Dean Sherzai MD, MAS, PhD (c)

1. Dean Sherzai MD, MAS, PhD (c) Director of Memory and Aging Center Director of Research Neurology, Loma Linda University Chair of Healthy Aging Commission of DAAS Community Vital Signs Steering Committee Member

2. Collective Impact:Displacing Heart Disease Together

3. Countywide Vision The Countywide Vision • A complete county • A sustainable system of community health “…and all sectors work collaboratively to reach shared goals.”

4. Community Vital Signs - Beginning • Spearheaded by Departments of Public and Behavioral Health and Arrowhead Regional Medical Center in 2011. • Originally built upon Countywide Vision to develop a Community Health Assessment to analyze health of the region, identify barriers to services, and establish health priorities for the County.

5. Community Vital Signs – Today Community Vital Signs: • Is a community health improvement framework jointly developed by San Bernardino County residents, organizations and government. • It builds upon the Countywide Vision by setting evidence-based goals and priorities for action • It provides the basis for aligning and leveraging resources and efforts by diverse agencies, organizations and institutions to empower the community to make healthy choices.

6. Community Vital Signs – Today • Community driven. • Purpose, Vision, and Value statements developed and adopted by community leaders. • Stakeholders identified short and mid-term objectives. • Aligns with the Countywide Vision

7. Community Vital Signs in Action • Phase I Data Gathering and Analysis – collection of existing data, analysis of that data and determination if gaps exist in data that are of importance to the community. • Phase II Community Engagement – discussion at the community level to: • Define regional stories behind the data • Establish health priorities • Identify community resources

8. Partnering with all Sectors

9. IsolatedImpact Collective Impact Isolated vs. Collective Impact When organizations have the vision, leadership and resources to engage the relevant stakeholders in a structured process to address a specific social problem When individual organizations demonstrate a successful intervention and then encourage others to replicate

10. Collective Impact in Action Community Vital Signs • Alignment • Common agenda • Goals • Focuses strategies and priorities • Metrics • Common measures of success

11. Collective Impact in Action ALIGNMENT • Healthy Communities/Healthy City Initiatives • Hospital Community Benefits Association • Non-profits and Community-Based Organizations • Education (Colleges, Universities, etc.) • Local Businesses • Senior Affairs Commission • Public Health Alliance As the Vision progresses, we have the opportunity to align individual efforts to support collective impact.

12. Collective Impact in Action GOALS • Displace Heart Disease as the No. 1 Cause of Death in our County METRICS • Percentage of adults with high blood pressure As the Vision progresses, we will engage the community, the cities and our stakeholders to set priorities, develop action steps and agree upon measures for accountability.

13. Action Planning Community Health Improvement Planning: • Identify prioritized indicators • Develop inventory and mapping of existing community resources • Develop actions steps, driven and acted upon by the community • Focus the community and the various regional initiatives around agreed-upon indicators that will measure success • Final Comprehensive Report is scheduled for public release on November 14, 2013

17. San Bernardino County 44 Ranking on a scale of 56 • Health Outcomes 44 • Health Factors 46 • Health Behaviors 48 • Clinical Care 52 • Social and Economic Factors 39 • Physical Environment 46

20. a health community by design would be…

21. An environment where making the healthy choice is the default choice • Built environment (includes transportation) • Food environment • Employment • Pollution-free environment • Education • Active recreation • Safety • Access to affordable, quality health care

22. Imagining a Healthy Community How we will get to where we need to be? What do we want our community to be? What makes your community healthy? Where are we today?

23. New Level of Thinking Focus less on day-to-day events and more on underlying trends and forces of change

24. Community Benefits Collaborative Goal: Displace heart disease as the leading cause of death in San Bernardino County Objectives:  Increase the proportion of primary care providers who regularly measure the body mass index for their patients by December 2015. Increase the proportion of hospitals following the American Heart Association “Get with the Guidelines” by December 2015.  Establish a Retail Food Environment Index for every city in San Bernardino County by December 2015.

25. Social-Ecological Model 24

26. Alignment of Indicators

27. Population Health Requires Partnerships to Improve Outcomes

28. American Heart Association • San Bernardino County Department of Public Health • Arrowhead Regional Medical Center • Kaiser Fontana and Ontario • Loma Linda University Health • Redlands Community Hospital • St. Mary’s Medical Center • St. Bernadine’s Medical Center • Community Hospital of San Bernardino • San Antonio Community Hospital Partners

29. Leading Change with Influence Concern • Create new mental models for health improvement and economic development • Merge the conversation about health, healthcare, and economic reform