building healthier communities: how schools play a role · rachelle bartnick sr. director,...

RACHELLE BARTNICKSR. DIRECTOR, COMMUNITY HEALTH – AMERICAN HEART ASSOCIATION

ST. LOUIS HEALTH STRATEGIES TEAM

Building Healthier

Communities: How

Schools Play a Role

Buildinga culture of

Health

2

Accelerate the discovery, interpretation, and

application of scientific knowledge to enhance

cardiovascular health and treat cardiovascular

diseases and stroke.

Engage individuals and organizations to build a

sustainable culture of health in communities so that

all Americans live in environments that support

healthy behaviors, timely and quality care, and well-

being.

Impact

Strategy


Health

3

AHA

Mission:Building healthier lives,

free of cardiovascular

diseases and stroke


Health

4


Health

5

• Improving and Extending People’s Lives

• Bringing Science to Life

• Speaking with a Trustworthy Voice

• Building Powerful Partnerships

• Inspiring Passionate Commitment

• Meeting People Where They Are

• Making an Extraordinary Impact

• Ensuring Equitable Health for All

Our Guiding Values….Our Promise


Health

6

Health Impact

Policy Change Systems ChangeConversation

Change

Positioning RevenueEngagement

STRATEGY MAP

Build a culture of health where the healthy choice is the default choice

Accelerating

Science

GU

IDIN

G V

ALU

ES

2020 Impact Goal

By 2020, to improve the

cardiovascular health of

all Americans by 20%

while reducing deaths from

cardiovascular diseases

and stroke by 20%

Not Smoking

Physical Activity

Healthy Diet

Healthy Weight

High Blood Pressure

Blood Cholesterol

Blood Glucose

“Life’s Simple 7”

http://www.iconfinder.com/icondetails/65067/128/130_icon


http://www.iconarchive.com/show/medico-icons-by-banzaitokyo/blood-icon.html


POOR INTERMEDIATE IDEAL

Smoking StatusAdults >20 years of age

Children (12–19)

Current Smoker

Tried prior 30 days

Former ≤ 12 mos Never /quit ≥ 12 mos

Physical ActivityAdults > 20 years of age

Children 12-19 years of age

None

None

1-149 min/wk mod or

1-74 min/wk vig

or 1-149 min/wk mod + vig

>0 and <60 min of mod or vig every day

150+ min/wk mod or 75+ min/wk

vig or 150+ min/wk mod + vig

60+ min of mod or vig every day

Healthy DietAdults >20 years of age


0-1 components

0-1 components

2-3 components

2-3 components4-5 components

4-5 components

Healthy Weight Adults > 20 years of age


≥30 kg/m2

>95th percentile

25-29.9 kg/m2

85th-95th percentile<25 kg/m2

<85th percentile

Blood GlucoseAdults >20 years of age


126 mg/dL or more

126 mg/dL or more

100-125 mg/dL or treated to goal

100-125 mg/dL

Less than 100 mg/dL

Less than 100 mg/dL

CholesterolAdults >20 years of age


≥240 mg/dL

≥200 mg/dL

200-239 mg/dL or treated to goal

170-199 mg/dL

<170 mg/dL

Blood PressureAdults >20 years of age


SBP ≥140 or DBP ≥90 mm Hg

>95th percentile

SBP120-139 or DBP 80-89 mm Hg or

treated to goal

90th-95th percentile or SBP ≥120 or DBP

≥80 mm Hg

<120/<80 mm Hg

<90th percentile

CARDIOVASCULAR HEALTH DEFINTION: 8

NHANES 2011-2012

27 M 5 M 42 M 38 M 13.4 M 13.6 M 3 M

Scenarios to reach 2020

Adults to move

up one level:

9

2035

44

78

12 14 9

2

34 12

21

41 4335

78

3144

0

47 4257

0

20

40

60

80

100

Smoking BMI Physical

Activity

Healthy Diet

Score*

Cholesterol Blood

Pressure

Glucose

Pe

rce

nt

of

Po

pu

latio

n -

Ad

ults

Poor Intermediate Ideal

Simple 7: Prevalence in US Adults &

Scenarios for 20% Improvement





1321

7

92

7 2 0

1457

8

1816 14

87

65

37

76 82 85

0

20

40

60

80

100

Smoking BMI Physical

Activity

Healthy Diet

Score*

Cholesterol Blood

Pressure

Glucose

Pe

rce

nt

of P

op

ula

tio

n -

Ch

ild

ren

Poor Intermediate Ideal10

Simple 7: Prevalence in US Children &

Scenarios for 20% Improvement

NHANES 2011-2012

6-16 M 3.5 M 11.7 M 1-10 M 0.4-8 M 6 M

Scenarios

to reach 2020

Kids to move

up one level:

