A New View of Health Robert K. Ross, M.D. Februar ebruary y 5, - - PowerPoint PPT Presentation

A New View of Health

Robert K. Ross, M.D.

Februar ebruary y 5, 2018 18

80%

• f what influences your life

expectancy happens outside

• f the healthcare system

10 - YEAR INITIATIVE

LOCAL LEVEL

Investing in 14 communities to build local leadership, partnership, and power

14 PLACES STATEWIDE

Fostering deeply engaged communities that are able to sustain long-term efforts to change policies and systems Making sure that public spending, systems, and policies are equitable and have the well- being of everyone in mind

SCHOOLS NEIGHBORHOODS

PREVENTION

Building Healthy Communities Theory y of Change ge

Time [yea ears] s] Driver ers of Change nge 3 Campaign aigns

[Trans nsform

• rmati

ative e 12] Healthy y People 2020 SDOH Objecti tives es

North th Star r Goals & I & Indicat dicator

• rs

North Star Goals Ecosystem

Goal al 4 Health thy y Neighbo ighborho hood

• d Land

nd Use/P e/Plann anning ing Youn ung People le In Margina inaliz lized d Communit mmunities ies Goal 2 Access essible, ible, Preven entiv tive He Health th Syst stem Goal al 3 Health thy/Su y/Suppor porti tive Schoo hool En Environme nment nt People le Power er – Voice ce – Civic ic En Engageme gement nt Goal 1

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,

• n, 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

• ol Clim

imat ate e Ref eforms:

• rms: 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

• n-Orien

Oriented d Just stic ice e Reform:

• rm: Prop

p 47 moves es $$ towar ards ds Preven enti tion

• n

BH BHC Impa pact ct to Da Date e (2010-20 2018) 8)

>500 500 Local al Wi Wins ns A Across

• ss 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

• nged

ed Evaluati uation

• n & L

& Lea earnin ing Ap g Appr proac

• ach;

h; “Place & Statewide”

• Util

iliz izin ing g Multip iple le Evaluator

• rs (USC, Harde

der & C & Co., Julia ia Coffma fman, , Pru Brown)

• Quantit

itati tive e and Q d Qualit itati tive, e, Strong

• ng Commun

munit ity y Fee eedb dback k Loop

• The 4

e 4 North th Star Goals and a d accom

• mpa

panyin ing g 10 Indi dicator

• rs:

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

• ns engaged

aged/f /forme

• rmed
• Vot
• ter 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

• nic

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

pr preven 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

• m

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

• n

Things ngs We Got e Got Wrong ng

• We Over-Cook

Cooked ed the Dish h with h Outcomes

• mes & Logic

ic Models ls Too Soon

• n
• 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

• n

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
• bjec

ect

• Even

n 10 years s is probab ably ly not enough gh

• Mus

ust t be be comfor

• rtable

table with h race and nd just ustic ice e lens ns

SCHOOLS NEIGHBORHOODS

PREVENTION

Low-res