Category Archives: Community development

Mar 26 2014
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County Health Rankings 2014: Western New York

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The County Health Rankings, a joint project between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, shows how communities across the country are doing and how they can improve on their health.

One of the communities highlighted in the 2014 report is Western New York. Across eight counties, the region struggles with a depressed economy and high rates of obesity, diabetes and heart disease.

They used the County Health Rankings to better understand their challenges and look at what types of programs and initiatives would help.

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Innovative community partnerships include a Baby Café Program where moms can get breastfeeding support and connections to community resources to ensure every baby has a healthy start; a Healthy Streets initiative to create better infrastructure for a healthy community; and a Farm to School Program to support healthier schools. The fifth edition of the County Health Rankings continues to show us where we live matters to our health.

Mar 26 2014
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County Health Rankings 2014: Rockingham County, N.C.

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The County Health Rankings, a joint project between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, shows how communities across the country are doing and how they can improve on their health.

One of the communities highlighted in the 2014 report is Rockingham County, North Carolina. The community went from a wealthy county to a poor one very quickly after losing two major industries only a couple of decades ago.  

The population of about 90,000 suffers from high smoking rates, high obesity rates and high rates of smoking during pregnancy. When the 2010 County Health Rankings were released, the community's poor standing served as a wake-up call, and only a few years later the Kate B. Reynolds Charitable Trust became involved and the county started to expand the conversation, looking at health as more than simply health care access.

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Innovative community programs include the Virtual Farmer's Market, which gives local farmers a new market for their products while also providing them with an education on how to reach out using technology as a means for boosting small business; a planned partnership between Triad Adult and Pediatric Medicine and the New Reidsville Public Housing Authority; and the planned Nurse-Family Partnership Program, which will pair home visiting nurses with at-risk moms and children up until the age of two. The fifth edition of the County Health Rankings continues to show us where we live matters to our health.

Mar 26 2014
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County Health Rankings 2014: Grant County, Kentucky

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The County Health Rankings, a joint project between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, shows how communities across the country are doing and how they can improve on their health.

One of the communities highlighted in the 2014 report is Grant County, Kentucky. The county has seen tremendous progress in its overall health outcomes and the health rankings, moving up from 89th to 60th place this past year relative to the state's other counties.  

The rural county — a "land of horses and tobacco farms" — has found that partnerships to improve health are absolutely essential, and that one of the advantages that smaller, more rural communities have is that it's relatively easy to bring together the business community, the churches, the schools and other groups.

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Innovative community programs include Fitness for Life Around Grant County, or FFLAG, which led the company Performance Pipe to provide employees with healthier food options; the four-week Biggest Winner Challenge, which focuses on getting people to try out different kinds of physical activity; and tobacco-free policies on school campuses. The fifth edition of the County Health Rankings continues to show us where we live matters to our health.

Feb 28 2014
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Faces of Public Health: Q&A with Chris Zimmerman

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As the demand for walkable communities keeps growing, experts are moving from asking “If they build it, will they come?” to questioning how to fund the new developments, as well as keeping our eyes on issues such as transit, affordability and improving population health. As of January sharing best practices for those and many other issues is the job of Chris Zimmerman, who recently joined the staff of Smart Growth America as Vice President for Economic Development, following a very long stint as a member of the Arlington County Board in Virginia. Before his post in Arlington, Zimmerman was Chief Economist and Committee Director for Federal Budget and Taxation at the National Conference of State Legislatures. In his new role, Zimmerman will focus on the relationships between smart growth strategies and the economic and fiscal health of communities.

NewPublicHealth spoke with Zimmerman soon after he landed in his new office.

NewPublicHealth: What did you do before joining Smart Growth America?

Chris Zimmerman: For the last 18 years I’ve been a member of the Arlington County Board, the governing body of Arlington County, Virginia, an urban county of about 220,000 people right next to Washington D.C. The county functions as a comprehensive local government, with functions from school funding to land use and development to standard municipal functions such as parks and recreation, public safety, waste removal and managing public infrastructure. We don’t run the schools, but the funds for the schools are part of the county budget, at a cost of a little more than $1 billion annually.

Arlington County has become a model for transit-oriented development that is studied by folks around the country and even around the world, particularly because of the way the county has chosen to develop around the Metro system. That includes the initial commitment to be involved in Metro Rail, to fund underground Metro stations and then to focus development around them, beginning even before the ideas of the vocabulary of Smart Growth and urbanism had really gotten started, decades ago.

