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, organizations, 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 System/Environment  Usually one time, short-  Ongoing impact at the term interventions at organizational or the individual level community level  Short-term changes  Produce behavior change over time Sustainable  May not be 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 other 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