The Bernalillo County Community Health Council asks publicly on our website for people to “Imagine a healthy Bernalillo County, where everyone has the ability to meet his or her full potential.” And we commit to providing the support for convening those organizations and institutions responsible for creating the conditions needed for health in the neighborhoods where we live, work, learn and play. 

Bernalillo County, NM… hitting bottom  But year after year we continue find our state of New Mexico at the bottom of all the lists. With a third of the state’s population living in Bernalillo County, what happens here helps drive those statistics down. And even worse, those average rates are not spread evenly throughout the county.

Children under 18 in Poverty Foothills 0% Albuquerque/Bernalillo County Parkland Hills 4% South San Pedro (International District) 82.5% For example, overall 26% of children under 18 are living in poverty, but compare 82% of children living in poverty in the South San Pedro neighborhood to 4% just across the street in the Parkland Hills neighborhood to 0% in the neighborhoods in the foothills. It’s not hard to see why New Mexico is continually at the bottom of all the lists, most notably 49th in child wellbeing. Bernalillo County average = 26% Source: CHNA.org – ACS

Life Expectancy Bernalillo County/Albuquerque 83.7 81.7 82.9 75.7 73.1 76.6 76.6 82.4 The consequences of that early childhood disparity can be seen at the end of life, where there is a 10 year difference in life expectancy between that South San Pedro neighborhood within the International District and those foothills neighborhoods in the far NE Heights. It is no coincidence that the neighborhoods with the lowest life expectancy are also predominantly communities of color. Suffice it to say that poverty, poor health and premature death are not equal opportunity conditions in Bernalillo County. 76

DISCONNECTS What we know would make our communities healthier How $ is spent What community says they need How those with $ make decisions Innovative programs & passionate workers Fragmentation & silos Scale of available programs & services Scale of need New ways we need to work Incentives for continuing to do what we’ve always done So why are we in this situation? There are several disconnects that perpetuate our current state of affairs, including: The disconnect between what we know would help our communities be healthier vs. how dollars are actually being spent, especially in the world of health care; The disconnect between how those with the dollars make their decisions vs. what people in the community are saying that they really need; The disconnect and fragmentation of all the innovative programs and passionate workers in those programs into territorial silos; The disconnect between the scale of the available programs/services and the scale of need at the population level; and The disconnect between the new ways in which we need to do our work vs. incentives for continuing to do what we’ve always done.

Healthy and sustainable communities WHERE WE WANT TO BE: We still imagine that healthy Bernalillo County where everyone has the ability to meet his or her full potential. In order to improve the health and well-being of all Bernalillo County residents, the health council has focused on three desired results: Healthy and sustainable communities where all families and individuals have their basic needs met for housing, healthy food, adequate income, safe streets, and parks/green spaces.

Improved health & education outcomes for children/youth Improved health and education outcomes for children/youth from pregnancy to age 25.

Improved healthcare access for physical & behavioral health Improved healthcare access and quality of service for physical and behavioral health through a comprehensive, integrated system that helps keep people healthy and then provides the right services at the right time to help when they become sick or injured.

What we need to do to get there… MICRO LEVEL WHAT WE NEED TO DO TO GET THERE: At the macro level community leaders need to see themselves as stewards of health for the whole community, working together as equal partners to rethink how available funds are spent and where to invest for maximum health in the community. At the micro level we need to continue to work to overcome the disconnects by connecting the dots and aligning all the initiatives and programs we currently have into a coherent system. MACRO LEVEL

Opportunities… Accountable Communities for Health (Presbyterian Healthcare Services, UNM Health Sciences Center and the Bernalillo County Community Health Council) Behavioral Health Initiative (Bernalillo County gross receipts tax = ~$17 million/annually) And we do have opportunities right now at both the macro and micro levels. A collaboration of Presbyterian Healthcare Services, UNM Health Sciences Center and the Bernalillo County Community Health Council has recently been awarded funding by CMS to implement an Accountable Health Communities project. This initiative will help add evidence to the growing body of research regarding lowering the cost of Medicaid and Medicare by addressing the social determinants of health using community health workers to help patients navigate multiple systems to meet their needs. Over the life of the initiative, those multiple systems will be invited into a larger coordinated system working toward that comprehensive response mentioned above. There is also recent work to develop a behavioral health system in the County, centered around new services funded by the behavioral health gross receipts tax, that also leverages other systems, programs and sources of funding. This work links in with efforts to move behavioral health services out of the criminal justice system (the County jail) into the community by creating diversion programs to keep people out of jail and creating an effective re-entry system into the community with warm hand-offs to needed services for those leaving incarceration.

What you can do to help… WHAT YOU CAN DO TO HELP: Here in Bernalillo County we have the opportunity to improve both health and health care by taking our available resources and reimagining how to best distribute them to create health in our homes, schools, workplaces, streets and the community as a whole, while still maintaining the ability to respond to injury and illness with quality care. A healthy community means healthy individuals and families able to make good, healthy choices resulting in healthy outcomes. But it also means creating and maintaining the conditions that allow individuals and families to make those healthy choices and to live fulfilling lives. To accomplish this, we are boldly asking people to make a major shift in how they do business in their institution or organization. We’re asking that leadership at all levels make the shift from a focus only on bottom line of their specific institution to seeing themselves as stewards of the health of the whole community. This will mean letting go of decades of historical competition in the healthcare field, expanding that tunnel vision within government jurisdictions unable to effectively collaborate at multiple levels, and overcoming the competition for (perceived) scarce resources among community-based organizations. With courageous leadership, imagination, passion and perseverance, it can happen. We hope you’ll join us in this important work!