Prior to serving on the county board, I served on the county’s planning commission and a number of other commissions. So I’ve had about 20 to 25 years of involvement in the development of every aspect of the community, including housing, planning development and economic development, and even agencies such as the Washington Metropolitan Area Transit Authority, which runs Metro Rail and Metro Bus and every other regional transportation planning body there is here in Washington. I was involved in a lot of regional transportation issues that obviously were fundamental to our county because of the way we chose to develop and because of where we’re located. There are seven crossings of the Potomac River and five of them go through Arlington, so although there are a couple hundred thousand people in Arlington, there’s a million and a half or so in northern Virginia and large numbers of them go through Arlington every day.

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Jan 30 2014
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NewPublicHealth Q&A: James McDonough, Chair of NACo's Healthy Counties Initiative

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NewPublicHealth is on the ground at the NACo 2014 Healthy Counties Initiative Forum. The theme of the forum this year is “Improving Health in a Climate of Change.” Ahead of the meeting we spoke with James McDonough, county commissioner in Ramsey, Minn., and chair of the Healthy Counties initiative about the meeting and the health changes he is seeing at the county level.

NewPublicHealth: Can you tell us how the NACo Healthy Counties Initiative got its start?

James McDonough: Three years ago the president of NACo at that time, Lenny Eliason, from Athens County, Ohio, really was concerned about how the majority of health care dollars were being spent on treating preventable conditions and the whole issue of the wellbeing of our constituents and our employees. So he elevated the issue of wellness and health in counties as a presidential initiative. Typically those are short term and last for a year or two, but NACo has embraced this and has continued this on as a task force to really embed it in the work that we do—elevating how counties can have an impact on wellness in communities.

NPH: What are the current goals?

McDonough: To really elevate and get the county commissioners and county managers throughout the country to just pause and take a look at what they're doing and what they could be doing. We’ve been talking about how we can do a better job supporting counties that are already doing great work in this area and helping share those best practices, and then helping counties that haven’t really taken a look at what their role is. That can help us have a better impact on getting ahead of some of the major preventable diseases in our communities.

NPH: How important is county-level action when it comes to health?

McDonough: For the most part, counties really are responsible for the public health departments within their communities. Throughout the country we operate almost 1,000 county hospitals and close to 700 county nursing homes, so we have a lot of responsibility for public health and—just as important—we employ more than 30 million people throughout the country.

Action, responsibility and efforts vary county to county, but for example, in Ramsey County, Minnesota, where I’m the County Commissioner, we run the public health department working with our cities, the state and with the federal government. So for us it’s a really big opportunity to be the convener as well to lead the Healthy Cities Initiatives as well to a larger regional more focused and concentrated effort.

NPH: The focus of the forum includes some critical topics such as behavioral health and key health issues in jails. How much of a financial burden do these health issues place on counties?

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Jan 15 2014
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New Report by RWJF Commission to Build a Healthier America Calls for Funding Changes to Help Improve the Health of the Nation

Recommendations released by the Robert Wood Johnson Foundation’s Commission to Build a Healthier America yesterday call for three areas of change essential to improving the nation's health:

  1. Increasing access to early childhood development programs;
  2. Revitalizing low-income neighborhoods;
  3. Broadening the mission of health care providers beyond medical treatment to include the social problems their patients face that keep them from living healthy lives.

The Commission, which reconvened last June after four years, deliberated over the past several months and determined that these areas have the greatest potential for improving the health of the population, especially for low-income families.

The independent, non-partisan Commission was chaired by Alice M. Rivlin, PhD, former director of the Office of Management and Budget, and Mark McClellan, MD, PhD, the former head of the Centers for Medicare & Medicaid Services. Commission members included journalists, physicians, academics, policymakers, public health experts and people engaged in community development.

The new recommendations are part of a new report, Time to Act: Investing in the Health of Our Children and Communities.

“We cannot improve health by putting more resources into health care alone," McClellan said. "We must find ways to help more Americans stay healthy and reduce the health care costs that are crowding out other national priorities."

"To achieve a healthier America, we must change our approach to investing in health to affect the actual determinants of health, not just the consequences of ill-health," said Rivlin. "If carried out, these recommendations will build a foundation of lifelong health for generations to come."

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Speaking at the release of the recommendations in Washington, D.C., yesterday RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA, said, “we must join forces to foster a culture of health in which everyone—regardless of where they live, their race or ethnicity, or how poor or wealthy they may be—has the opportunity to lead a healthy life." 

