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Antelope Valley Partners for Health Fall Wellness Summit

October 29, 2015

Photo by Rudy Espinoza

Prevention Institute

A Coordinated, Community Approach to Advancing Health, Safety, and Equity

Photo by Rudy Espinoza

Photo from glenarborsun.com

Manal Aboelata, MPH Managing Director

Maureen Silva, MPHProgram Coordinator

Julie Leung, MURP, MPHProgram Coordinator

Deepen understanding of a prevention-based community health approach to health inequities

Demonstrate knowledge of successful examples – locally and nationally – that connect community efforts to changing environments, policy, and practices

Increase capacity to prioritize community level factors that are linked to chronic disease in the Antelope Valley

Keynote Objectives

a systematic process that reduces the frequency and/or severity of illness or injury.

Promotes healthy environments and behaviors to prevent problems from occurring before the onset of symptoms

HEALTH & SAFETYBEHAVIORBEHAVIOR

ENVIRONMENT

What’s Health and Equity Got To Do

With It?

Photo Courtesy of Health and Human Services

Photo courtesy of http://spacedust.atspace.com/soccer_archery.html

Photo courtesy of Latino Health Access

It is unreasonable to expect that people will change their

behavior easily when so many forces in the social, cultural, and physical environment

conspire against such change.

“

”Institute of Medicine

Source: Institute of Medicine. (2000). Promoting health: Intervention strategies from social and behavioral research (B. D. Smedley & L. S. Syme, Eds.). Washington, DC: National Academies Press.

The health inequities we see…are not about just individual bad

choices:

Nancy Krieger, Harvard School of Public Health

“”they are about things not

being fair

Health Equity

“Health equity means that every person, regardless of who they are—the color of their skin, their level

of education, their gender or sexual identity, whether or not they have a disability, the job that they have, or the neighborhood that they live in—

has an equal opportunity to achieve optimal health.”

Source: Braveman PA, et al. Health disparities and health equity: The issue is justice. 2011.

Race/Ethnicity in California

Photo Source: Nationalequityatlas.org

Child Restraint and Safety Belt Use Smoking Prevention Bans on School Junk Food School-Based Wellness Policies for PA Childhood Immunizations Motorcycle and Bicycle Helmet Laws

Child Restraint & Safety Belt Use

Oh, Britney…

Smoking Prevention

Pharmacy Tobacco Ban

Social, Physical, Economic

Environment&Behaviors 70%

Medical Care, 10%

Genetics20%

$2.2 Trillion

Current Health Care Spending

Factors Influencing

Health

National Health

ExpendituresReferences: Bipartisan Policy Center. “Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future.” June 2012

Medical Care, 10%

Genetics20%

Prevention, 3%

Health Care Services

97%

$2.2 Trillion

Current Health Care Spending

Factors Influencing

Health

National Health

ExpendituresReferences: Bipartisan Policy Center. “Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future.” June 2012

Social, Physical, Economic

Environment&Behaviors 70%

Source: 2013 Community Health Needs Assessment Kaiser Permanente

1. Access to Primary Care

2. Obesity/Overweight for Adult and Youth

3. Mental Health

4. Dental Health Services

5. Uninsured Population

6. Physical Environment/Transportation

7. Poverty Rates

8. Diabetes

9. Prenatal Care

10. Breastfeeding

Source: 2013 Community Health Needs Assessment Kaiser Permanente

Community Health Needs Assessment Priorities

Take 2 Steps to Prevention

Health Care

Services

Exposures &

Behaviors

Environment

Source: http://www.schmidtlaw.com

The 1st step ...

Health Care

Services

Exposures &

Behaviors

Environment

Heart Disease

Cancer

Stroke

Type 2 Diabetes

Injuries & Violence

Diet & Activity Patterns

Tobacco

Alcohol & Drugs

Making Links to Exposures & Behaviors

SOURCE: McGinnis JM , Foege WH. Actual causes of death in the United States. Journal of the American Medical Association. 1993; 270: 2007-2013.

Let’s take another step ...

Health Care

Services

Exposures &

Behaviors

Environment

Parks & open space

Elements of Community HealthPLACE

THRIVETool for Health and Resilience In Vulnerable Environments

http://preventioninstitute.org/thrive/index.php

Social Networks & trust Participation & willingness

to act for the common good Norms & Culture

Living wages & local wealth

Education

What’s sold & how it’s promoted

Look, feel & safety Parks & open space Getting

around/Transportation

Housing Air, water, soil Arts & cultural

expression

Elements of Community Health

PEOPLE

PLACEEQUITABLE OPPORTUNITY

THRIVE Framework

Community Health Factors

PLACELook, feel & safety Parks & open spaceGetting

around/Transportation

HousingWhat’s sold and

how it’s promotedAir, water, soil Arts & cultural

expression

The physical environment in which people live, work, play, and go to school.

People

Place

EquitableOpportunity

Parks and Open Space Improving Opportunities for Walking and Jogging

Boyle Heights, CA

What’s Sold & How It’s PromotedHouston, TX

Salud America! Growing Healthy Change

Community Health Factors

EQUITABLEOPPORTUNITY

Living wages & local wealth

Education

People

Place

EquitableOpportunity

The level and equitable distribution of opportunity and resources.

Library Cards For AllSalinas, CA

Education

Community Health Factors

PEOPLE Social networks & trust Participation & willingness

to act for the common good

Norms & CultureThe relationships between people, the level of engagement, and norms, all of which influence health outcomes.

EquitableOpportunity

Place

People

Social Networks & TrustHealthy Hometown Restaurant Initiative

Louisville, KY

Source: A Practitioner's Guide for Advancing Health Equity: Community Strategies for Preventing Chronic Disease (CDC)

Participation & Willingness to Act for the Common Good

Source: Multnomah County Health Department

Multnomah County, OR

Norms & CultureTurlock School District, CA.

Eden Area Livability Initiative (EALI)

Designing Initiatives for Health Equity

Select, Design and Implement Health Equity Oriented Strategies

Assess Impacts of Potential Policies on Equity

Building Organizational Practices that Support Equity

Partner and Collaborate for Health Equity

Focus on Nontraditional Providers with high degree of contact with populations experiencing inequities

“Intellectuals solve problems.

Geniuses prevent them.”

Albert Einstein

@preventioninst

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Email: manal@preventioninstitute.org

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www.preventioninstitute.orgPhoto credit: Emily Barney

TOOLS

Collaborator 4Expertise:

DesiredOutcomes:

Key Strategies:

Collaborator 3Expertise:

DesiredOutcomes:

Key Strategies:

Collaborator 1Expertise:

DesiredOutcomes:

Key Strategies:

Collaborator 2Expertise:

DesiredOutcomes:

Key Strategies:

Shared Outcomes

Partner Strengths

Joint Strategies

Collaboration Multiplier

The Spectrum of Prevention

Source: National Academy of Sciences

Funded by: Robert Wood Johnson Foundation

Health Equity & Prevention Primer

Communities Taking Action

Developing Effective Coalitions: The 8-Step Process

1. Analyze program objectives, determine whether to form a coalition

2. Recruit the right people

3. Devise preliminary objectives and activities

4. Convene the coalition

5. Anticipate necessary resources

6. Develop a successful structure

7. Maintain coalition vitality

8. Improve through evaluation

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