The Role of State Government in Public Health Nutrition Assessment Policy Development Assurance

Assessment  State level assessment of population nutrition assessment  Identify high risk areas of state  Coordinate state and local assessment initiatives Provide data to local agencies Provide data to local agencies Provide technical assistance & training Provide technical assistance & training

Assurance  Manage/administer/deliver federal nutrition programs: WIC, NSLP, SNAP  Manage/deliver state funded programs: MSS  Build state capacity to address nutrition Technical assistance/capacity building, networking, communication Technical assistance/capacity building, networking, communication Secure and distribute resources for long term goals Secure and distribute resources for long term goals

Policy Development  Advise governor and legislature  State-level planning

Infrastructure

Mission Objectives, Strategies & Activities Health Improve health outcomes for the people of Washington State Increase access to healthy foods and opportunities for physical activity Agri- culture Facilitate the movement of Washington agricultural products in domestic and international markets Promote the economic vitality of the agriculture industry, safeguard the environment; assist growers and agribusinesses to enter new markets DSHS  Improving the health status of vulnerable populations  Improving economic stability, employment and self-sufficiency  Improving individual and public safety  Improving individuals’ readiness and ability to succeed in school  Increasing public trust through strong management practices that ensure quality and leverage all resources

Governor’s Executive Order: Washington Food System Interagency Workgroup  Members: DSHS, DOH, DOA  Invited: OSPI, Conservation Commission  Charged to: “produce a report to the Governor and Legislature which provides an assessment of existing data and identifies remaining gaps and opportunities in Washington State food policy to help address food security, nutrition, and health challenges faced by Washington citizens and to support realistic solutions to these issues.”

The report is intended to help agencies, stakeholders and legislators:  Explore ways to promote nutrition, especially for those who are most in need.  Identify ways to educate the public and policy makers on the status of hunger in Washington State and the role they play in addressing the issue of food security, nutrition, and health.  Educate the public and policy makers on the importance of farmland preservation and the importance of promoting Washington-grown products to farmer’s markets, food banks, and institutions.

Washington State Department of Health Board of Health Board of Health Secretary Mary C. Selecky Mary C. Selecky Mary C. Selecky Developmental Disabilities Council Developmental Disabilities Council Deputy Secretary Gregg Grunenfelder State Health Officer Maxine Hayes, MD, MPH Maxine Hayes, MD, MPH Maxine Hayes, MD, MPH Public Health Systems Development Public Health Systems Development Allene Mares Director Public Health Systems Development Policy, Legislative, and Constituent Relations Policy, Legislative, and Constituent Relations Brian Peyton Director Policy, Legislative, and Constituent Relations Office of Communications Office of Communications Tim Church Director Office of Communications Public Health Preparedness and Response Program Public Health Preparedness and Response Program John Erickson Director Public Health Preparedness and Response Program Community and Family Health Community and Family Health Allene Mares Assistant Secretary Community and Family Health Environmental Health Environmental Health Maryanne Guichard Assistant Secretary Environmental Health Epidemiology, Health Statistics and Public Health Laboratories Epidemiology, Health Statistics and Public Health Laboratories Jennifer Tebaldi Assistant Secretary Epidemiology, Health Statistics and Public Health Laboratories Health Systems Quality Assurance Health Systems Quality Assurance Karen Jensen Assistant Secretary Health Systems Quality Assurance  Financial Services Financial Services Financial Services  Human Resources Human Resources Human Resources  Performance and Accountability  Information Resource Management  Risk Management Risk Management Risk Management  Adjudicative Service Unit Adjudicative Service Unit Adjudicative Service Unit  Privacy/Public Disclosure Privacy/Public Disclosure Privacy/Public Disclosure  Office of Infectious Disease and Reproductive Health Office of Infectious Disease and Reproductive Health Office of Infectious Disease and Reproductive Health  Office of Maternal and Child Health Office of Maternal and Child Health Office of Maternal and Child Health  Community Wellness and Prevention Community Wellness and Prevention Community Wellness and Prevention  Drinking Water Drinking Water Drinking Water  Radiation Protection Radiation Protection Radiation Protection  Shellfish and Water Protection Shellfish and Water Protection Shellfish and Water Protection  Environmental Health, Safety and Toxicology Environmental Health, Safety and Toxicology Environmental Health, Safety and Toxicology  Communicable Disease Epidemiology Communicable Disease Epidemiology Communicable Disease Epidemiology  Non-Infectious Conditions Epidemiology Non-Infectious Conditions Epidemiology Non-Infectious Conditions Epidemiology  Health Statistics Health Statistics Health Statistics  Public Health Laboratories Public Health Laboratories Public Health Laboratories  Informatics Informatics  Customer Service Customer Service Customer Service  Community Health Systems Community Health Systems Community Health Systems  Health Professions and Facilities Health Professions and Facilities Health Professions and Facilities  Investigation and Inspection Investigation and Inspection Investigation and Inspection  Legal services Legal services Legal services