The Commission’s members all spoke about the findings and recommendations during panel discussions at an event at the Newseum to release the report. Suggested next steps include engaging both citizens and policymakers to advance the issues. “Often aspiring policymakers are looking for an issue and we’re trying to hand them one,” said Rivin. Anne Warhover, a member of the Commission and president and CEO of the Colorado Health Foundation, pointed out that turning the recommendations into successful actions will include helping each community determine both what it needs and what it can do, and realizing that “one size does not fit all” when it comes to these changes.

The Robert Wood Johnson Foundation, said Lavizzo-Mourey, “will make the [Commission’s report] our compass going forward to allow everyone to live a healthy life. It’s not going to stay on the shelf. We’re going to use this every day.”

>>Bonus Links:

  • Resources created to accompany the release of the recommendations of the Commission to Build a Healthier America include video interviews with key leaders who are already helping to change the health of their communities.
Nov 15 2013
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‘Culture of Health Hangout’: The Continuing Evolution of Public Health Departments

Earlier this week, the Robert Wood Johnson Foundation held its first ever “Culture of Health Hangout,” a new series meant to explore what communities across the country are doing to advance and transform public health. This first foray looked at how public health departments have evolved in recent years, and are continuing to evolve to meet the changing needs of the communities they serve. The panel was moderated by Paul Kuehnert, RWJF senior program officer and Public Health team director.

file Muntu Davis, Alameda County

According to Muntu Davis, Public Health Director and County Health Officer of Alameda County, the core role of public health hasn’t really changed—public health departments and officials continue to gather and analyze data to explain what’s happening to the health of a community. However, what has changed is where they put their focus. Now, in health departments across the country, the focus is not simply on individual decisions, but on social and economic factors that dictate which options are truly available.

“Although it does boil down to an individual choice, if there’s no opportunity there for communities, then ‘health’ is definitely not an easy choice to make,” said Davis.

One of the more innovative approaches his health department has undertaken is utilizing maternal and child health workers to provide, in addition to their traditional work, financial coaching to people who may be of lower incomes. “Studies have shown link between income, wealth and life expectancy,” said Davis, and that’s what makes it important for public health to help support not just the immediate health need but also “the full picture of what might be shaping their health.” These workers are able to provide education and assistance, while also linking them to financial coaching and tools that can help them manage the money they have.

file Karen DeSalvo, New Orleans

Karen DeSalvo, City of New Orleans Health Commissioner, spoke extensively on the importance of community partnerships when it comes to advancing community health. She said Hurricane Katrina was, in a way, a “catalyst for change” that enabled the entire community to hit the reset button, assess where they were and determine how best to move forward together. One of the first realizations was that the city simply did not have a strong enough local health department.

“It allowed us to begin planning, and to decide to move away from an expensive, hospital-based system to one that was more about prevention and primary care,” she said. “And over the course of years, once we stabilized that infrastructure at the frontline of primary care and moved more toward prevention, the glaring need to have a strong public health department became obvious.”

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Oct 16 2013
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Place Matters: A Q&A With David J. Erickson, Federal Reserve Bank of San Francisco

file David Erickson, Federal Reserve Bank of San Francisco

At the recent Place Matters: Exploring the Intersections of Health and Economic Justice conference in Washington, D.C., David J. Erickson, PhD, was a key member of a panel called “What Works for America’s Communities?” Dr. Erickson, who is director of the Center for Community Development Investment at the Federal Reserve Bank of San Francisco, has been a key leader in a Healthy Communities collaboration between the Federal Reserve and the Robert Wood Johnson Foundation. The joint effort has convened more than ten conferences around the country and released numerous publications, including an article in Health Affairs about partnerships to improve the wellbeing of low-income people.

>>Read more reporting from the Place Matters conference, in a Q&A with David Williams of the Harvard School of Public Health and the RWJF Commission to Build a Healthier America.

NewPublicHealth spoke with Dr. Erickson at the Place Matters meeting.

NewPublicHealth: Are the Healthy Communities conferences continuing?

David Erickson: We still have what we call “consciousness raising” meetings planned in Ohio, Florida, Louisiana and other cities, and these are initial meetings that get together the health and community development world. But then there is another phase, we call it phase two—how do you operationalize this idea? What do we do tomorrow? Who do I call? How do I structure the transaction? Who’s my partner? And that’s harder to answer so we’re trying to figure that out. So we need phase two meetings to get hospitals together with banks to talk about how they might blend some of their community benefit dollars with community reinvestment dollars to help alleviate some of the upstream causes of bad health [like poverty and poor housing].