2 M





Progress to CV Health Goal

NHANES 2011-2012 compared to 2007-2008

Overall Total Population Improvement: 3.5%

1 Worsening in “poor” but improving in “ideal”. Overall average decreased.2 Change is small: ~1-3%

Smoking – Kids & Adults

Phys Act – Kids2 & Adults

Glucose – Kids

HBP – Kids

Cholesterol-Adults

Healthy Diet – Adults2

IMPROVING

BMI – Kids1 & Adults2

Cholesterol – Kids

HBP – Adults1,2

Glucose – Adults1

WORSENING

NO CHANGE

Healthy Diet –

Kids

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Percent of Children with Ideal Healthy Diet Metrics

Source: NHANES 2007-2008; Age 12-19

5%

56%

9%

3%

32%

0%

9%

8%

0% 10% 20% 30% 40% 50% 60%

Saturated fat <7% of total…

Processed meats ≤2 …

Nuts, legumes, seeds ≥4 …

Whole grains

Sugar-sweetened beverages …

Sodium < 1500 mg/day

Fish ≥2 3.5 oz serving/wk

Fruits & Vegetables ≥4.5 cups …

Sim

ple

7 H

ea

lth

y D

iet

Sc

ore

Oth

er

Die

t M

ea

sure

s

92% of children in the US do not consume the recommended amount of fruits and vegetables per day

Only 30% of kids attend gym class

daily

Only 40% have access to a

community playground

78% of teens have a cell phone

24% percent of high school

students vape

60 texts per day average

95% are now online12

Trends in Kid’s Heart Health


Health

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What is a “Culture of Health”


Health

Global & Federal Policy and Industry

State Policy and Industry

CommunityWork, Faith-based,

Neighborhood

Family, Friends, Social Networks

Individual

15

Culture of Health: Socio-ecological Model

15


Health

16

Imagine if …

Volunteer

Engagement(You – School Nurses!)

Strategic

Partnerships

(Your Schools!)

Impacting the

Health of

Millions of People

HEALTHY LIVINGHealthy Diet

Secondary Prevention

Decrease Sugar-Sweetened Beverage Consumption

Increase Fruit/Veggie Consumption

Reduce Sodium Consumption

Reduce Tobacco

Usage

Increase Physical Activity

Increase Control of HBP & Other Health

Factors

HIGH BLOOD PRESSURE

STROKE& ACUTE CV EVENTS

Improve Acute

Systems of Care

+ Social Determinants

2020 IMPACT GOALBy 2020, to improve the cardiovascular health of all Americans by 20%

while reducing deaths from cardiovascular diseases and stroke by 20%

PATIENTS

WOMEN

MULTI-

CULTURAL

HEALTH IMPACT PRIORITIES, MARKETS, & CHANNELS

KIDS

SCHOOL

-SITE

FAITH-

BASEDHEALTH-

CARE

WORK-

SITE

17



Healthy Living – Student Health18

Early WINS:

• Advocate for healthier environments

• Healthy Diets

o Healthy, Hunger-Free Kids Act - Fight to preserve the

30M kids eating healthier in schools

o Food System - Work with Aramark and others to lower

sodium, saturated fat, calories by 20% and increasing

fruits and vegetables, and whole grains by 20% by 2020

o Part of a larger strategy to influence industry to improve

food quality including reducing sodium in the top 50

foods.

Build Healthier Environments & Impact Social Norms

Healthy Living – Student Health19

How can we partner to improve health?

• Use AHA tools and consultation to improve the food in the

lunchroom.

• Join us in our assessment of current policies for a healthy food

environment beyond the lunchroom.

Smart Snacks

Food fundraising

Healthy incentives – added recess vs. pizza party

• Join the AHA to create Heart Healthy Food and Beverage

standards for your school.


The American Heart Association is working to

improve the health of children in your community.

Jump Rope For Heart: This program helps millions of Elementary School students across the country learn about the importance of heart-health,

community service and raising dollars to support lifesaving research. JRFH

teaches jump-rope skills and is a fun way to meet physical education

standards within your jump rope unit. Free jump ropes in every kit.

Hoops For Heart: This program helps Middle School students learn about the importance of heart-health, community service and raising dollars to

support lifesaving research. Students learn basketball skills and how their

heart works. Free basketball in every kit.

HeartChase for High Schools: HeartChase is an American HeartAssociation community service game that teaches students that

developing heart-healthy habits is important, being physically active can

be fun, and raising funds for cardiovascular research and education helps

save lives in their community and across the country.


