Collective Impact for Neighborhood and County Health (CINCH) 1

Goal Create a healthier community by achieving positive changes in:  nutrition/weight  physical activity  tobacco use  the built environment  access to clinical preventive services (such as blood pressure screening) Improve health and wellness of county residents through policy, environmental, programmatic, and infrastructure changes 2

How? Reduction in deaths and illnesses from heart disease, diabetes, cancer, and asthma through policies that increase opportunities for:  physical activity and healthy eating  healthy neighborhoods  environments free of tobacco smoke Participatory Planning Approach  Leadership, advisory teams and community input Research  Policy Scan, Health Assessment, qualitative data gathering 3

Health Assessment Key Findings Hispanics in Bernalillo County:  Have disproportionately high rates of death from Heart disease (men) Stroke (men and women) High blood pressure  Have high rates of obesity  High rates of poverty – 21.2%  High rates of smoking among high school students

African Americans in Bernalillo County:  Have disproportionately high rates of death from Lung cancer Heart disease Stroke  See higher rates of obesity than any other population group  Are most likely to encounter financial barriers to obtaining health care Health Assessment Key Findings

American Indians in Bernalillo County:  Have disproportionately high rates of death from Cancer Diabetes  See higher rates of overweight than any other population group  Are most likely to have no health insurance than any other group  Have highest rates of smoking among high school students and adults

Areas with highest concentration of families living in poverty have the highest rates of chronic disease

CINCH Community Engagement  Focus group-style community meetings  Six communities identified in health assessment  Geographic – International District, South Valley, I-25 Corridor  Racial/Ethnic – African American, Native American, Hispanic  Two-hour meetings in community settings (schools, community centers, etc.)

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CINCH Community Engagement Key informant interviews  Fill in the gaps from community meetings Who was not represented?  Community health workers, youth advocates, community center leaders

CINCH Community Engagement Key findings - Healthy eating  Need increased access to affordable, quality fresh food  Need education about healthy food preparation  Wanted more fresh food in schools and at summer programs  Low price and easy access to fast food makes it difficult to eat well when time and money are constraints

CINCH Community Engagement Key findings – Active Living  South Valley – need for safer streets and sidewalks  International District – concerns about crime  Supported increased access to school yards after hours  Expressed need for increased use of community centers for recreation opportunities

CINCH Community Engagement Key findings - Tobacco  Difficult for smokers to quit – become defensive when regulations are proposed  Enforcement is lacking – smoking in public places as well as sales of tobacco to minors  Need to deal with larger issues of why people are smoking – stress, poverty  Living in a smoke-free environment is important, especially for children

CINCH Community Engagement Key findings – Clinical Preventive Services  Hesitation to go for screening because costs are often unclear  Need more providers similar to the race and ethnicity of the communities they serve  Would like to see community health workers in non- clinical settings Schools, community centers  Need to make people aware of free clinics and screening services

Policy Change Written policies at the state, local, and institutional level (schools, workplaces) Includes legislative, regulatory, and organizational policies that promote population health Focus on prevention of heart disease, cancer, stroke, and diabetes 15

Examples of Effective Policies Tobacco-free school policies Policies that increase opportunities for physical activity in communities (e.g., joint use) Policies that support breast-feeding Mixed-use zoning policies Complete Streets policies Training and technical assistance to improve delivery of clinical preventive services 16

The Community Transformation Implementation Plan CINCH’s two-year long planning process informed the development of a three-year implementation plan for Bernalillo County that focuses on prevention of chronic disease. The CINCH Planning Team met for six months to review results of the Health Assessment, Policy Scan, and focus groups, and to prioritize implementation activities. 17

The Community Transformation Implementation Plan Policy, environmental, programmatic, and infrastructure changes consistent with CDC’s strategic directions Implementation activities must impact the entire population of Bernalillo County, as well as specific population subgroups with disproportionately high rates of health and social disparities 18

The Community Transformation Implementation Plan Submitted to CDC for consideration in May 2013 Implementation project period: October 1, 2013 – September 30, 2016 If funded, activities will be carried out through contracts with community partners Seven objectives, each with an overarching goal and specific activities to accomplish the goal 19

The Community Transformation Implementation Plan Active Living Project Goal: Increase the number of schools that are authorized to provide safe, inviting, accessible places for physical activity opportunities during non-school hours Objectives: 1.Increase the number of district-wide joint use agreements that facilitate the shared use of school property for physical activity purposes 2.Increase the number of schools that employ joint-use and shared-use practices 20

The Community Transformation Implementation Plan Healthy Eating Project Goal: Increase the number of people in lower-income neighborhoods who have access to healthy, affordable food Objectives: 1.Increase the number of people served by mobile produce vending programs that link consumers with fresh, locally grown fruits and vegetables 2.Increase the number of people served by healthy corner stores initiatives that facilitate access to fresh fruits and vegetables 3.increase the number of students served by initiatives that provide schools with locally grown fruits and vegetables 21

The Community Transformation Implementation Plan Tobacco-Free Living Project Goal: Increase the number of people living in smoke-free multi-unit housing in Bernalillo County's International District Objectives: 1.Increase the number of property owners/managers who receive education, training, and outreach related to smoke-free housing 2.Increase the number of people exposed to smoke-free multi-unit housing messages 3.Increase the number of tenants receiving education and outreach related to smoke-free multi-unit housing in the International District 22

The Community Transformation Implementation Plan Tobacco-Free Living Project Objective: Decrease the number of middle and high school students in priority neighborhoods with access to tobacco products Goals: 1.Increase the number of community-based youth tobacco compliance task forces 2.Increase the number of tobacco merchants in priority neighborhoods receiving education about tobacco sales to minors 3.Increase the number of community members in priority neighborhoods receiving education about enforcement and reporting of tobacco sales to minors 23

The Community Transformation Implementation Plan Healthy and Safe Physical Environments Project Objective: Increase the number of adopted land use/transportation plans, policies, or funded projects that incorporate Complete Streets design principles Goals: 1.Increase the number of transportation engineers, planners, and other stakeholders in Bernalillo County that are familiar with Complete Streets principles and proficient in applying Complete Streets design standards 2.Increase the number of adopted land use/transportation plans, policies, or funded projects that incorporate Complete Streets design principles 24

The Community Transformation Implementation Plan Clinical Preventive Services Project Objective: Increase the number of people who receive health education and preventive services from community health workers who are representative of the target populations Goals: 1.Increase the number of community health worker programs that have sustainable funding sources 2.Increase the number of Bernalillo County-based community health workers participating in a formal learning collaborative 3.Increase the number of certification programs that incorporate community health worker core competency curriculum modules that focus on chronic disease, social determinants of health, and CTG strategies 4.Increase the number of community health workers placed in community settings 25

Thank you! Questions?