Community Wellness & Prevention Community Wellness & Prevention  Asthma  Breast & Cervical Health  Cancer Registry  Heart Disease and Stroke Prevention  Tobacco Prevention & Control  WIC  Nutrition, Physical Activity, Obesity Prevention  SNAP-ED  Diabetes Control

Washington State’s Nutrition & Physical Activity Plan

The Six Objectives  Objectives  Access to Health Promoting Foods  Food Insecurity  Proportion of Mothers Who Breastfeed Their Infants & Toddlers  Free and Low-Cost Opportunities for Recreation and Physical Activity  Physical Activity Opportunities for Children  Active Community Environments

Planned Activities  Partner with agencies, coalitions & local communities  Provide technical assistance, training, tools & resources  Support pilot programs and development of local action plans  Encourage development & implementation of policy recommendations by sector

Planned Outcomes Short-Term  Partnerships established & working  Partners knowledgeable about environ. & policy issues that impact nutrition & phys. activity  Partners incorporate Plan into their work plans  Financial support for nutrition & phys. activity efforts increases Intermediate  Changes in policy & the environment  Increased phys. activity & improved dietary behavior Long-Term  Decreased obesity  Decreased incidence of chronic disease

Why “Partners of the Plan”? Assessment and Evaluation  Annual Survey of Partners Involvement with the Plan’s objectives, settings impacted, and scope of influence  Key Informant Interviews, 2007 Partners’ perceptions of working with the Plan, gaps in plan implementation, communication needs  Statewide Interviews, 2010 Partners and potential Partners, familiarity with the Plan, knowledge of Partners, communication needs, ideas for sustainability

Why Partners of the Plan?: Partnering to Achieve the Plan’s Objectives Partners pledge to work toward one or more of the Plan’s 6 objectives Potential Partners: Anyone in WA working on initiatives related to the Plan Potential Partners: Anyone in WA working on initiatives related to the Plan Recruited by pledge cards distributed at meetings and available online Recruited by pledge cards distributed at meetings and available online

Partners of the Plan Membership Members Represent more than 250 organizations in 31 counties, including: Local & state health departments Local & state health departments Healthcare organizations Healthcare organizations Schools & universities Schools & universities Businesses Businesses Community groups, nonprofit organizations & coalitions Community groups, nonprofit organizations & coalitions Government agencies Government agencies Tribal organizations Tribal organizations

Partners in Action Web Site

 Communicate about needs identified by Partners  Inform about policy and environmental changes supporting the Plan  Highlight activities, programs, events and resources Quarterly E-newsletter

What We’ve Learned: Annual Survey of Partners

What We’ve Learned: In Key Informant Interviews with Partners (2007, n=17) they described: Using the Plan to establish priorities and select activities Using the Plan to establish priorities and select activities Positive experiences associated with the Plan Positive experiences associated with the Plan  New partnerships – “something that we need to celebrate!”  Plan puts everyone “on the same page”  Plan lends legitimacy and a “selling point” for local efforts

What We’ve Learned: Key Informant Interviews with Partners (2007, n=17) Partners described: Common barriers and challenges Common barriers and challenges  Funding, time, resources  Involving necessary partners and working with non-traditional partners  Learning curve associated with policy and environmental approaches. – “People still want to focus on the individual.”

What We’ve Learned: Partners Evaluation (2010, n=113) Key Findings: Plan-related activities are being implemented statewide. Plan-related activities are being implemented statewide. Funding, tools, materials and resources, and decision maker buy-in are the top three things respondents reported needing to be able to implement new and existing policy and environmental initiatives related to nutrition and physical activity. Funding, tools, materials and resources, and decision maker buy-in are the top three things respondents reported needing to be able to implement new and existing policy and environmental initiatives related to nutrition and physical activity. Initiatives are being sustained through creative funding sources, fostering partnerships, sharing resources, and building community support. Initiatives are being sustained through creative funding sources, fostering partnerships, sharing resources, and building community support.

What We’ve Learned: Partners Evaluation (2010, n=113) Key Findings: Respondents identified many of the current activities of Partners, including providing relevant resources, tools and funding opportunities, and sharing success stories from across the state, to be helpful. Respondents identified many of the current activities of Partners, including providing relevant resources, tools and funding opportunities, and sharing success stories from across the state, to be helpful. The interviews and surveys served a dual role of promoting the Plan and Partners. The interviews and surveys served a dual role of promoting the Plan and Partners. More work needs to be done to tell Washingtonians engaged in physical activity and nutrition work about the Plan and Partners. More work needs to be done to tell Washingtonians engaged in physical activity and nutrition work about the Plan and Partners.