Environmental Change Brenda Hughes, MPH Lowcountry Region - - PowerPoint PPT Presentation

Addressing Health Inequalities Using System & Environmental Change

Brenda Hughes, MPH Lowcountry Region Community Transformation Grant Coordinator SC DHEC

Overview

 Community Engagement  Systems and Environmental Change  Health Inequalities  Context  Systems and Environmental Change in Action  Lessons Learned

Why Community Engagement?

 Community members are the experts  Sense of ownership of problems and

solutions

 Empowerment  Enhanced sustainability

Community Engagement

 Dynamic relationships & dialogue  Mutual exchange of information, ideas,

resources between the community and public health experts

 Community includes individuals, groups,

• rganizations, associations, informal networks

who share common characteristics, interests, concerns

Source: Morgan, M., Lifshay, J. (2006) Community Engagement in Public Health, Contra Costa Health Services

Making the Case: Programs vs. System and Environmental Change

Programs



Usually one time, short- term interventions at the individual level



Short-term changes



May not be sustainable

System/Environment



Ongoing impact at the

• rganizational or

community level



Produce behavior change over time Sustainable

Health Inequalities

Differences in:



Environment



Access to, utilization of, and quality of care



Health Status



A particular health outcome deserving of scrutiny

Source: Pokras, O., Baquet, C. (2002). What is a health disparity. Public Health Reports, 117. 426-434.

Health disparities persist despite significant advances in science (i.e. behavioral science, medicine, genomics, etc).

Source: Mullan, I., Rhee, K., Stoff, D., Polhaus,H., Sy, Francisco., Stinson, N., Ruffin,J (2010), Moving Toward Paradigm-Shifting research in health disparities through translational, transformational and transdisciplinary approaches. American Journal of Public Health 500(1). 19-24.

Health Inequalities



Non-biological factors contribute to poor health in populations most affected by health inequities



Residents of rural areas, ethnic and racial minorities, low socioeconomic status disproportionately affected by obesity



A balance between evidence-based strategies, community engagement, systems and environmental change is necessary to improve health outcomes and address disparities.

Source: Mullan, I., Rhee, K., Stoff, D., Polhaus,H., Sy, Francisco., Stinson, N., Ruffin,J (2010), Moving Toward Paradigm-Shifting research in health disparities through translational, transformational and transdisciplinary approaches. American Journal of Public Health 500(1). 19-24.

Context

County Poverty Obese Sedentary <5 F/ V Hospital Costs Beaufort 12% 65% 21% 80% 86,653,100 Colleton 23% 67% 37% 86% 31,895,400 Hampton 25% 78% 22% 83% 13,837,300 Jasper 25% 67% 25% 80% 1,074,200

Orangeburg

25% 73% 29% 83% 96,479,700

Systems and Environmental Change in Action

 Promote Smoke-Free Environments  Worksite Wellness  Increased Access to Physical Activity  Increased Access to Healthy Food

Smoke-Free Environments: Hampton, Estill, Yemessee

Worksite Wellness: Beaufort Jasper Water Authority

Working Well/BJWSA



Considering expansion of the current smole-free policy into a tobacco-free, property-wide policy



A community-supported agriculture (CSA) opportunity has been created.



Fresh fruits and zero calorie beverages in their break rooms



Creating a 1-mile walking trail, marked with signage, and potentially maps at their administrative site.



Including employee wellness into their organization’s strategic plan and the creation of an employee wellness and safety committee

Worksite Wellness: Orangeburg

Tobacco- Working Well



Orangeburg County School District 5 realigned their policies and procedures related to all tobacco and nicotine products,



All Tobacco-related signage has been updated.



Tobacco cessation posters, identifying free resources, are in place in all schools/district buildings.



School nurses provide tobacco cessation awareness at schools and at the district office.

Physical Activity

Hampton County

 Sidewalk Audits  Walking Behavior Survey (n=229)  Signage at Lake Warren, seasonal events  Comprehensive Walking Plan (incl. Complete

Streets principles)

 Partnering with local government and hospital to

implement walking plan recommendations

Physical Activity

Orangeburg

 Each elementary school provides scheduled PE

classes for 80-90 minutes per week

 Encourage teachers to use recess for organized

activities, walking, as well as “free play”

 Provide training in using movement to stimulate

brain activity in conventional classroom settings

 Provide increased opportunities for those who

work in offices to walk during lunch hour, etc.

Food Access

Beaufort: Sheldon Township Faith-Based Consortium Community Garden Network

 4 Gardens: Each Church supports 2 other

churches

 Over 200 community members served at each

site

Sheldon Township

Food Access

Hampton County: Fennell Elementary Community Garden

 Garden has served approximately 500 community

members in a 2 yr. period.

 Seedlings are used to sustain garden & are given to

• ther schools in the county to promote & support

gardening efforts.

Food Access

Colleton County: 4 Community Gardens (2 schools, 2 neighborhoods)

 Over 100 lbs of produce distributed  Seedlings are raised at a school garden and

will be used to sustain the entire garden network

Community Garden Block Party

Food Access

Jasper: Jasper County Neighbor’s United (JCNU). “Garden of Hope”, 2 schools

 More than 93 families served by harvest (JCNU)  Master Gardener in residence (JCNU). Provides

technical assistance to all gardens in Beaufort/Jasper network

JCNU

Lessons Learned

 Community Engagement is an ongoing

process (levels of engagement change, staffing issues, interpersonal conflicts)

 Flexibility  Community gardens are A LOT of work (but

worth it!)

https://www.youtube.com/watch?v=rS-- SjfJH8c

Questions

Brenda Hughes, MPH hughesbd@dhec.sc.gov 843.549.1516, ext 214