NPH: What would be examples of such a collaboration?

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Oct 15 2013
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Place Matters: Bringing Community Development and Health Leaders Together

file David Williams, Harvard School of Public Health and RWJF Commission to Build a Healthier America (photo credit: Alliance for Health Reform)

At the recent Place Matters conference in Washington, D.C., David Williams, PhD, the Norman Professor of Public Health at the Harvard School of Public Health and staff director of the reconvened Robert Wood Johnson Foundation Commission to Build a Healthier America, talked about the need for cooperation between the community development industry and health leaders.

“Community development and health are working side by side in the same neighborhoods and often with the same residents but often don’t know each other or coordinate efforts.”

NewPublicHealth recently asked Dr. Williams about how synergies between the two fields can help improve population health.

>>View David Williams' PowerPoint presentation from the conference:

NewPublicHealth: Is there progress on the community development and health fields working together to help improve the health of communities?

David Williams: I would say there is increasing recognition by individuals both in health and in community development that they are two groups working in many ways on the same challenges and often in the same communities and in many ways there can be there could be synergy from working together. But I would also say that this is all so new, and I don’t think the field has matured in terms of our full understanding of where the potential is. To me, one of the greatest hungers out there is for people to see examples of success and progress and initiatives that in fact have worked well together, and we’re still in the beginnings of seeing that—such as the Federal Reserve healthy communities conferences, which have raised awareness levels and have begun to help similar initiatives. But we’re still in the infancy of really capitalizing on the potential.

One of the key challenges is that this area of healthy communities is a broader issue. And that includes the need to recognize the importance of a health in all policies approach—that policies in many sectors far removed from health have health consequences. A good example is the education sector—and having teachers recognize that they are themselves are health workers in a certain sense because the work they do can have such an important impact on health.

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Oct 7 2013
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Evaluating HIAs: A Q&A with Andrew Dannenberg

Andrew Dannenberg, MD, MPH, an affiliate professor at the University Of Washington School of Public Health Andrew Dannenberg, MD, MPH, an affiliate professor at the University Of Washington School of Public Health (Image credit: NRDC)

A key session at the Second National Health Impact Assessment Annual Meeting held recently in Washington, D.C., was a panel discussion on several evaluations of the value and benefits of health impact assessments (HIAs). Andrew Dannenberg, MD, MPH, an affiliate professor at the University Of Washington School of Public Health, was a consultant on a recent evaluation of HIAs funded by the Robert Wood Johnson Foundation and a member of the evaluation panel at the HIA meeting. NewPublicHealth spoke with Professor Dannenberg about some recent findings.

NewPublicHealth: What have the recent evaluations of HIA as a tool told us about the value conducting health impact assessments?

Andrew Dannenberg: Essentially, HIA works. The tool does seem to promote health, and does have influence in some cases but not others. HIAs can influence the health component of [policy] decisions.

There are also indirect HIA benefits: by getting public health professionals talking with decision makers in other sectors—such as transportation and housing—HIAs create partnerships and collaborations for longer-term value. So a transportation department building a highway may then always realize that there are health implications of what gets constructed.

We also came away with a list of factors that influence HIAs to make them successful. The list includes:

  • Timeliness is often a factor when doing an HIA (in that the HIA must be completed and recommendations made in time to support or influence the policy decision).
  • Involving stakeholders and decision makers gives a better chance that the recommendations will be considered.
  • It is important to have community engagement and feedback, or, particularly when it is an HIA being done rapidly, it is critical to have a well-informed health leader at the helm.
  • It is critical to screen the topic to be sure it is appropriate for an HIA.
  • Dissemination to stakeholders, decision makers and media is very important, using methods, length and language appropriately customized for those audiences.
  • HIA recommendations need to be clear and actionable.
  • The Australian evaluation found that a key to successful HIAs was getting the right people at the right time to work together.

NPH: Do you have an example of an HIA that showed that using the tool leads to better decision making?

Dannenberg: An HIA conducted in San Francisco several years ago is one of our clearest examples. A developer wanted to tear down some low-income housing to build more expensive apartments that would have displaced the low-income people living at the site. The Department of Health conducted an HIA, which made it clear that it is bad for health to take low income people in an expensive city and throw them out in the street with no housing.

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