A single instrument cannot perform a symphony, and a comprehensive Culture of Health cannot be built by the health care system alone.
It is going to take the input and innovation of many. In California, the Live Well San Diego initiative is a prime example of how a crosscutting approach can improve the well-being of an entire county. In 2010, using data about the health of its residents, a coalition of community members, businesses, schools, faith-based organizations and local government set 10-year goals for improvement. Then, working together, they began building safer and more resilient communities by encouraging physical activity, turning parking lots into parks, helping seniors age in place, promoting community policing, and creating plans for future growth with health in mind. Data tracking the county’s progress is shared openly with the public and the entire community is invited to help move the needle forward.
On the other side of the nation, Durham County, N.C., once known as the heart of tobacco and textile country, is becoming a world-renowned center of biotechnology, medical care, and higher education. The change has benefited many. But it also has underscored the community’s economic and health disparities, including uneven rates of obesity, heart disease, unemployment, poverty and education. Community leaders knew they had to work together with a common purpose to address these issues. But knowing it and doing it are very different things.
“Some people came to the table with great hesitancy, feeling if they gave over their ideas to others—the things they had worked so hard on—they would lose their identity,” says Durham County Public Health Director Gayle Harris, explaining the early challenges she and others faced when they decided to create a community-wide coalition called the Partnership for a Healthy Durham. “It takes work to connect the dots and get people to recognize that everyone has equal weight and has a unique role to play. But it can’t be about them. It has to be about the greater good."
“You have to get people comfortable with the notion of real collaboration,” she says. “Bringing thoughts to the table, putting them on the table, and then taking their hands off and allowing the group to mold those ideas into something that benefits the greater good. There’s a saying I’ve heard that I like: Change happens at the speed of trust.”
Today, the Partnership for a Healthy Durham is an active coalition of more than 500 individuals, health care providers, elected officials, university researchers and civic organizations that meet regularly to assess data about the community’s health, set priorities, and tackle the issues together. Over the past decade, the partnership has established a network of free health clinics and created 32 miles of dedicated bike lanes and walking trails. The school district has turned 30 acres of empty land into a vast garden, where students can grow, harvest and learn about healthy food. A Veggie Van works with churches, child-care centers and other organizations to deliver fresh produce to residents with limited access to nutritious fare. The partnership has also addressed early childhood education and helped to boost high school graduation to 80 percent. Additionally, in a historic move, the county that once considered tobacco its economic lifeblood recently banned smoking on city and county property, in city parks and sidewalks near hospitals and bus stops.
Partnerships like these are serving as models for the rest of the nation by sharpening the connection between health and a strong, sustainable economy. Through programs like the RWJF Culture of Health Prize, our Foundation will continue to spotlight and support communities that are committed to improving the overall well-being of their residents. We also will continue to help these communities connect so they can share successes, challenges, tools and resources.