Judy Dillon, MSN, MA, RN. Director of Community Health

Transcription

1 Judy Dillon, MSN, MA, RN Director of Community Health

2

3 2015 Community Need Index (CNI) Map 4.00 to 5.00 (Significant socio-economic barriers) 3.00 to to to 1.99 (Lowest level of socio-economic barriers)

4 Prioritized Regional Community Health Needs #1. Access to Care #2. Behavioral Health #3. Healthy Living

5 PaWS: Pantries and Wellness Support 2014 to present Improve Health: identification of untreated chronic conditions, education & coaching Better Care: facilitation of referrals Lower Costs: access to primary care

6 PaWS: Internal Partners Nurses Advance Practice Clinicians Physicians Administrative Support Staff Penn State College of Nursing Penn State College of Medicine Penn State School of Public Health Sciences Health Topic Experts

7 PaWS: External Partners Pennsylvania Psychiatric Institute Penn State Extension Central PA Food Bank Food Pantry Locations Corporate Sponsors

8 PaWS: Pantries and Wellness Support Continuity Building trust Personalization Culturally-appropriate targeted messages Relevant topics Reinforcement Empathy Positive environment

9 PaWS- Video

10 PaWS: Health Assessments Cardiovascular Risk Score Age Sex Race Blood pressure Glucose Lipids

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12 PaWS: Flu Shots

13 PaWS: 2016 Flu Shots Manna FP Manna FP Steelton FP Hummelstown FP Palmyra FP Manna FP Hummelstown FP Manna FP Grantville FP Cocoa Packs FP Grantville FP 9 TOTAL 169

14 PaWS: Tomatoes 550 plants given to clients 9 sites Each client received: tomato plant grow bag or bucket soil bamboo stake w/ plant clip instructions

15 PaWS: Pantry Client Opportunities Accessibility Transportation Accountability Education

16 PaWS: PSHMC Opportunities Resources Replication Communication strategies Research Sustainability

17 Newest Initiative: Emergency Food Boxes Pilot Location: Pediatrics Clinic Social Determinants of Health Two-question screening tool identifies food insecurity

18 PaWS: Impact Persons served 1,480 4,328 Community benefit $16,609 $21,010 Employee hours Volunteer hours

19 Healthy Food For All: Lancaster County Partnerships Brenda Buescher, MPH Health Promotion Specialist, Lancaster General Health Coordinator, Lighten Up Lancaster County

20 Background Lancaster General Health Part of the Penn Medicine network, LG Health is a non-profit comprehensive outpatient and inpatient services. Lighten Up Lancaster County Convened by Lancaster General Health in 2007, Lighten Up community partners from multiple sectors to improve access safe spaces for physical activity.

21 Food Insecurity in Lancaster In Lancaster County, 10.5% of the population is food insecure. Nearly 17% of children are food insecure. Over 55,000 people (nearly the population of Lancaster City) don t have access to enough food for a healthy, active life.

22 Screening & Referrals All patients asked annually about social challenges, including difficulty paying for food Pilot project ( ): Patients needing food assistance are referred to social service hubs Other patients receive information about SNAP hotline, 2-1-1, community meals, and pantries

23 Community Food Access

24 School & Community Gardens

25 The Survey Says 41 of 116 public schools have at least 2 raised beds including all elementary schools in Lancaster City Vegetables and herbs are most popular things to grow Garden produce is used in many ways 70% send produce home 65% enjoy during garden time 60% offer taste testing during classroom instruction

26 Healthy Corner Stores

27 Hunger-Free Lancaster County

28 Training & Resources Our health educators and registered dietitians: Develop healthy menus and easy recipes Provide nutrition education materials and specialty resources for agencies Provide resources to encourage healthy donations Offer health/nutrition education for staff & volunteers

29 Menu Makeovers

30 Education Materials

31 Healthy Food Donations

32 Training on Food Environment

33 What can we do together? Create education resources and learning opportunities about healthy choices. Encourage donors to donate healthy items. Support community & school gardens. Create an environment that makes the healthy choice the easy choice. Train volunteers and staff about connections between hunger, poverty, and health.

34 Questions? Brenda Buescher

35 Fresh Food Pharmacy: Changing how we take care of patients that are food insecure

36 Program premise: What if we could eliminate hunger and preventable chronic disease?

37 Food insecurity: definition and statistics Defined as the inability to afford nutritionally adequate and safe foods. Food insecurity is evident when families or individuals: o Lack access to food o Depend on food assistance programs o Skip meals o Substitute nutritious foods with less expensive alternatives o Seek assistance from soup kitchens and food pantries Anderson SA. Core indicators of nutritional state for difficult-to-sample populations. J Nutr. 1990;120 Suppl 11:

