2. Mind Your Business Presented to Roanoke Valley Chamber of Commerce Annual Meeting January 22, 2015 Karen McNeil-Miller President Kate B. Reynolds Charitable Trust

3. Across America, Differences in How Long and How Well We Live

5. Why Is It That……? DiabetesAs of 2007, Native Americans and Alaska Natives (17%), African Americans (12%), and Hispanics/Latinos (10%) were all significantly more likely to have been diagnosed with diabetes compared to their White counterparts (7%). 1 Heart DiseaseIn 2000, rates of death from diseases of the heart were 29 percent higher among African American adults than among white adults, and death rates from stroke were 40 percent higher. 2 Infant MortalityIn 2002, Sudden Infant Death Syndrome (SIDS) deaths among American Indian and Alaska Natives was 2.3 times the rate for non-Hispanic white mothers. 3 References: 1 CDC (2008), 2 NCHS (2002), 3 NICHD (2007)

6. Social Determinants of Health Access to health care Access to resources Education Employment Environment Income/Poverty Insurance Coverage Housing Racism/Discrimination Segregation Transportation

7. How could income affect health? Income directly shapes:  Nutrition & physical activity options  Housing quality  Neighborhood conditions  Social networks & support  Stress due to inadequate resources to face daily challenges  Medical care Parents’ income shapes the next generation’s:  Education, which shapes their  Working conditions (physical & psychosocial), and income, which shapes their  Health Center on Social Disparities in Health, UCSF

8. How can a neighborhood affect health?  Safe places to exercise  Access to healthy food  Exposure to targeted advertising of harmful substances  Social networks & support  Norms, role models, peer pressure  Fear, anxiety, stress, despair  Violence and fear  Quality of schools

9. Social Determinants of Health Access to health care Access to resources Education Employment Environment Income/Poverty Insurance Coverage Housing Racism/Discrimination Segregation Transportation

10. Place Matters Parks Sidewalks Grocery Stores Financial Institutions Better Performing Schools Good Public Transportation Fast Food Restaurants Liquor Stores Unsafe/Limited Parks Poor Performing Schools Increased Pollution and Toxic Waste Sites Limited Public Transportation Communities of Opportunity Low-Income Communities Good Health Status Poor Health Status contributes to health disparities: Obesity Diabetes Asthma Infant mortality Reference: PolicyLink

11. ADD Picture of Tree

12. Improved Health Outcomes: Improved Health Outcomes: This Is the Trust’s Business

13. Fulfilling Mrs. Reynolds Vision “…Mrs. Reynolds was interested in the community and played an active role in addressing issues that affect quality of life for all…”

14. Kate B. Reynolds Charitable Trust Health Care DivisionPoor and Needy Division

15. Trust is Focused on Rural Health Improvement

16. North Carolina Rural Health Action Plan 1.Invest in small businesses 2.Increase support for quality child care 3.Work with schools to support healthy eating and active living 4.Improve access to behavioral health services 5.Educate rural residents about new health insurance options Source: NC Institute of Medicine

17. Healthy Places NC A new Trust initiative supporting community-wide health improvements in rural North Carolina counties.

18. Trust Investments in Halifax More than $4.6 million over last three years to support Halifax’s work to become a healthier community.

19. Halifax County

20. HEALTHY PLACES NC $100 million over 10 years in 10-15 rural, Tier 1 NC counties

21. Innovations in Rural Health Award

22. Halifax County’s 2014 Ranking 99 Improved Health Outcomes: This Is Your Business Source: University of Wisconsin Population Health Institute, County Health Rankings & Roadmaps, 2014County Health Rankings & Roadmaps

23. County Health Rankings & Roadmaps Model

25. Halifax County’s rank on clinical care 60 Halifax County: Clinical Care Source: University of Wisconsin Population Health Institute, County Health Rankings & Roadmaps, 2014County Health Rankings & Roadmaps

26. Halifax’s rank on physical environment 95 Halifax County: Physical Environment Source: University of Wisconsin Population Health Institute, County Health Rankings & Roadmaps, 2014County Health Rankings & Roadmaps

27. HALIFAX COUNTY HalifaxNorth Carolina HS graduation rate78%80% Unemployment10.6%6.8% Poverty rate Children living in poverty 31% 39% 17.2% 25% Residents living in poor/fair health29%10% Low birth weight13%6% Adult obesity39%25% Recreational facilities**5 per 100,000 residents11 per 100,000 Fast food restaurants**59% of Total49% of Total

28. These numbers don’t tell the whole story. The numbers highlight its challenges. The people who call the County home tell its story. HALIFAX COUNTY

29. EquityEnvironment Health Intersection of Health, Place & Equity Access to Healthy Food Schools/ Child care Health facilities Community Safety/ Violence Transportation Traffic patterns Work environments Housing Parks/Open Space/ Playgrounds Reference: PolicyLink

30. Six Ways to Talk about Social Determinants of Health Health starts – long before illness – in our homes, schools, and jobs. All Americans should have the opportunity to make the choices that allow them to live a long, healthy life, regardless of their income, education or ethnic background. Your neighborhood or job shouldn’t be hazardous to your health. Your opportunity for health starts long before you need medical care. The opportunity for health begins in our families, neighborhoods, schools, and jobs. Robert Wood Johnson Foundation

31. Data to Action “Data is only valuable if it’s actionable …”

32. Make Health Your Business

33. Share of Population that is a Racial/Ethnic Minority by State 2005-2006

34. Thank You!