Focusing on the Moved and the Shaken Kansas University School of Medicine – Wichita Quality Improvement Conference 11.02.17 Becky Tuttle, MA Shelley Rich, ME

Today Equality versus Equity Health & Wellness Coalition of Wichita overview Systems and environmental change focus! Call to action Questions

Equality versus Equity

Why Health Equity Matters Reducing health inequities is important because health is a fundamental human right and its progressive realization will eliminate inequalities that result from differences in health status (such as disease or disability) in the opportunity to enjoy life and pursue one's life plans. www.who.org In a culture of health, everyone has the opportunity to live a healthier life, no matter who we are, where we live, or how much money we make. Personal responsibility plays a key role in health, but the choices we make depend on the choices we have available to us. While we can’t ensure that each of us will be healthy, we can make it much more possible for everyone to have the opportunity to make healthy choices, and for health to be much more accessible to all. www.rwjf.org Inequities are created when barriers prevent individuals and communities from accessing these conditions and reaching their full potential. Inequities differ from health disparities, which are differences in health status between people related to social or demographic factors such as race, gender, income or geographic region. Health disparities are one way we can measure our progress toward achieving health equity. www.apha.org

How will we achieve health equity? We value all people equally. We will pause and be intentional. We optimize the conditions in which people are born, grow, live, work, learn and age. We work with other sectors to address the factors that influence health, including employment, housing, education, health care, public safety and food access. 

What should community organizations do? Bring together professionals from a range of sectors (e.g., transportation, health, environment, labor, education, and housing) with community representatives to ensure that community health needs are identified and that needs and barriers are addressed. Help ensure that prevention strategies are culturally, linguistically, and age appropriate, and that they match people’s health literacy skills. Provide skill-building to help residents find reliable health information and services. https://www.surgeongeneral.gov

HWC Vision and Mission Vision – Our entire community lives a healthy lifestyle. Mission – We will promote physical activity and good nutrition for every generation living in the Greater Wichita area through people, programs and policies.

HWC History Fall of 2003 – Grant from the Kansas Health Foundation to Wichita YMCA to develop a coalition Focus areas – healthy eating and physical activity First meeting in January 2004 16 individuals representing 12 organizations Has met consistently for 13 years Serves as a role model across the state/nation fit campaign

The HWC today… www.hwcwichita.org Strong Leadership Team 2 City Council Members, Assistant City Manger and County Commissioner 135+ individuals 95 organizations PARTNERS, PARTNERS, PARTNERS!!! Physical activity and healthy eating still core Monthly newsletter sent to 8000+

Who we are… Membership is FREE www.hwcwichita.org Varied levels of membership…WELCOME!!! Many levels of involvement NETWORKING!!!

HWC Action Areas Bike Month Physical Activity Healthy Eating Healthy School Worksite Wellness

National Bike Month Celebrated annually in May www.bikemonthwichita.org 10 month planning Safe and viable transportation – health equity Bike to School Day/Bike to Work Day

Physical Activity Walk to School Walk at Work Day Walktober Work Well, Live Well Bike Share ICT Support active transportation

Healthy Eating Wichita Food Deserts. Why We Should Care. The Hurdles to Healthy Food Access Food Policy Committee Healthy Food Donation Policy Feed Your Active Faith Healthy Bites, Healthy Worksites National Kids Eat Right Month Food Day (Pantry Raids, Flip Your Fridge) Try Day Friday National Healthy Eating Day Food Tour Double Up Food Bucks We All Eat! March 29, 2018

Worksite Wellness Initiatives Working Well Conference Working Well Award Think Tank

Kansas Health Foundation Health Communities Initiative Grant 3.5 years Health & Wellness Coalition of Wichita Greater Wichita YMCA fiduciary agent 1 FTE

HCI Grant Objectives Objective 1:   By July 15, 2017, a full-time employee will be hired to lead the efforts of achieving health equity in the greater Wichita area. Objective 2: By November 30, 2017, develop an advisory committee of the “moved & shaken” in our community to provide advice on health equity issues. Objective 3: By December 31, 2017, assess and understand health equity issues in our community and identify potential priority populations using key informant interviews, walking tours, and other quantitative and qualitative methods. Objective 4: By February 28, 2018, four community convenings will be held with priority population partners to identify health needs and actionable items where residents live, learn, earn, play and pray. Objective 5: By May 31, 2018, three new HWC Leadership Team members will be added who represent different voices/audiences from current members. Objective 6: By May 1, 2018, Sedgwick County will have finalized their Community Action Plan for the Healthy Communities Initiative: Improving Health Equity in Kansas work.

Where we live, learn, earn, play and pray! Policy Focus Where we live, learn, earn, play and pray! Policy is inclusive! Food Policy Committee Support for active transportation/living Worksites and key institutions

What is the value of policy? Supportive health policies affect large groups/ALL employees (equity) Make adopting healthy behaviors easier Creates and fosters a culture of health Sustainability Community mobilization starts at the organizational level Not “add-on” benefits, but basic investments in human capital, similar to training, mentoring, and other employee development programs

Why have health policies? Organizational policy (little p) plays a key role in: Securing multilevel support with an organization Providing a basic foundation for building comprehensive worksite wellness programs Rational Expectations Resources

Program, practice, policy Programs (interventions) can: Gather baseline data Build support/buy-in for comprehensive wellness programs Offer “fun and creative” methods to lifestyle changes Programs (interventions) can’t: Ensure sustainability Ensure inclusion of all Ensure consistency from all levels of Engagement (top-down/bottom-up)

What is an policy? Any plan or course of action designed to influence and determine decisions – Written Easy to understand and follow Able to enforce consistently Revisited frequently Easy to access/locate Accomplishes goals of comprehensive wellness program

AAFP Guidance Educate, train, and equip family physicians and chapters to address social determinants of health and diversity within the context of the medical home and medical neighborhood. Advocate for policies at the national, state, and local levels to address social determinants of health and support health equity. Collaborate with key stakeholders and organizations to strategically amplify a synergistic approach for raising awareness and developing solutions to address social determinants of health, diversity, and health equity to improve the health of the population. Communicate prolifically about social determinants of health, health equity and diversity, and the AAFP's leadership role in working to advance these issues. Increase diversity of the family physician workforce by increasing the representation of students from underrepresented populations in U.S. medical schools. Advance evidence addressing social determinants of health in clinical practice and through the medical neighborhood and transform evidence into practice. Promote primary care integration and collaboration with public health, behavioral health, oral health, and other key stakeholder organizations to develop synergy to improve health equity and promote diversity.

Call to ACTION! Join a local health coalition Understand resources in the community to refer Understand that not everyone has/knows what you do As leaders in your communities, physicians can advocate for public policies at the national, state, and local levels that protect all individuals from health risk. These might include promoting: The restriction of environmental contamination Access to high-quality health care and insurance coverage Access to healthy food options The use of vaccinations and other public health initiatives Economic development and fair access to employment Equal opportunities for high-quality education for all

Becky Tuttle, MA Community Development, Director Greater Wichita YMCA Health & Wellness Coalition of Wichita, Chair becky.tuttle@ymcawichita.org 316.719.7764 Shelley Rich Director of Health Equity Shelley.rich@ymcawichita.org 316.719.7765 ext. 7765