Category Archives: Healthy communities
Cardiovascular disease is the focus of the 2013 annual report to Congress of the Community Preventive Services Task Force, an independent and unpaid panel of public health and preventive services experts. The report was discussed at a recent Congressional briefing that included health experts, Congressional staff, community health promotion partners and policy-makers.
Each year the Task Force reviews and updates the Guide to Community Preventive Services, a free resource that provides examples of evidence-based strategies to help communities choose programs and policies to improve health and prevent disease.
It’s not hard to understand why cardiovascular disease was the focus topic this year. According to John Clymer, executive director of the National Forum for Heart Disease & Stroke Prevention, almost half of all Americans have at least one of three modifiable risk factors for heart disease: tobacco use, high blood pressure or uncontrolled high cholesterol.
The Task Force has identified effective approaches to address most of the risk factors for heart disease, which include integrated community and health system practices. Some examples of such practices are a team approach to preventive care that includes doctors, nurses and community pharmacists; tobacco quitline interventions at no cost including follow-up counseling calls; and behavioral counseling and support for heart disease risk factor behaviors.
Jonathan Fielding, MD, MPH, co-chair of the Task Force and health director of Los Angeles County in California, says his county used evidence in the Guide that found that mass media efforts aimed at getting people to stop smoking only work in conjunction with other efforts.
Several community and health leaders of San Bernardino, Calif., the largest geographic county in the U.S., spoke at the recent briefing on use of the Community Guide to help improve population health in their county. San Bernardino ranked 44th out of 57 counties in the 2013 County Health Rankings. “The [Community] Guide has been instrumental in our work looking at population health,” says Dora Barilla, DrPH, Asst. Vice President for Strategy and Innovation at Loma Linda University Health, at the recent briefing. Loma Linda was part of a community initiative begun several years ago to improve population health in San Bernardino, which has 4.2 million residents in San Bernardino, “many with significant disparities,” said Barilla.
“We needed to identify the highest impact initiatives and without the community guide, we could not have done that,” said Barilla. “We used it to move forward fast. We needed science and evidence. Using the guide we were able to galvanize 20 of 24 cities. We were able to use what worked and not waste time on practices that were ineffective and outdated.”
Critical features of the Guide, said Barilla, is that it has targeted approaches for different populations “and does not take a one size fits all approach.” One key outcome, according to Barilla, was that hospitals engaged in community benefit efforts—a requirement for nonprofit hospitals under the Affordable Care Act. “We now had science and metrics to invest in upstream initiatives.”
>>Bonus Link: Watch a County Health Rankings and Roadmaps video on initiatives now in place to help improve population health in San Bernardino.
U.S. News & World Report has added a new set of rankings, “America's 50 Healthiest Counties for Kids” to its just released annual report on the Best Children’s Hospitals. The top counties have some important measures including fewer infant deaths, fewer low-birth-weight babies, fewer deaths from injuries, fewer teen births and fewer children in poverty than lower ranked counties. Most of the measures were taken from this year’s County Health Rankings, a collaboration of the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.
According to U.S. News, “America’s 50 Healthiest Counties for Kids,” represents the first national, county-level assessment of how health and environmental factors affect the well-being of children younger than 18 and shows that even the highest-ranking counties grapple with challenges such as large numbers of children in poverty and high teen birth rates.
>>Read the full U.S. News & World Report article.
Last week, a lunch briefing hosted by Women’s Policy, Inc., a national nonprofit that focuses on women’s issues, brought together a packed house of policymakers, public health leaders, academics, and legislative staff in key Congressional offices to discuss how data can inform action around women's and population health.
The briefing focused on the County Health Rankings & Roadmaps, a collaboration between the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute that measures the health of every county in the United States and provides tools to help create solutions that make it easier for people to be healthy in their own communities. Measuring health outcomes like length and quality of life along with health factors like education, income, and obesity rates, the Rankings provide an annual snapshot of where counties are doing well and where they can improve.
