What does it take? Creating a Culture of Health at the Local Level

6.2.16

Dr. Sarah Martin-Anderson

Director of Community Engagement, Policy and

Accountability

• Engage and Motivate People

• District Meetings• Government Relations• Bridge Building LifeX• Empower with data

• Make Good Policy• Run Mayor’s Health

Commission and Committees

• Track legislation• Get stuff passed

• Accountability • Manage SNP contracts• Performance

Management• Public Dashboards• Monitor Trends

So what does CEPA Do?

Context

Bias

Social and

Economic

Factors

40%

Health

Behaviors

30%

Clinical Care

10%

Physical

Environment

10%

Genes and

Biology

10%

What Creates Health?

What are the Determinants of

Health?

Tarlov AR. Public policy frameworks for improving population health. Ann N Y Acad Sci 1999; 896: 281-93.

The Community Health Improvement Plan 2016-2021

The Local Public Health System

Assessment

Data on health and social equity

Community feedback

Chances ChoicesPreventable

Disease

Issue area #1: Education

Early Childhood Education

• Increase the percentage of 3 and 4 year olds who attend high-quality Early Childhood Programs (ECE).

Preventable Absences

• Decrease the number of school days missed because of preventable physical, mental and social health issues.

The Digital Divide

• Increase the number of households with consistent access to a computer with high speed internet.

Goal: Kansas City 3rd Graders should be able to read at grade level.

Issue area #2: Violence

Youth and Family Master Plan

•Create, implement and sustain a Youth and Family Violence Prevention Plan by 2021

Violence Prevention

• Increase the priority of violence prevention as a public health issue

High School Graduation

•Demonstrate incremental progress towards a 90% average 4-year adjusted cohort high school graduation rate in Kansas City’s most vulnerable schools for African American and Hispanic students by 2021.

Goal: Reduce the incidence of violent crime and address racial disparities in incarceration.

Issue area #3: Economic Opportunity

Living Wage Jobs

• Increase access to living wage jobs through both supply-side (job skills and vocational training) and demand-side (example: raising the minimum wage) policies.

Predatory Lending

• Decrease the negative impact of predatory lending on borrowers and increase the access to alternative forms of affordable short-term lines of credit.

Goal: Decrease the income and wealth gap between zip codes.

Issue area #4: Access to care

Cultural Competence

• Increase the number of health care providers measuring their level of culturally competent care

• Increase number of colleges/universities with health care profession programs that offer a cultural competency course

Provider Shortages

• Incrementally decrease HPSA Score from current score of 16 for Jackson County and Clay/Platte counties

Goal #1: Improve health through increased utilization of mental health care.

Issue area #4: Access to care

Preventable Hospitalizations

• Incrementally decrease the number of hospital admissions that are preventable

Prenatal Care

• Increase the rate of African American mothers receiving prenatal care in their first trimester

Rates of Sexually Transmitted Infections

(STI’s)

• Decrease the rate of chlamydia, gonorrhea and syphilis—particularly among the adolescent population

Goal #2: Increase utilization of preventative health services

Issue area #5: Built environment

Blight Reduction

• Improve the efficacy of blight reduction programs including illegal dumping enforcement, Land Bank and KC Homesteading Authority.

Food Systems

• Improve access to locally grown, processed and marketed healthy foods

Smoke-Free Housing

• Increase the number of multi-unit housing facilities that are completely smoke free.

Goal: Increase the proportion of neighborhoods that are safe, clean, well-maintained and consistently improved.

Life expectancy by zip code, Kansas City, MO 2010-2014

*Too small population to calculate life expectancy

@ 2010-2014 American Community Survey 5-Year Estimates

64153 64154 64156

64163

64155

6411964151

64134

64129

64120

64157

64161

64132

64138

64149

64131

64116

64130

64137

64117

64136

64118

64160

64164

64139

64133

64127

64165

64133

64108

64133

64128

64147

64111

64158

64109

64126

64118

64124

64114

6414664145

64110

64113

64152

64079

64106

64166

64112

64123

64125

64012

64152

6410564101

64102

64167

64030

64079

64081

64079

64152

Life expectancy

70-72 years

73-79 years

80-83 years

Too small pop.*

Indicates zip codes with the lowest increase in life expectancy over the last 10-15 years

Life expectancy

<74.7

74.8-77.2

77.3-79.9

80+

Life expectancy in 1990-1994 Life expectancy in 2010-2014

64119

64134

64151

64129

64120

64161

64132

64149

6413864131

64116

64130

6411764160

64137

64136

64118

64139

64133

64127

64147

64133

64108

64133

6412864111

64158

64109

64126

64118

64124

64114

6414664145

64110

64113

64152

64106

64112

64123

6412564105

64152

6410164102

64119

64134

64151

64129

64120

64161

64132

64149

6413864131

64116

64130

6411764160

64137

64136

64118

64139

64133

64127

64147

64133

64108

64133

6412864111

64158

64109

64126

64118

64124

64114

6414664145

64110

64113

64152

64106

64112

64123

6412564105

64152

6410164102

64153 64154 6415664155 6415764153 64154 6415664155 64157

64163

64164 6416564166 64167

64163

64164 6416564166 64167

Biggest and smallest increasing life expectancy (LE) between 1990-1994 vs. 2010-2014

64153 64154 64156

64163

64155

6411964151

64134

64129

64120

64157

64161

64132

64138

64149

64131

64116

64130

64137

64117

64136

64118

64160

64164

64139

64133

64127

64165

64133

64108

64133

64128

64147

64111

64158

64126

64118

64114

6414664145

64110

64113

64152

64109

64079

64106

64166

64112

6412464123

64125

64012

64152

6410564101

64102

64167

64030

64079

64081

64079

64152

Smallest increasing LE

Bighgest increasing LE

zipcode boundaries

• The biggest increasing life expectancy between 2010-2014 vs. 1990-1944 are zip codes 64106, 64112, 64118, and 64155.

• The smallest increasing life expectancy between 2010-2014 vs. 1990-1994 are zip codes 64123, 64129, 64137, and 64138.

65.3

73.3

76.1

67.83

1990-1994 2000-2004 2010-2014 Quality-Adjusted forIncome (2014)

Life

Exp

ect

ancy

(Ye

ars)

Life Expectancies for Zip Code 64106

75.7

72.5 72.5

66.67

1990-1994 2000-2004 2010-2014 Quality-Adjusted forIncome (2014)

Life

Exp

ect

ancy

(Ye

ars)

Life Expectancies for Zip Code 64123

CONNECT!

2400 Troost Ave. │ Suite 4000 │ Kansas City, MO 64108

Phone: 816.513.6244 │ KCMO.GOV │ Sarah.Martin-Anderson@kcmo.org

More Health. More Life. More KCDr. Sarah Martin-Anderson