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Community Strategies to Improve Health Community Strategies to Improve Health March 16, 2006 Rebecca Flournoy, MPH

Community Strategies to Improve Health March 16, 2006 Rebecca Flournoy, MPH

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Community Strategies to Improve Health

Community Strategies to Improve Health

March 16, 2006Rebecca Flournoy, MPH

Community Strategies to Improve Health

PolicyLink is a national nonprofit research, communications, capacity building, and advocacy organization,

dedicated to advancing policies to achieve economic and social equity

based on the wisdom, voice, and experience of local constituencies.

Community Strategies to Improve Health

Why Focus on Community Factors and Health?

Access to care accounts for only 10% of total mortality in the U.S.

Environmental conditions, race, social and economic factors, and health behaviors all impact health status

Community Strategies to Improve Health

Community Strategies to Improve Health

Community Strategies to Improve Health

Quality and quantity of employment opportunities

available

to residents; the amount of collective wealth and assets

in

the community.

Employment, Income, Wealth and Assets

Living wage jobs with health benefits; safe workplaces. Savings, adequate retirement income, and homeownership provide economic stability.

Large numbers of community residents with low-wage jobs with no benefits and unsafe working conditions. Racial and economic segregation and concentrated poverty lead to higher stress and premature mortality.

Factors protecting against disparities

Factors increasing risk for disparities

Community Strategies to Improve Health

Factors protecting against disparities

Factors increasing risk for disparities

Presence of commercial services including grocery

stores,

banks and restaurants.

Neighborhood Economic Conditions

Attracts public and private investment in services and infrastructure.

Disinvestment leads to loss of jobs, businesses, and decline in property values.

Community Strategies to Improve Health

Community Strategies to Improve Health

Values, attitudes and norms (related to a range of

behaviors, including diet) deriving from

race/ethnicity/gender, religion or nationality, as well as

from other types of social and cultural groupings.

Cultural Characteristics

Cohesion, a sense of community, and access to key cultural institutions with healthy cultural norms/attributes.

Racism, language barriers, and acceptance of unhealthy behaviors. Absence of community norms and expectations that promote healthy behavior and community safety.

Factors protecting against disparities

Factors increasing risk for disparities

Community Strategies to Improve Health

Friends, family, colleagues, and neighborhood

acquaintances

And organizations. These networks exist within the

community

and beyond it, such as churches and clubs.

Social Support and Networks

Social capital that can provide access to social supports and economic opportunities, as well as to certain health services and resources. Adult role models and peer networks are influential to young people.

Lack of social supports and role models. Residents do not have access to networks outside the neighborhood that can link them to employment and other key opportunities. Sometimes referred to as absence of “bridging” social capital.

Factors protecting against disparities

Factors increasing risk for disparities

Community Strategies to Improve Health

Community Strategies to Improve Health

Factors protecting against disparities

Factors increasing risk for disparities

Air, water, land shared across a region.

Environmental Quality

Policies and practices that maintain a clean, healthy environment.

Presence of and exposure to toxics and pollution.

Community Strategies to Improve Health

Factors protecting against disparities

Factors increasing risk for disparities

Housing, parks and recreation, and workplaces.

Built Environment and Infrastructure

Access to affordable, high-quality housing, local parks, and safe workplaces. Urban design that supports physical activity.

Exposure to lead paint, problems with inadequate sanitation and pest infestation, dangerous types of work and unsafe work environments. Urban design that inhibits physical activity.

Community Strategies to Improve Health

Community Strategies to Improve Health

Factors protecting against disparities

Factors increasing risk for disparities

Accessibility, affordability, and quality of care for

individuals

and families.

Health Services

Necessary, accessible care delivered in a culturally sensitive manner in satisfactory health facilities with well-trained and culturally appropriate practitioners with attention to acute and preventive care.

Lack of access to necessary health care services, while what is available is culturally inappropriate and of poor quality.

Community Strategies to Improve Health

Community Strategies to Improve Health

What is Advocacy?

1. Identifying an Issue

2. Drawing attention to the issue

3. Working towards a solution

Community Strategies to Improve Health

The Advocacy Process

ORGANIZING AND

COALITION BUILDING

MOBILIZATION AND

COMMUNICATIONS

MAKING A PLAN

FINDING INFORMATION/ RESEARCH

POLICY CHANGEFOR CHANGE

CLIMATE READY

Community Strategies to Improve Health

Community Action to Fight Asthma (CAFA)

3-year initiative Focus on reducing

environmental triggers for children with asthma

Community Strategies to Improve Health

Organization of CAFA

12 Local Coalitions State Coordinating Office Technical Assistance

Providers

Community Strategies to Improve Health

PolicyLink Role

Technical Assistance: Policy and Communications

Inform and Mobilize CAFA State Policy Efforts

Community Strategies to Improve Health

CAFA Policy SuccessesLocal Examples Helped pass ordinance to replace old diesel city buses Influenced discussions about regional air regulations and

enforcement Brought health voice to discussions about local freeway

expansion

State Examples Helped get eight bills passed and 2 air quality regulations Invited to suggest bill language

Community Strategies to Improve Health

Other Outcomes New leaders Increased awareness New partnerships Enhanced skills

Community Strategies to Improve Health

For More Information: www.policylink.org

Community Factors:www.policylink.org

/Research/JC-Stronger Communities www.policylink.org/CHB

Advocacy:www.policylink.org/AdvocatingForChange