Community Health Equity Needs Assessment and Implementation Plan Process

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Community Health Equity Needs Assessment and Implementation Plan Process Stephen Wade Health Equity Policy Analyst Washtenaw County Public Health January 2017

History Coalition of HIP Partnership Existed since 1995. Founding partners Washtenaw County Public Health (WCPH), Chelsea Community Hospital, St. Joe s Ann Arbor, Michigan Medicine Funded countywide HIP survey every five years In 2007, adopted health improvement objectives for the year 2020 In 2013, adopted goals and objectives through a CHNA and CHIP. The Community Health Committee (CHC) is the HIP partnership s community coalition Worked on many equity focused projects for example Ypsilanti Health Coalition, Ypsilanti Farmers Market, Latino Health Survey, infant mortality reduction

Successes Coalition in Washtenaw Pa County Productive collaboration Evidence-based practices Improved health outcomes Smoking rates Infant mortality Recent decrease in obesity rates

Coalition Definitions Pa Health inequities Systemic, avoidable, unfair and unjust differences in health status and mortality rates Community Groups 2015 HIP Survey, the Latino Health Survey (EBV), the Opportunity Index, Community Commons experience with existing community based networks, identified five community groups that experienced systemic, avoidable, unfair and unjust health differences Social Determinants of Health (SDOH) Conditions in the places where people live, learn, work, and play affect a wide range of health risks and outcomes (e.g. housing, transportation, parks, etc).

County Health Rankings 7 th healthiest (of 83 counties) 6 th in children in poverty 80 th in income inequality 75 th in severe housing problems

Average Age of Death - years Unjust Health Disparities Average Age of Death by Race/Ethnicity in Washtenaw County White 75 Latino 55 Black 62 Mean Age at Death by Race, Washtenaw County Residents, 1970-2011. Vital Records and Health Statistics Section, Michigan Department of Community Health, 2011.

Zip Code More Coalition Important Than Pa Genetic Code Childhood poverty rate Educational Attainment Percentage African-American Unemployment Community Commons Washtenaw County Profile http://www.communitycommons.org/maps-data/

Opportunity Coalition Index Pa Washtenaw Opportunity Index http://www.opportunitywashtenaw.org/opportunity-index.html

Coalition Goals Pa Identify and address community-identified health equity priorities. Broaden the definition of health Support and guide the three groups that create health in addressing health inequities. Transform the community health planning process by embedding community voice.

Systemic Change vs. Intervention San Francisco State University Health Equity Institute https://healthequity.sfsu.edu/sites/default/files/health%20equity%20framework_1_0.pdf

Current Coalition Health Dynamic Pa Community Government SDOH Organizations Elected Officials Institutions Funders

Future Coalition Health Dynamic Pa Community Government SDOH Organizations Elected Officials Institutions Funders

Community Empowerment Coalition Pa Health Equity Engaging & supporting leaders Collaboratively identifying challenges Supporting place-based interventions

Coalition Description Pa A continuous process resulting in a five year plan 1. Listen for needs assessment 2. Do for implementation plan 3. Evaluate effectiveness of process o HIP Survey data, Opportunity Index Guiding Team is organizing body Complements and builds on Michigan Medicine and St. Joe s hospitals Unified Needs Assessment Implementation Plan Team Engagement (UNITE).

Coalition Pa

Guiding Team (formerly Coalition HIP Coordinating) Pa YMCA (CHC Co-Chair) Corner Health/Ozone (CHC-Co-Chair) Washtenaw County Public Health UMHS St. Joe s Hospital United Way 5 Healthy Towns Washtenaw Intermediate School District Michigan Institute for Clinical Health Research (MICHR) EMU Washtenaw County Sheriff s Office Washtenaw County Office of Community and Economic Development Washtenaw County Parks Washtenaw Area Transportation Study (WATS) Ann Arbor Area Community Foundation Washtenaw Health Initiative Blueprint for Aging Washtenaw Housing Alliance

Decision Coalition Makers Pa Board of Commissioners Board of Health Ann Arbor City Council Ypsilanti City Council Ypsilanti Township Supervisor Superior Township Supervisor Northfield Township Supervisors Washtenaw County Parks Commission Washtenaw Area Transportation Study (WATS) US Representative Dingell US Senator Stabenow/Peters MI Representative Driskell/Irwin/Zemke MI Senator Warren

Community Coalition Groups Pa Five groups will guide the formulation of Community Health Equity Needs Assessment and Implementation Plan. While these groups will primarily provide input specific to their communities, they will also provide a lens through which to look at health needs in other communities and among other demographics. New West Willow Neighborhood Association, Whitmore Lake, South of Michigan Avenue (SOMA) in the City of Ypsilanti, IDEA (Latino residents), Ypsilanti Youth Creating Change (Y2C2) If there are additional capacity and resources, there are a number of other groups that could be more actively involved in this process (e.g. Sugarbrook, Augusta Township, Manchester, LeForge, MacArthur Blvd, new immigrants, youth involved in the criminal justice system, low-income seniors).

Coalition Year 1 Pa For the first seven months of year one, the Guiding Team prepares for and attends a meeting with both one of the Decision Makers and at least one of the Community Group leaders. This meeting is facilitated by one community member and one member of the Guiding Team. Purpose of these meetings is to build relationships, learn about the health needs as seen by the Decision Makers, and to bridge the gap between community voice and existing institutions For the next five months of year one, the Guiding Team meets with one Community Group each month to hear about their health needs.

Coalition Year 2 Pa For the first seven months of year two, the Guiding Team organizes a meeting with both one of the Decision Makers and at least one of the Community Group leaders. This meeting is facilitated by one community member and one member of the Guiding Team. purpose of these meetings is to discuss findings from the needs assessment and to draft the implementation plan. For the next five months of year two, the Guiding Team meets with one Community Group each month to discuss findings from the needs assessment and to draft the implementation plan.

Role for Washtenaw Coalition County Pa Public Health WCPH will be the primary staff for this process by providing backbone support and coordination. Commitments to this process 1 FTE $ towards community work HIP Internal monthly WCPH staff meetings to review progress and alignment of work Meeting attendance from WCPH staff Guiding team all Guiding team and decision makers all Guiding team and community groups all

Role for Washtenaw Coalition County Pa Public Health Continuously provide data on needs identified by the community and by ongoing surveillance both acute community identified needs (e.g. health care access) as well as longer term, bigger picture health disparities (e.g. childhood obesity). Continue ongoing work with numerous community partnerships Including Coordinated Funding, Washtenaw Alliance for Children and Youth (WACY), Washtenaw Health Initiative, among others Convene CHC four times/year to complement, amplify this process.

Communications Coalition Pa Bi-weekly email newsletters press releases, social media, meeting schedules and summaries Materials for Community Groups, Decision Makers, and the Guiding Team

Expectations Coalition of Guiding Pa Team Commitment from Guiding Team members to attend as many meetings as possible Financial support is needed approximately $50,000 for two years Guiding Team staffing support is needed e.g. organizing meetings, facilitating meetings, developing internal and external communications, analyzing data, taking minutes, etc.

Discussion Coalition Questions Pa Does this make sense? Do you think it could be effective? What is it missing? Do you have the time to attend meetings? Do we have enough resources?