Building Coalitions to Improve Community Health

1. Building Coalitions to Improve Community Health Jeffrey L. Lake, MS Deputy Commissioner for Community Health Virginia Department of Health November 29, 2004

2. Overview A healthy community impacts all sectors, not just health Changing times Partnerships - Do we have to? It’s all about relationships Lessons learned

3. Healthy Communities - Think Broadly Safe neighborhoods Adequate and affordable housing stock Ample recreational opportunities High-performing public schools Low unemployment and decent wages Clean air and water Accessible health and health care services

4. Why Access to Care is Last Lifestyle choices are responsible for more premature illness and death than any other single factor, including genetics. What we eat Whether we exercise Whether we smoke or drink alcohol Whether we take illegal drugs Whether we engage in risky sexual behavior Whether we engage in violence

5. Changing Times Market-driven changes in health care Changing role of government Policy-makers don’t reward collaboration; they expect it Technology is transforming how we use data

6. Partnerships for Healthy Communities Partnerships - Do we have to? Do you have the capacity and resources to resolve or address the issue? What about over the long term? Engines driving partnerships Issues are complex; solutions require new policies, knowledge and resources

7. Partnerships for Healthy Communities It’s all about relationships Sharing VISION is easy Sharing POWER is tough Sharing RESOURCES is hardest Why partnerships sometimes fail Lack of trust; turf issues Unclear about the benefit they gain for participating Unprepared for the long haul

8. Virginia Center for Healthy Communities - A New Model A public-private partnership reflecting changing times and focus for public health 501 c3 status Inter-sector membership Using local data to engage business sector on health improvement Outgrowth of the Robert Wood Johnson Foundation Turning Point grant

9. Focus of the Center Providing access to innovative health data – Virginia Atlas of Community Health Compare and contrast communities Community Health Ranking Creating forums to discuss critical issues involving health status, economic prosperity and improved health outcomes Business Roundtables on Health Working with local groups to implement a community health improvement initiative Healthy Virginia Communities

10. Virginia Atlas of Community Health Web based community health data source integrated into a GIS mapping system Aggregates data at the city/county and ZIP code level Direct response to needs expressed by not for profit community based organizations Free to users based on grants from the Virginia Consortium of Health Philanthropy

11. Virginia Atlas of Community Health Users can access data by: downloading it to their computer via an excel spreadsheet printing regional or ZIP code level reports mapping a planning district by ZIP code Provides data driven decision making and allows more targeted interventions www.vahealthycommunities.com

12. Healthy Virginia Communities Work with the business community Identify pressing health concerns in their area Is there a business case? Link business community to health improvement efforts; ask for their support and participation, not just their money Businesses have tremendous assets that can be brought to bear on health improvement: fundraising, strategic planning, marketing, communications, etc.

13. Healthy Virginia Communities Businesses’ success depends on a skilled workforce that remains healthy and productive There are positive steps businesses can take to enhance the health of the community Improving the health of employees and the employment pool with will reap both short (productivity) and long term gains (less health care utilization)

14. What is the Link? Healthier workforce may use fewer health care resources; translates into lower premiums or slowing the rate of premium increases Businesses have a record of corporate leadership Community-level health improvement provides an opportunity to demonstrate business leadership and get a benefit Health improvement touches all sectors of the community

15. What is the Link? Rising costs and increased utilization impacts coverage Premiums are expected to increase 8% over figures for 2003. Three year trends show an overall increase of 32.3% In 2002, 88% of businesses increased the employee’s share of the premium to offset costs One-third have considered dropping health insurance coverage This crisis is moving decisions about insurance coverage from HR to the CEO and CFO

16. New Opportunities Chronic disease provides good opportunities for collaboration between businesses and community health Chronic disease can be prevented and drives up health care utilization rates Utilization experience is a primary factor in determining cost of health insurance

17. Keys for Successful Partnerships Do your homework Invite the right partners to the table Make the scope practical and feasible Share decision-making Build capacity for system/policy change Focus on community assets Be honest about your bottom line needs

18. Lessons Learned Make a friend before you need one Profit is not a four letter word Learn their language, don’t make them learn our acronyms Find out who influences your audience Be prepared for skeptics; some believe health improvement intrudes on their personal choices.

19. Lessons Learned Time is money Short meetings; tight agenda Clear decisions A different time horizon for measurable change Everyone has a bottom line

20. Conclusions We can’t go it alone – partnerships are essential Sharing power and resources is difficult Partnerships are worth the investment - they contribute positively to the effectiveness and stability of long range health improvement initiatives

21. Web-based Resources How to get started developing partnerships Community Toolbox (http://ctb.ku.edu/) National Committee for Quality Assurance (www.ncqa.org) National Network of Public Health Institutes (www.nnphi.org) Association for Community Health Improvement (www.communityhlth.org) Virginia Center for Healthy Communities (www.vahealthycommunities.com) Community Health Resource Center (www.CommunityHealthResource.net)