Category Archives: Local government
Many of the sessions at the National Association of Counties (NACo) Health Initiatives Forum meeting in San Diego this week have been moderated by Nick Macchione, director of San Diego’s Health and Human Services Agency and vice chair of the Healthy Counties Initiative Advisory Board. Macchione is a key architect of Live Well San Diego, a program voted in by the San Diego Board of Supervisors that is a long term, comprehensive and innovative strategy on wellness with a goal of helping all San Diego County residents become healthy, safe and thriving.
NewPublicHealth spoke with Nick Macchione ahead of the forum. Senior Policy Advisor Julie Howell and Dale Fleming, director of strategic planning and operational support, joined the conversation.
NewPublicHealth: The buzz about San Diego is that you’re working hard toward population health improvement.
Nick Macchione: I think the excitement about San Diego is that we have earned a reputation as a health innovation zone by having a collective impact on health and wellness. Our deeds demonstrate our words because over the past decade there have been five major broad-based population health improvements: reduction of heart disease and stroke; reduction of cancer rates; reduction of childhood obesity; reduction of infant mortality; and reduction of children in foster care. That reduction is extremely important to population health because we also look at the social determinants of health and not just pure health care.
We've taken an ecological approach to population health—working with partners across all sectors and coming together not just from traditional health care but beyond that to public health, social services, business, community, schools and the faith community.
And we’ve done that in the context of optimizing existing resources to improve outcomes. We’ve been blessed with a lot of competitive federal grants and philanthropy investments, but really the framework is how we leverage and optimize what we have first before we go and seek to augment with other resources. That has worked exceptionally well and that’s earned us that innovation zone reputation.
NPH: Tell us about Live Well San Diego.
Macchione: Live Well San Diego is a comprehensive public health initiative that involves widespread community partnerships to address the root causes of illness and rising health care costs. The tagline is healthy, safe and thriving. We think it’s a great template that communities can use, it’s transferable because San Diego has every imaginable bio-climate except a tropical rainforest. So we have desert towns, we have rural communities, we have mountain villages, we have beach towns and everything in between urban core. We also call it Project 1 Percent because 1 percent of San Diego represents the nation both in its diversity and its population. So, if we can achieve what we're achieving on advancing population based health in a broad scale it can be demonstrated throughout the country.
This week the National Association of Counties (NACo) will hold the fourth Healthy Communities Initiative Forum, in San Diego, bringing together county health directors and staff to share best practices to improve community health. The NACo Healthy Counties Initiative supports innovative public-private partnerships to enhance community health.
Ahead of the conference, NewPublicHealth spoke with Linda Langston, president of NACo and Supervisor of Linn County, Iowa, who will be attending and presenting at the conference.
NewPublicHealth: Tell us about the Healthy Counties Initiative.
Linda Langston: I was the first chair of the initiative when it came into being four years ago. We modeled it after what we had done with our Green Government initiative—we had local government elected officials and staff connected to various areas of health, and then we also populated the committee with some of our corporate sponsors that were ultimately working toward very similar kinds of goals and trying to figure out how we could work affectively together.
We're also helping people understand upcoming issues and ideas they may know about.
NPH: What are the key health issues that counties face in 2014 and how is NACo generally helping counties with those issues?
Langston: Many counties are responsible for safety-net services and virtually every county in the nation has a jail. We’ve learned that many people, including many federal legislators, don’t understand the difference between jails and prisons. Jails are unique to local government, at the county level, and are often where people who have been arrested but can’t afford bail wait until their trial dates. Our challenges include providing health care in the jails, as well as connecting those released to health services in the community, with a goal of continuity for such services as mental health care and treatment for substance abuse.
We are also employers and very often, particularly in small-to-medium-sized counties, we are the largest employer in the area. So we have a lot of employees who need our best efforts, such as looking at how to incentivize people to make good decisions about their own health. And, of course, we also have the community public health responsibility. So we're pretty effectively placed to deal with all things related to health.
Risa Lavizzo-Mourey, MD, MBA, President and CEO of the Robert Wood Johnson Foundation (RWJF) today joins the ranks of Nelson Mandela, the National Association of Community Health Centers, the National WIC Association and families of public health workers everywhere as recipients of the prestigious APHA Presidential Citation.
Risa Lavizzo-Mourey, MD, MBA, President and CEO of RWJF, accepted the award today in a keynote speech in the Opening Session of the American Public Health Association Annual Meeting. This represents the first time that a philanthropy has received the citation.
“To improve Americans’ health, we need to look at where people live, learn, work and play to get at the factors that shape health even more profoundly than the health care we get when we’re sick,” said Lavizzo-Mourey in a Q&A with the APHA blog, Public Health Newswire. “Improving America’s health requires leadership and action from every sector, including public health, health care, education, transportation, community planning, private business and other areas.”
In her acceptance speech, Lavizzo-Mourey congratulated everyone in the hall and beyond for their hard work in advancing public health, even through a tough economic period.
“After all the hard work, after all the progress – the most imminent threat to public health turns out to be something beyond our own control. It’s called the new age of austerity,” said Lavizzo-Mourey. “The resources simply are not there. Basic public health services are in question.”
In her speech, speaking on behalf of the Foundation's grantees, partners and staff, and the public health community, Lavizzo-Mourey emphasized that now more than ever it’s important to make the case for public health. The future of public health – the “new” public health – will depend on collaboration and tearing down silos. The new public health, she said, will be accredited and accountable to communities, it will engage in political process, and it will rely on hard evidence to determine the course of action.
“Your time is ripe. Your time is now. It only seems impossible – until it is done.”
>>Read the full transcript of Risa Lavizzo-Mourey’s speech here.
>>Follow NewPublicHealth coverage of the APHA Annual Meeting here.
Last week, the Association of State and Territorial Health Officials (ASTHO) released the latest iteration of the Profile of State Public Health, with support from the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation, at their Annual Meeting. The meeting also offered a chance to recognize public health heroes from the field.
The Profile of State Public Health provides a snapshot of state public health agencies and the contributions they make to the health of the nation.
Some of the key findings include:
- State health agencies continue to connect people with access to personal health services. For example, 84 percent of agencies support health disparities or minority health initiatives and about 75 percent provide direct support for primary care providers.
- State health agencies are prioritizing prevention. The vast majority offer tobacco prevention and control services (88 percent), HIV prevention programs (84 percent) and injury prevention programs (80 percent).
- Almost three-quarters of state health agencies (72 percent) plan to pursue public health accreditation.
- The state and territorial health agency workforce includes over 100,000 full-time employees.
- The average number of vacant positions at state health agencies is 288. Presumably due to budget cuts and hiring freezes, state health agencies are only recruiting for 15 percent of these positions.
The report is designed to enable public officials and policy-makers to make well-informed decisions to strengthen America’s public health system.
In addition to shining a spotlight on the contributions of state and territorial health agencies as a whole, state projects and individuals that have helped improve the lives and health of Americans were also highlighted and recognized for their efforts with awards at the ASTHO Annual Meeting.