A New View of Health Robert K. Ross, M.D. Februar ebruary y 5, 2018 18
80 % of what influences your life expectancy happens outside of the healthcare system Source: David Satcher, former Surgeon General of the United States, The Public Health Approach to Eliminating Disparities in Health
10 - YEAR INITIATIVE 14 PLACES LOCAL LEVEL STATEWIDE Investing in 14 communities Fostering deeply engaged Making sure that public to build local leadership, communities that are able to spending, systems, and policies partnership, and power sustain long-term efforts are equitable and have the well- to change policies and systems being of everyone in mind
PREVENTION SCHOOLS NEIGHBORHOODS
Building Healthy Communities Theory y of Change ge Time [yea ears] s] 3 Campaign aigns Healthy y People 2020 Driver ers of SDOH Objecti tives es [Trans nsform ormati ative e 12] Change nge North th Star r Goals & I & Indicat dicator ors
North Star Goals Ecosystem Goal al 4 Health thy y Neighbo ighborho hood od Land nd Use/P e/Plann anning ing Youn ung People le In Margina inaliz lized d Communit mmunities ies Goal 2 Goal al 3 Access essible, ible, Preven entiv tive Health thy/Su y/Suppor porti tive Health He th Syst stem Schoo hool En Environme nment nt Goal 1 People le Power er – Voice ce – Civic ic En Engageme gement nt
BH BHC Impa pact ct to Da Date e (2010-20 2018) 8) Sup uppo porti tive e Force ce in in ACA Impl plemen ementa tati tion, on, Med edic icai aid d Expa pans nsio ion n an and E d Enr nrollment lment (Un Uninsured insured rate e cut by more re than n 50%)
BH BHC Impa pact ct to Da Date e (2010-20 2018) 8) #Health4All Campaign: New Health Coverage for “Dreamers ”
BH BHC Impa pact ct to Da Date e (2010-20 2018) 8) Hea ealthie hier r School ool Clim imat ate e Ref eforms: orms: School hool Sus uspe pens nsion ions Down n by >40% 0%
BH BHC Impa pact ct to Da Date e (2010-20 2018) 8) Health/ alth/Pre reven enti tion on-Orien Oriented d Just stic ice e Reform: orm: Prop p 47 moves es $$ towar ards ds Preven enti tion on
BH BHC Impa pact ct to Da Date e (2010-20 2018) 8) >500 500 Local al Wi Wins ns A Across oss the e BHC Sit ites es!
BH BHC Impa pact ct to Da Date e (2010-20 2018) 8) A New Narrati tive e of Hea ealth h Preven ention ion is is E Emer ergin ging
EV EVAL ALUATIO TION N & ME & METRI TRICS CS (It’s Complicated…) • Multi-Pr Prong onged ed Evaluati uation on & L & Lea earnin ing Ap g Appr proac oach; h; “Place & Statewide” • Util iliz izin ing g Multip iple le Evaluator ors (USC, Harde der & C & Co., Julia ia Coffma fman, , Pru Brown) • Quantit itati tive e and Q d Qualit itati tive, e, Strong ong Commun munit ity y Fee eedb dback k Loop • The 4 e 4 North th Star Goals and a d accom ompa panyin ing g 10 0 Indi dicator ors: s: Revi viewed ed Annually ly
Stu tuff f We Me Meas asure ure & T Track ack GOAL 1: • #’s of engaged residents and youth in sites # of colla labora borati tions ons engaged aged/f /forme ormed • • Vot oter tur urno nout ut • Polling ing on attitu tudes des Medi dia mention ntions/ s/so soci cial al media dia reach ch •
Stu tuff f We Me Meas asure ure & T Track ack GOAL 2: • ACA/Me Medi di-Ca Cal l en enrollmen lment-co cover erage ge • Hea ealth h in inter ervie iew sur urvey y da data • # of loca cal l counti unties es pr provid idin ing g care e to un undo documen cumented ed
Stu tuff f We Me Meas asure ure & T Track ack GOAL 3: • Per erce ceptions ptions of saf afety ety in schools chools • Suspension pension rat ates/ch /chronic onic ab absen enteeism/rest eeism/restorativ ative e justice tice growth wth
Stu tuff f We Me Meas asure ure & T Track ack GOAL 4: • Land use & Planning “wins” (for preven pr ention ion) • Fun undi ding ng for r pa park rks sid idewal alks, s, tran ansit it, water er station ions • Dolla lars s bei eing ng shif ifted ed from om pu punis ishme ment t to pr preven ention ion/Pr Prop p 47
Things ings We Did Right ht • Putt tting ing Community mmunity & Leader ers s at the Cent nter; er; the Power r of Place • Syst stem ems s & P & Polic icy y Chang nge • Being ng Pa Pati tien ent, t, Agile le and Flexible; xible; Mistak takes es = Learn rning ing • Embrac bracing ing A Racial al Justice tice – Social Social Justi tice ce Orientati ientation on
Things ngs We Got e Got Wrong ng • We Over-Cook Cooked ed the Dish h with h Outcomes omes & Logic ic Models ls Too Soon on • We Had a “Super Hub” Fantasy in the Sites – Had d to ditc tch it • We Und Underesti erestimat mated ed Anger er & Distr trust ust at the Commun mmunity ity Level • We Und Underesti erestimat mated ed the Roles les of Trauma auma-Op Oppres pression sion-Disc Discri riminati mination on
Implications lications for th the e Socia cial l Det eterm erminant inants s Work • Think nk about t Power, , Voice, e, Plac ace e and Narrat rative • People ple Power r & Voice e is the path h to scale: e: Science ence NEEDS EDS Power er • Community as an “action verb,” not a direct objec ect • Even n 10 years s is probab ably ly not enough gh • Mus ust t be be comfor ortable table with h race and nd just ustic ice e lens ns
PREVENTION SCHOOLS NEIGHBORHOODS
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