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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
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
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
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
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
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