Building Healthy Communities: Understanding Outcomes One, Two and Three

1. Building Healthy Communities:Understanding Outcomes One, Two and Three Joel Diringer, JD, MPH Michael Cousineau, DrPH Dana Hughes, DrPH Long Beach, December 3, 2009

2. Building Healthy Communities: Guiding principles Shift in thinking toward addressing root causes of poor health and policies that prioritize prevention. This will involve changes in the way things are currently done – “systems change” Through advocacy and strategic communications, local experiences will influence and shape policy at the regional, state and national level.

3. Building Healthy Communities: Goals 10-year strategic plan designed to improve health systems and the physical, social, economic and service structures that support healthy living and healthy behaviors in California. Four goals guide The Endowment’s work: • Health systems prioritize prevention; • Schools promote healthy behaviors and are a gateway for resources and services; • Human services systems prioritize prevention and promote opportunities for children and their families; • Physical, social and economic environments in local communities support health.

4. Building Healthy Communities: “Big Results” The Four Big Results • Big Result #1: Provide a health home for all children • Big Result #2: Reverse the childhood obesity epidemic • Big Result #3: Increase school attendance • Big Result #4: Reduce youth violence

5. Building Healthy Communities: Outcomes The 10 Outcomes of Success • All children have health coverage. • Families have improved access to a “health home” that supports healthy behaviors. • Health and family-focused human services shift resources toward prevention. • Residents live in communities with health-promoting land use, transportation and community development. • Children and their families are safe from violence in their homes and neighborhoods. • Communities support healthy youth development. • Neighborhood and school environments support improved health and healthy behaviors. • Community health improvements are linked to economic development. • Health gaps for young men and boys of color are narrowed. • California has a shared vision of community health.

6. Outcome 1 – All Kids Have Coverage

7. Outcome 1 – All Children Have Health Coverage Roadmap to coverage • Expand health coverage to all children in California • Improve systems and policies to ensure that children get enrolled and stay enrolled • Increase points of access for children by using coverage to provide preventive health care and health promotion services (inclusive of physical, dental, mental, and vision) • Reduce the burden of chronic health conditions through coverage of prevention strategies

8. Outcome 1 – All Kids Have Coverage Examples of systems change approaches

9. Outcome 2 – “Health Home” A “Health Home” is a primary care provider who: • Coordinates and integrates care across the health care system (e.g., subspecialty care, hospitals, home health agencies) and the patient’s community (e.g., family, public, and private community-based services). • Considers a patient’s cultural traditions, personal preferences and values, family situations, and lifestyles. • Puts responsibility for self-care and monitoring in patients’ hands—but provides the tools and support needed to carry out that responsibility. • Focuses on promoting good health through ensuring that transitions among providers, departments, and healthcare settings are respectful, coordinated, and efficient. • Emphasizes preventing disease and poor health by using health care providers other than physicians.

10. Outcome 2 – Health Home Promising Strategies and Practices • Integrated, Coordinated, and Comprehensive Care • Patient- and Family-Centered Care • Culturally Competent Care • High-quality Care

11. Outcome 2 – Health Home

12. Outcome 3 – Services shift to prevention • Support systems for families include • Social supports • Financial resources • Human services • Resource poor families living in isolated neighborhoods are more reliant on public health and human services systems than those in more affluent communities • Current focus is more on intervention of those with problems • Need to shift focus to prevention when it comes to health, family security, and social services • Links to other outcomes on youth, economic and community development

13. Outcome 3 – Prevention • Strategies to create seamless, coordinated, culturally competent and accessible “quilt” of health and human services that: • Support health and human services systems to become more preventive in their approaches • Coordinate services to strengthen families and promote children’s health development • Strengthen family’s economic security

14. Outcome 3– Prevention

15. Concluding remarks • The outcomes are inter-related and should be viewed as a package • Focus on changing the current systems to be more responsive to and inclusive of families and community • Try to get ahead of the curve by emphasizing prevention at the policy, community, family and individual level

16. Questions? Thank you!