Health

Our Jump/Hoops

educational resources

include PE Games,

newsletters, posters

and classroom lesson

plans.

These resources are

related to:

• Physical Activity

• Healthy Eating

• Reducing Sodium

• Avoiding Tobacco

• Reducing Sugary

Drinks

Educating Kids About Heart Health

Healthy Living – Growing Lifesavers22


How can we partner to grow lifesavers?

Become an early adopter of the new CPR in Schools Law

(required 2017 school year)

23

Healthy Living – Employee Health


Workplace Health SolutionsContinuous Quality Improvement for Workplace Health

Healthy Living – Employee Health24

Employees Overestimate Their Health

Most employees report being in very good or good health

Of the 74% who say they are in very good or good health 42% have been diagnosed with a chronic illness.

Overall Health Few Know Their Numbers

Leadership Makes A Difference

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57% 71% Overall Among Those

EncouragedSay being in a healthy environment is extremely or very influential

27% 52% Overall Among Those

EncouragedSay employers are extremely or very concerned about the health of employees

Employee Engagement is Vital

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Impact of Participation

Those encouraged by leadership are nearly twice as likely to report improved health.

Impact on Health(a great deal/a fair amount)

Health Outcomes

Lifetime CVD Risk at Age 50

27

Source: Lloyd-Jones et al. Circulation. 2006;131:791-798

Poor CVH Predicts Higher Direct Medical Costs28

People (with and without CVD) with a Poor CVH risk profile incur 2x in direct medical costs

Data: 2012 MEPS

Source: Valero-Elizonda et al. Circ Cardiovasc Qual. 2016:9;:143-153

AHA Workplace Health – Streamlined Logic Model

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ACTIVITIES

CEORT meetings & actions

Provide MLC™ to employees

Advocate for adoption of LS7

metrics

Agree standard workplace health

metrics

Launch Playbook (best practices

resource)

Implement AHA National

Recognition Program (Index)

Measure disparities & develop

targeted health equity plans

Provide technical assistance

Form new community partnerships

OUTPUTS

Improvements in:

Leadership support for workplace health

Employees with complete LS7 data

Use of standard metrics

Adoption of CWWPs

Participation in AHA’s recognition program

Workplace health program quality

Adoption of best practices

Health equity

Community partnerships

OUTCOMESLong-term (Impact):

1. Optimal Cardiovascular Health

2. Increased Productivity & Engagement

3. Reduced Healthcare Costs

Short-term & Intermediate:

Improvements in:

Workplace culture of health

Employee & company LS7 scores

LS7 knowledge, attitudes & self-efficacy

Health behaviors (smoking, diet & PA)

Health equity

Workplace-community linkages

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Leadership(7%)

Policies &

Environment(21%)

Communications(6%)

Progra

ms(12%)

Engageme

nt(6%)

Partnership

s(2%)

Reporting

Outcomes(6%)

Structure & Process Measures

Performance Measures (Life’s Simple 7)

Diet

Qualit

y

Body

Mass

Index

Physical

Activity

Level

Smokin

g

Status

Fasting

Blood

Sugar

Blood

PressureBlood

Cholester

ol

31

• Online risk assessment and health

promotion tool

• Provides a composite score out

of 10 points based on LS7

• Aggregate MLC score was 7.3†

• Preliminary data showed that

using the tool improved

knowledge of CVH risk factors and positive attitudes to

behavior change

• More rigorous evaluation is

required

†Preliminary finding, since samples were not representative of each participating company

The Result: Continuous Quality Improvement for Workplace Health

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Assess Culture of Health

Status

GuidanceUsing AHA Resources

Implement, Improve and

Re-assess

Recognize and Award

Achievement

Data Insights Based on Health

Analytics

AHA Workplace Health

Achievement

I N D E X

POINT OF ENTRY

Healthy Living: Employee & Family Health33

High Blood Pressure Control

Hypertension Control through Communities

• Partner with Large Employers and School Districts to offer individuals

living with HBP evidence-based support to manage their condition.

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Poverty, education, housing, inequality

Social Determinants of Health

Community Policies, Systems,

and Environments

Organizational

Policies & Culture

Social Norms

(Demand)

Individual

Knowledge

& Skills

Building a

Culture of Health:

WorksiteHealthcare System

Schools / Early Childcare

Faith-based

Education | Economic Stability | Housing | Healthcare | Social Context

Active DesignHealthy Food

Access

Access to Quality Systems of Care

Tobacco-Free

In Communities

35


Health

37

One

Goal

Imagine if ….

American Heart

Association is your

partner in creating a

culture of health

building healthier communities: how schools play a role · rachelle bartnick sr. director,...

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