public health activities and aim to address the root causes of poor health, including the local food system, education and poverty.

Following his presentation at the International Making Cities Livable Conference, NewPublicHealth was able to speak with Rumble about the ways in which his work with HPPE is pushing to achieve health equity in Sonoma County. Rumble will soon move into a position as Deputy County Administrator of Community and Government Affairs for the County of Sonoma, where he plans to continue his commitment to a vision of health and quality of life for the county.

NewPublicHealth: Sonoma is making a concerted effort to help address the root causes of poor health, like poverty and lack of education. Tell us about some of those efforts.

Peter Rumble: Health Action is our real heartbeat of addressing social determinants of health, and it’s a roadmap for our vision of being the healthiest county in California by 2020. Health Action is a community council that advises the Board of Supervisors. There are 45 seats on the council, including elected officials, individual community leaders, nonprofit leaders, and representative from the business, financial, labor, media, transportation and environmental sectors. If you pick a name out of the hat for all of the sectors in the community, we’ve got somebody who either directly or tangentially represents that sector. That group began talking about needing to do something around health in 2007. 

If we’re going to be the healthiest county in California by 2020, what do we need to do to achieve our ten goals based on the best evidence available? We certainly have goals associated with the health system, but predominantly, we’re focused on influencing the determinants of health. Our first goal is related to education. We want all of our children to graduate from high school on time and ready to either enter a thriving workforce or go into college or a technical career academy.

file Community garden in Sonoma County (photo by Arlie Haig)

We started with some grassroots initiatives. Being a real strong agricultural community, iGROW was a good place to start. It was a movement to develop community gardens—for people to tear up their front lawns and plant a garden there, and increasing access to healthy food. That was a huge hit. We set a goal of a few hundred community gardens, and we’re up to a thousand now—it’s just caught fire.  

That was all great, but a community garden is not going to make us the healthiest county in California, right? You can see the beautiful posters out on shop windows, you can see your neighbor tore up their front lawn and is growing this beautiful zucchini and has an edible lawn now and all that’s wonderful, but we only have a graduation rate of 70 percent. We’ve got nearly one in four kids living in poverty by the federal poverty standards and if you look at what actually it takes to raise a family in Sonoma County, about half of all families can’t make ends meet. 

NPH: Does that surprise people to hear about Sonoma?

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May 8 2013
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Public Health Law Research: Zoning for Walkability

Municipal mixed-use zoning is a public health strategy to create more walkable neighborhoods by creating integrated, un-siloed access to daily activities—such as going grocery shopping and traveling to school and work. A recent study in a special issue of the Journal of Health, Politics, Policy and Law funded by Public Health Law Research, a program of the Robert Wood Johnson Foundation, evaluated municipal zoning ordinances in 22 California cities to see whether the ordinances improved walkability in those communities. NewPublicHealth spoke with the study’s two authors, Sue Thomas, PhD, senior research scientist at the Pacific Institute for Research and Evaluation-Santa Cruz (PIRE) and Carol Cannon, PhD, formerly with PIRE and current associate research scientist at the CDM Group, Inc, a consulting firm in Bethesda, Md.

>>Read the full study.

NewPublicHealth: What was the scope of your study? 

Carol Cannon: We looked at ordinances that create municipal mixed use zoning, and whether these laws seem to have an impact on the potential for walking to destinations. 

NPH: In what ways were the study and findings innovative?

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Jul 12 2012
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L.A. Emergency Operations Center: Model for Preparedness and Collaboration

L.A. EOC Main Coordination Room L.A. Emergency Operations Center Main Coordination Room

This year’s National Association of County and City Health Officials (NACCHO) Annual Meeting offered attendees a unique opportunity to get a behind-the-scenes look at the City of Los Angeles Emergency Operations Center (EOC), a central point for coordinating emergency planning, training, and response and recovery efforts for disasters such as fires, floods, earthquakes, and acts of terrorism. The EOC draws on best practices for preparedness by facilitating collaboration between multiple city departments. What is unique is that this cross-department teamwork is enabled by a state-of-the-art, 84,000 square feet, two-story, seismically-base-isolated facility that also houses the Fire Department Operations Center and the Police Department Real-Time Analysis and Critical Response (RACR) Division and Operations Center.

Because of this shared space, strong relationships are established across critical public health, preparedness, police and fire department contacts that enable working together in an emergency that much easier. In the event of an actual emergency, the Center serves as a base where, literally, the right people can all be brought to the table. While NACCHO visitors were at the facility, the staff were triaging the response to the National Weather Service Excessive Heat Warning in the Valley by opening additional cooling centers and arranging to have local libraries extend their hours to serve as additional cool spaces for the community, said James Featherstone, general manager of the Emergency Management Department.

