1. How nature can Improve Health
Bobby
Bobby Cochran, Willamette Partnership
Emily Henke, Oregon Public Health Institute
Cameron Brown, Willamette Partnership

2. Did you know? Your zip code determines 90% of your health?
In South Seattle zip code, life expectancy is 8 years less than in other parts of the city
If you are American Indian, African American, Latino, or live anywhere in rural Oregon—you are likely to experience much greater chronic disease
Bobby
What questions need answering?
Tell us what you want to know
What metrics are meaningful?
How much certainty do you really need?

3. Factors that Affect Health
Largest
Impact
Smallest
Examples
Advice to eat healthy, be physically active
Counseling
& Education
Rx, i.e., for blood pressure, cholesterol, diabetes
Clinical
Interventions
Immunizations, smoking cessation, colonoscopy
Long-lasting Protective Interventions
Emily
What do we mean by health?
WHO definition of health: "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity."
Fluoridation, 0g trans fat, smoke-free spaces, what is in vending machines
Changing the Context
to make individuals’ default
decisions healthy
Poverty, education, racism, inequality
Socioeconomic Factors
Presentation to Oregon Future of PH Task Force, Jan 21, 2014 3

4. Emily
Infant mortality – Healthy Birth Initiative
Baker - Oregon Health Authority (OHA). (n.d.). [Table]. Age-adjusted and unadjusted prevalence of modifiable risk among adults, by county, Oregon Retrieved from
Asthma and diabetes:

6. Emily
Equity is just inclusion in a society in which a broad range of resources and opportunities are provided for all to participate and flourish. The goals of equity are to create conditions that allow all to reach their full potential, eliminating inequities on the basis of race, income, ability, geography, age, gender, immigration status, and sexual orientation, among others.2
Equity is distinct from equality.
Like you see on the left side of this picture, equality provides each person or community with the same amount and type of resources, regardless of where they’re starting from. In the picture, each of the people on the left gets the same number of boxes, but ultimately that doesn’t allow everyone to reach the apple.
Equity is represented on the other side of the picture, and here we see that the three people are given different numbers of boxes—the number they need to all reach the apples. An equity lens recognizes that each person or community doesn’t start at the same place and may need different types or amounts of resources to achieve similar outcomes. Some communities need more resources to experience the same outcomes as communities that have historically had access to more resources and opportunities.
Equity requires that all people and communities have the conditions they need to achieve their full potential. Issues of equity differ among communities. Each community must carefully consider the relevant issues, and ensure that representatives and leadership of the populations most vulnerable to those issues are prominently engaged in decision-making processes so that their experiences and aspirations influence the outcomes.

7. We can make the link between health and outdoors explicit
Planting trees strengthens social cohesion
Closer, safer, cleaner greenspace increases physical activity
Bobby
…But we know there are inequities in both health and access to the outdoors
Progress will depend on working partnerships between champions for health and champions for the outdoors
Time outdoors improves mental health
Trees
clean air

8. Still a lot we don’t know Research priorities
Bobby
What questions need answering?
Tell us what you want to know
What metrics are meaningful?
How much certainty do you really need?
Which mechanisms create health from time in nature?
How much is enough? How often?
How do I react differently from being outdoors than you?
Are there best practices for programs?
From:

9. Linking your work to Community health needs
Community Health Needs Assessments
Community healthworkers
Regional health equity coalitions
Hospital & CCO community benefit spending
Bobby

10. Poll: Are you already working with health providers?
Yes No
Bobby

11. Cameron

12. Common Health Priorities
Hospitals (n=55)
Counties + CCOs (n=52)
Health Priority Area
Frequency of Prioritization
% of Hospitals w/ Priority
Mental Health 36
65%
Chronic Conditions 33
60%
Physical Activity 24
44%
Obesity 16
29%
Child/Maternal Health 9
16%
Cameron
All CHNA’s in Oregon
Health Priority Area
Frequency of Prioritization
% of Counties w/ Priority
Mental Health 27
52%
Obesity 23
42%
Chronic Conditions 19
37%
Maternal/Child Health 13
25%
Physical Activity 11
22%

13. Community Benefit Spending
Coast
$93 million
($2 million)
Willamette
$1.5 Billion
($41 million)
Eastern
$172 million
($4.6 million)
Cameron
Southern
$207 million
($4.7 million)

14. Culturally relevant programs Supporting Strategies Policy options
The Oregon Health and Outdoors
Action Framework
Bobby
Community Strategies
More parks
Better access
Culturally relevant programs
Supporting Strategies
Policy options
Research
Communication tools
GET FRAMEWORK

15. Making this Happen LatinXplorers
Led by community health workers
Responsive to community need
Measurement of health outcomes
Funded by hospital and business
Bobby

16. Making this Happen LatinXplorers Hike It Baby: Baker Adaptive Sports: Portland Black Parent Initiative
Bobby

17. HEAL Cities Research Agenda Outdoor Ed. Guideline
Making this Happen
HEAL Cities Research Agenda Outdoor Ed. Guideline
Bobby
$12.8 billion in consumer spending on outdoor recreation in OR
141,000 direct jobs—all over OR
68% of Oregonians participate in outdoor recreation
Growth = lifestyle, not niche

18. You can do to advance health through time in nature
Five Things
You can do to advance health through time in nature
Take a community healthworker, hospital administrator, or favorite doctor out for coffee or a walk on one of your projects to talk health
Before you ask for healthcare $, get serious about health equity
Build Health and Outdoors in all programs and policy
Cross-sector collaboration is doable and brings more opportunities to building community health
Give us more good examples we can point to
Bobby

19. What should we do together?
Poll
What should we do together?
Give me a call, let's figure that out together
b. Help me measure the health benefits of my work
c. Connect me to the local hospital and community healthworkers
d. Give me best practices for improving health through my work
GET IN TOUCH:
Bobby