How to Advance Minority Health? A Successful, Sustainable Effort to Promote Healthy Choices in Miami.

Apr 28, 2014, 1:00 PM

To mark National Minority Health Month, the Human Capital Blog asked several Robert Wood Johnson Foundation (RWJF) scholars to respond to questions about improving health care for all. In this post, Lillian Rivera, RN, MSN, PhD, administrator/health officer for the Florida Department of Health in Miami-Dade County, responds to the question, “Minority health is advanced by combating disparities and promoting diversity. How do these two goals overlap?” Rivera is an alumnus of the RWJF Executive Nurse Fellows program.


In order to address this question, it is important to identify the areas within your jurisdiction where there are identified health disparities and to develop initiatives with those needs in mind.

Miami-Dade County in Florida is one of the few counties in the United States that is “minority majority,” meaning the minority makes up the majority of the population. More than two-thirds of the 2.5 million residents are Hispanic; 19 percent are Black; more than 51.2 percent are foreign-born and most of  them speak a language other than English at home (mostly Spanish and Creole);  19.4 percent live below poverty level; and 29.8 percent of the population  under age 65 (more than 700,000 individuals) is uninsured .

In 2003, the Florida Department of Health in Miami-Dade County (DOH-Miami-Dade) established the Consortium for a Healthier Miami-Dade as a community-based planning approach to reduce chronic disease risk factors and improve community health guided by the goals and objectives established in Healthy People.

A Consortium grant writing team succeeded in helping the DOH-Miami-Dade receive an award of $14.7 million from Communities Putting Prevention to Work (CPPW) to reduce obesity and its associated risk factors by implementing policy, systems, and environmental changes. The areas with the greatest need and disparity were given priority. The DOH-Miami-Dade contracted with 30 community partners to create environments that encourage healthy eating and physical activity. The local CPPW media campaign was branded as Make Healthy Happen Miami and developed in three languages: English, Spanish, and Haitian-Creole.

This initiative was supported by five Consortium committees: Children’s Issues; Health and the Built Environment; Health Promotion/Disease Prevention; Marketing/Membership; and Worksite Wellness. Through this collaboration and partnerships, CPPW worked to encourage healthy lifestyles by implementing 11 goals:

  1. Increase number of high-level community leaders who enact and support evidence-based policies.
  2. Raise awareness of healthy eating and promote healthy food choices and physical activity through mass media campaigns.
  3. Increase access to healthy food and beverages, require daily activity, and limit screen time in child care centers.
  4. Improve access to healthy foods and reimbursable meals in public schools.
  5. Increase physical activity in public schools.
  6. Increase community access to healthy and affordable foods.
  7. Increase access to healthy foods, fruits, and vegetables through farmers’ markets.
  8. Increase breastfeeding practices and breastfeeding friendly facilities.
  9. Increase active transportation and recreation through the built environment.
  10. Increase sustainable Safe Routes to School initiatives.
  11. Increase the number of worksite wellness programs that implement nutrition policies and physical activity.

CPPW has made a significant impact on the quality of life of residents and visitors in Miami-Dade County. The community has increased access to opportunities to participate in physical activity and make healthier choices. The accomplishments and successes of CPPW are being sustained through the work of the Consortium.

See all the blog posts in this series.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.