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Because of this shared space, strong relationships are established across critical public health, preparedness, police and fire department contacts that enable working together in an emergency that much easier. In the event of an actual emergency, the Center serves as a base where, literally, the right people can all be brought to the table. While NACCHO visitors were at the facility, the staff were triaging the response to the National Weather Service Excessive Heat Warning in the Valley by opening additional cooling centers and arranging to have local libraries extend their hours to serve as additional cool spaces for the community, said James Featherstone, general manager of the Emergency Management Department.

Rob Freeman, emergency preparedness coordinator for the City, showcased the Main Coordination Room—a 7,500 square-foot home base for the kinds of emergencies that necessitate nimble, timely coordination of both information and resources across departments. The room, said Freeman, is laid out and functions according to the National Incident Management System.

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“This floor is designed with collaboration in mind,” said Freeman. The room is clustered into teams or pods of different roles, each with its own monitors and information screens, such as emergency management, operations, planning, logistics, and finance and administration. Each is color-coded and has a designated set of delineated roles that need to be at the table—but the teams are inter-disciplinary, and those roles might be drawn from any number of city departments such as transportation, public works, fire, police, housing and more. For example, Freeman said there is a “mass care” team that includes representatives from the Departments of Parks and Recreation, Disability and Animal Services, and also draws on partnerships with the Red Cross and school districts.

Freeman said it’s also critical that those specific roles, functions, objectives, workflow processes are all in place ahead of time. Constant training keeps the city ready. “That’s a challenge, though, because the city’s workforce is so fluid,” said Freeman. “We have more than 500 people who might be called to come to this location at any given point.”

Part of the idea of bringing all of these functions together regularly ahead of time is that the relationships are there when they’re needed. “We’re part of a public safety team,” said Freeman. “We work closely with the police and fire departments and the Mayor’s office all the time.”

Command Center LA Police Department Command Center for the Los Angeles Police Department

The Command Center for the Los Angeles Police Department is also located in the same facility, again creating greater opportunities for tight integration, and is staffed 24 hours a day. Officer Modesta Smith described a situation when a major tanker erupted in a tunnel, blocking a major entrance into the city, which would threaten vital city operations like doctors getting to hospitals and police officers getting to work. “One of the first calls we made was to James Featherstone of the EOC,” said Smith. “Sharing information works better.”

>>Follow the rest of the NewPublicHealth coverage of the NACCHO Annual Meeting.

Jul 12 2012
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Jonathan Fielding: NewPublicHealth Q&A

Jonathan Fielding Jonathan Fielding, Los Angeles County Department of Public Health

Jonathan Fielding, MD, MPH, MBA, County Health Officer and director of the Los Angeles County Department of Public Health, responsible for all public health functions including surveillance and control of both communicable and chronic diseases, was the morning plenary speaker at the NACCHO’s Annual Meeting today. He challenged the thousands of local health officials meeting here to keep their attention on the most vulnerable in their communities and to realize how much policies can impact improved population health.

“The greatest changes will come not from tweaking programs but from getting new policies introduced,” said Fielding. To help policy-makers make those changes, he said, many  public health departments may need to add expertise in areas such as policy analysis and economics. He also urged health leaders to embrace the health-in-all-policies approach.

NewPublicHealth spoke with Dr. Fielding about his vision for public health.

NewPublicHealth: What changes do we need at the local level to improve population health?

Dr. Fielding: We all have to be advocates for the underlying social determinants of health. We need to think about education, poverty, the tax structure, mobility, social conventions and at the same time focus on our natural environment such as climate change and the built environment. And that includes the environment we find ourselves in with regard to marketing and advertising such as vending machines and billboards. And we need to enact policy and not just programs. In Los Angeles we are putting in a great deal of emphasis on policy by working with decision makers and other partners.

And we have to convince the funders at all levels of how essential core public health is to the quality of life we have now and how we aspire to improve it, to reduce the burden of risks and injury. Public health can’t do what it does if it keeps getting cut, and cut and further cut.

We also need to combine and enhance relationships so that the core capabilities we know are so critical in public health are broadly disseminated regardless of whether a health department is in a metropolitan area, a rural area or on an Indian reservation.

NPH: Big cities such as Los Angeles can offer model practices for smaller communities. What are some model practices to highlight in L.A.?

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