Larry Cohen, MSW Executive Director Good Health Counts: Community Indicator Reports as Tools for Change November 7, 2007 APHA 2007 Washington, DC

Reports and Indicators “Good reports are inarguable. They are what they are. When the community has been involved in identifying the indicators and measures, the community can accept and argue about what they want to do about it, and not argue about the information on the report and not trusting or believing it.” Ben Warner, JCCI Ben Warner, JCCI

What’s wrong with this picture?

A Key Opportunity for Prevention DISPARITIES IN HEALTH DISPARITIES IN HEALTH ROOT FACTORS ENVIRONMENTALFACTORS & BEHAVIORAL MEDICALSERVICES The Trajectory of Health Disparities

Let’s take a step back...

Heart Disease Cancer Stroke Diabetes Injuries & Violence & Violence Diet & Activity Patterns Tobacco Alcohol & Drugs Making Links to Actual Causes of Death

It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change. “ ” Institute of Medicine

HEALTH BEHAVIOR BEHAVIOR ENVIRONMENT

Actual Causes Community Factors Let’s take another step back...

What is sold & how it is promoted?

 What’s sold & how it’s promoted  Look, feel & safety  Parks & open space  Getting around  Housing  Air, water, soil  Arts & culture Elements of Community Health THE PLACE

 Social Networks & trust  Participation & willingness to act for the common good  Acceptable behaviors & attitudes  Racial justice  Jobs & local ownership  Education  What’s sold & how it’s promoted  Look, feel & safety  Parks & open space  Getting around  Housing  Air, water, soil  Arts & culture Elements of Community Health THE PEOPLE THE PLACE EQUITABLE OPPORTUNITY

Community environment Medical Services + Community Health

People Medical Services EquitableOpportunity Place Community Health Factors

 Preventative Services  Access  Treatment Quality, Disease Management, In-patient Services & Alternative Medicine  Cultural Competence  Emergency Response Medical Services

Purposes of Reports and Report Cards  Community engagement and multiple stakeholder collaboration  Health care quality improvement  Framing accountability  Informing policy  Getting media attention

Model Indicators  # of preventable hospital room visits  Access (safety) to parks and playgrounds  Parents reading to their children on a daily basis  Commute Time  Salmon Spawning

Sample Community Health Tools Government  County Rankings on Community Health  Hurts us/Helps Us: An Analysis of State Policies and Community Health Business  The 100 Top Businesses in California Promoting Community Health  Community Health Business Certification Media Grading the Media

TOOLS

THRIVE Tool for Health and Resilience In Vulnerable Environments

Promising Practices in Nutrition and Physical Activity Catalogues promising policies in nutrition and activity at the local level Catalogues promising policies in nutrition and activity at the local level Local Policy Database

Influencing Policy and Legislation Changing Organizational Practices Fostering Coalitions and Networks Educating Providers Promoting Community Education Strengthening Individual Knowledge and Skills The Spectrum of Prevention

Developing Effective Coalitions: The 8-Step Process 1.Analyze program objectives, determine whether to form a coalition 2. Recruit the right people 3. Devise preliminary objectives and activities 4. Convene the coalition 5. Anticipate necessary resources 6. Develop a successful structure 7. Maintain coalition vitality 8. Improve through evaluation

Collaboration Math DataConceptsFundingTrainingPartnersKey IssuesOutcomes Sum Remainder: Average:Sum:Product:Sum: Exponential Product: Crisis Centers Education Health Faith Business Media Law Enforcement TOTALS

The Tension of Turf

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