38 Food insecurity: statistics In 2015 it was estimated that: 12.7% (almost 1 in 8) of Americans were food insecure* 18% (1 in 6) of American children were food insecure^ Food insecurity and poverty, while closely linked, are not synonymous. Each family has its own expenses and standard of living, and different costs. It is possible to earn below poverty levels and be food secure or earn above poverty level and be food insecure.^^ * ^ ^^

39 Food insecurity and health implications Compared to the food secure, food insecure people : o o o o o Are disproportionately poorer in health and functional status Have higher prevalence of risky health behaviors Have greater prevalence of mild and severe depressive symptoms Are less likely to report arthritis, cancer, hypertension and diabetes due to limited access to healthcare Have more unmet needs for chronic disease screening and prevention

40 Food insecurity and diabetes The food insecurity is much higher for people with diabetes: Feeding America reports 12.3% (almost 1 in 8) of Americans are food insecure Americans with an A1c of : about 20%, or 1 in 5 of the population are food insecure* Americans with an A1c of 9 or higher: 25%, or 1 in 4, of the population are food insecure* *Berkowitz SA, Baggett TP, Wexler DJ, Huskey KW, Wee CC. Food insecurity and metabolic control among U.S. adults with diabetes. Diabetes Care. 2013;36:

41 Diabetes and related diseases in our community 1 in 4 patients with diabetes don t know they have it and are untreated An additional 22,000 Northumberland Co. adult residents have prediabetes and most (90%) don t know it Heavy burden of food insecurity and diabetes in Northumberland, Location Lackawanna, and Juniata Northumberland CountiesLackawanna Juniata PA USA Food Insecurity Rate 14.2% 13.0% 11% 13.8% 12.7% Child Food Insecurity Rate 22.5% 22.0% 18% 19.3% 18% Diabetes Rate 12.1% 11.0% 12.3% 9.6% 9.3%

42 Where do we start? Fresh Food Pharmacy (FFP) program o Kulpmont pilot began in July 2016 o Full program expansion in March 2017 to serve 250+ patients and their family members in Year 1 Food-as-medicine approach o Addresses both medical and socioeconomic determinants of health Starting with diabetic patients and will expand to treat obese, pre-diabetic, and patients with other chronic conditions

43 Coming together Partnership already includes: o Central Pennsylvania Food Bank o Weis Markets o Shamokin Area School District and Northumberland County Career and Technology Center o Degenstein Foundation o Many local community organizations o Geisinger healthcare team

44 How the program works Identified patients with A1c levels over 8.0 who are food insecure Geisinger provides comprehensive and coordinated clinical intervention in conjunction with PCP: o Registered Dietitian o Health/Case manager o Wellness coach/community based classes o Pharmacist o Healthy food prescription and delivery each week of healthy food for patient and family Feeds on average 4 people in the household, including 2 children Food provided for 2 meals per day, 5 days per week for the patient and his/her family

45 Patient stories

46 Where are we now? Expansion into Juniata County, Scranton and Danville over the next 2 years. Adding a rigorous evaluation component to prove outcomes o Will make it easier for funders to support the program and its expansion o Will help the program become scalable and sustainable

47 Click to edit Master title style 11/6/

48 Screen and Intervene Your way to connect your program to healthcare prevention programs Joe Anne Ward-Cottrell, MPH Health Educator Community Health and Wellness

49 Our Mission: Working as one to improve health through exceptional care for all, lifelong wellness and healthy communities.

50 Community Health Improvement Plan Strategy for Addressing Needs Population Health = Clinical Health + Community Health Source: Centers for Disease Control and Prevention. Community Health Assessment and Group Evaluation (CHANGE) Action Guide: Building a Foundation of Knowledge to Prioritize Community Needs. Atlanta: U.S. Department of Health and Human Services, 2010.

51 Community Health Improvement Plan Prevention and Wellness Strategy Priority: Overweight and Obesity Improve the care and treatment of overweight/obese adults who are managed by WellSpan Medical Group primary care practices. Increase the proportion of community members who engage in healthy eating and physical activity behaviors as a means to manage their weight. Priority: Depression Increase community awareness about depression and available resources in the community.

52 Priority: Overweight and Obesity Market Bucks for Patients Audience: WellSpan Medical Group patients, as identified through established criteria (food insecurity & clinical). Basics: Participants receive healthy eating guidance and Market Bucks vouchers redeemable for fruits and veggies at participating farmers markets. Length of Program: 4 months

53 Priority: Overweight and Obesity Healthy Eating & Physical Activity WellSpan Programs Sandy Gladfelter

54 Priority: Overweight and Obesity Healthy Eating & Physical Activity Community Partnerships Adams County Food Policy Council Better Together Karen Bachman: Katie Berkheiser: Hunger Free Lancaster York County Food Alliance Joe Anne:

55 Priority: Overweight and Obesity Community Support WellSpan Community Partnership Grants LifePath Christian Ministry York County Food Alliance Catholic Harvest Food Pantry York County Expansion to Lebanon

56 Priority: Overweight and Obesity Priority: Depression Community Awareness WellSpan Philhaven