In turn, the Roadmaps to Health program helps counties partner with other local leaders to use that data to improve the health of residents. One of the featured speakers at the briefing was Claude-Alix Jacob, Chief Public Health Officer of Cambridge, Mass., one of six inaugural winners of RWJF’s Roadmaps to Health Prize.
Jacob pointed out the value of having data to work with determining where to put resources in order to improve community health. Women’s health data points of in Cambridge include:
- Girls reported slightly higher rates of smoking and binge drinking than boys
- Girls reported rates three times higher than boys of verbal abuse.
- Girls reported being three times more likely to hurt themselves than boys
- 87 percent of eligible women have had Pap smears, and 85.5 have had mammograms
- One-third of single mothers live in poverty
One key program that Jacob pointed to that Cambridge has begun is Baby University, a free 16-week innovate program designed for parents with children from birth to age 3. The goal is to increase parents’ knowledge about child-rearing topics, strengthen parent-child relationships and connect parents to community resources. “While the first few cycles have largely included only moms,” said Jacob, “ the two most recent cycles have included more dads.”
The program includes childcare and transportation costs for enrolled parents, as well as home visits by professional staff. Parents who complete the program become part of an alumni association that continues the relationship between the parents and the program staff. So far, the program has had 140 graduates.
>>Read more about the briefing from the County Health Rankings blog.
>>Bonus Link: Among the resources for improving community health discussed at the Women Policy Inc. briefing was the “Town Hall Meeting in a Box” to help facilitate community conversations. The toolkit includes invitation samples, venue ideas and presentation documents. See more County Health Rankings & Roadmaps resources here.
As scholars together at the Columbia Mailman School of Public Health in New York City, public health researchers Kimberley Roussin Isett, PhD, and Miriam Laugesen, PhD, watched major policy changes unfold across the city over the past several years. They decided to look at New York City as a model for improving public health that other cities could replicate. “Things were happening in New York City rapidly, and in a health-focused way that really not seen before,” says Isett. Since then, other cities across the country have enacted similar, comprehensive smoke-free policies. Voluntary calorie postings on restaurant menus were also integrated as a requirement in the Affordable Care Act. The researchers decided to look at New York City as a model for improving public health that other cities could replicate. NewPublicHealth recently spoke with Drs. Isett and Laugesen about their research. Dr. Isett recently took a new position as an Associate Professor in the School of Public Policy at the Georgia Institute of Technology in Atlanta, and Dr. Laugesen is an Assistant Professor of Health Policy and Management at Mailman and a former Robert Wood Johnson Foundation Health & Society Scholar.
NewPublicHealth: Because of its large budget and powerful public leaders, New York City isn’t always seen as a model for other, particularly smaller, health departments. But your work shows some of their efforts to be important, maybe critical for other departments to study and replicate. How did you come to that conclusion?
Miriam Laugesen: In our research, one theme that kept coming across again and again was the scientific basis—the amount of research and data—that the Bloomberg administration and staff had collected to justify and design their policies. That was a very big component, we thought, of many of their policies and that New York City had many innovative, interesting examples of how policymakers can base their policies on evidence.
Resilience is about how quickly a community bounces back to where they were before a public health emergency—and only a healthy community can do that effectively.
RWJF President and CEO Risa Lavizzo-Mourey, MD, weighed in on what it takes to create healthy, resilient communities—and shared examples of some communities that have done just that—through a post on the professional social networking site, LinkedIn. Dr. Lavizzo-Mourey is one of about 300 LinkedIn Influencers. Read an excerpt of the LinkedIn post below.
It is a testament to the American spirit that less than a day after a tornado brought a 20-mile-wide swath of death and destruction to Moore, OK, public officials and residents unequivocally pledged to rebuild the community. “We will rebuild and we will regain our strength,” Gov. Mary Fallin told a news conference after viewing the devastation.
Similar assertions were made after Hurricane Sandy wiped out entire neighborhoods on the New York and New Jersey coasts eight months ago, and I am sure they will be made again after future natural disasters. I applaud the can-do determination. But I also suggest that we take a minute and think, not just about rebuilding, but creating something better. Why not rebuild communities where health and wellness is a top priority?
Imagine rebuilding neighborhoods that make healthy living an easy and fun choice, that offer more places to safely walk or bike, more open spaces where families can exercise and play, and more restaurants that offer healthy choices and provide nutritional information on their menus.
This is not just some do-gooder’s pipe dream. New Orleans has shown us that it can be done.
In February, the Robert Wood Johnson Foundation honored six communities with the inaugural RWJF Roadmaps to Health Prize, which recognizes outstanding community partnerships that are helping people live healthier lives.
Recently, NewPublicHealth spoke with Claude-Alix Jacob, chief public health officer at the Cambridge, Mass., department of health, one of the six prize-winning communities to be recognized by the Foundation. Mr. Jacob spoke to NPH about how collaborating around and winning the Prize has impacted the community, including resilience in the face of tragedy.
>>Apply to become a winner of the 2013-2014 RWJF Roadmaps to Health Prize. This year's application deadline is May 23, 2013.
NewPublicHealth: What did winning the RWJF Roadmaps to Health Prize mean to your community?
Claude Jacob: It has been great and exiting news for our community. Over the course of the last few months and through National Public Health Week last month we’ve had a chance to celebrate. We’ve been able to share our public health plans and community partnerships, but also under the aegis of the Robert Wood Johnson Foundation, we now have more credibility for all of our efforts. The Foundation is associated with promoting important health improvement efforts nationwide and just to be linked to the Foundation will open doors, especially now that we’re one of the six inaugural prize winning communities.
During National Public Health Week we invited our community stakeholders to celebrate to thank them for their hard work in helping us to prepare for the site visit that was required of prize finalists. So it’s been a phenomenal few weeks.
NPH: How has winning the prize impacted the health improvements of your community?
Urban Farming, founded by recording artist Taja Sevelle, is a nonprofit organization with a goal of reducing hunger and increasing access to fresh, healthy foods by encouraging people in urban, rural and suburban areas to plant gardens on unused land. There are now over 66,600 community, residential and partner gardens that are part of the Urban Farming Global Food Chain around the world.
NewPublicHealth recently spoke with Taja Sevelle about the group and its plans for the future.
NewPublicHealth: How did you become interested in the issue of Urban Farming?
Taja Sevelle: I was recording a CD for Sony Records in Detroit, Mich., when I began to see the vast amounts of unused land in the city. I knew that numerous jobs were being shipped overseas and a lot of people who had lost their jobs were suffering. So, in 2005 I put my music career on the back burner and started Urban Farming with three gardens and a pamphlet. It was always a global vision that grew rapidly and started to get international coverage quickly.
Even though this seems like a new idea, it really is just reacquainting people with the age-old act of planting food. The World War II victory gardens, for example, are a great model because during that time, 20 million Americans planted gardens and grew almost half of the U.S. produce supply. Recently, when the economic downfall hit around the world, planting a garden became a necessity for many people who may not have been thinking about it previously.
NPH: What are the key goals for Urban Farming?
Howard County has been the healthiest in Maryland since the Country Health Rankings launched in 2010. NewPublicHealth recently spoke with the county’s executive, Ken Ulman, about how the Rankings have helped drive further progress in improving the health of Howard County. Health initiatives introduced by Howard County have included a program that certifies schools as “Healthy Schools,” if they meet criteria in several areas including nutrition and physical activity, and a smoking ban in all county parks.
NewPublicHealth: Howard County has been consistently been ranked the healthiest county in Maryland. What key factors do you credit for that?
Ken Ulman: We start with some advantages. We have the blessings of a highly educated population that cares deeply about their community and have good jobs, and many, though not all, have [adequate financial] resources and access to care. We also have the advantage of having a nonprofit, the Horizon Foundation, based in Howard County that is dedicated to improving the health and wellbeing of people living and working in our county.
So it’s a combination of policy initiatives coupled with a public that really wants to make progress in these areas.
NPH: Have the County Health Rankings helped drive any of your public health and prevention initiatives?
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?