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Published byRebecca Paul Modified over 6 years ago
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A Definition of Health Health is an individual’s capacity, relative to his or her aspirations and potential, for living fully in the social, economic, and political environment. This definition is also applicable to populations.
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The Social Determinants of Health
The environmental, social, behavioral, and psychological factors -- such as income, employment, housing, and education -- that influence the health status of individuals and populations.
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The LaLonde Model Factors Influencing Health Status
Lifestyle/Behavior Medical Care Environment Human Biology
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Health Status
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A Popular Population/Community Health Status Improvement Model
Community Capacity for Health Status Improvement Ecological Factors Access to Care Health Status + + = Policies Social Capital Supporting Functions Social Determinants Community Characteristics Population Characteristics
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Poor Maternal Nutrition
Infant Mortality Low Birth Weight Genetic Problems Lack of Prenatal Care Poor Maternal Nutrition Maternal Smoking Lack of Knowledge Accessibility Don’t Value Cultural Values Transportation Language Money Location Don’t Read
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Factors Influencing Community Health Status
Demographics/Social Determinants of Health Pooled Risk for Disease/ Opportunities for Prevention Prevalence of Diseases & Disabilities Current Health Status Consumption of Medical, Health & Human Services Factors Influencing Access to & Quality of Care Availability & Application of Social Capital
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Methods For Understanding Community Health
Qualitative Methods Quantitative Methods Community Discussion Groups; Individual Interviews Secondary Data Collection and Analysis General Population Survey On-Site Observation
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Secondary Data Data from existing sources (local and state) are examined to incorporate the insights gathered by others. Sources include: Various web-based data sources Data on key health indicators Economic, political, social and cultural information for the area of interest Comparisons of the local area of interest to the state, for indicators such as disease or health risks
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Community Discussion Groups
Meetings are scheduled with a wide variety of audiences to try and hear from all segments of the community: Youth, middle aged, and the elderly Racial and ethnic minorities People with different income levels Community leaders, and Health and human service providers Meetings are scheduled with a wide variety of audiences to try and hear from all segments of the community: Youth, middle aged, and the elderly Racial and ethnic minorities People with different income levels Community leaders, and Health and human service providers
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Agenda Describe your community
What are the issues and challenges facing your community? What are local resources for addressing these issues and challenges? What are examples of local collaboration to solve problems? What advice do you have for us?
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Instrument Components of a Comprehensive Community Survey
Demographics Functional health status (SF-12) Chronic conditions and disabilities Risks to poor health from behaviors Preventive screening Presence of, and characteristics of “regular provider” Challenges to accessing services Insurance (coverage, history of lack of insurance) Social capital measures Places for regular care Use of emergency room for care Readiness to change and counseling received from regular provider Need for supportive community services Community issues of concern
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Application Of Community Health Information
Planning and Evaluation Program/Service Planning Program/Service Evaluation Strategic Planning Market Planning Estimation of Risk Pooling Capitation (or other Financing) Contracting (especially Medicaid and Medicare) Grant Writing Meeting Requirements Community Benefits Documentation HEDIS Reporting JCAHO Requirements Physician (and other staff) recruitment
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Why Use Community Data To Drive Improvement Efforts?
Understanding the factors influencing community health allows us to allocate resources more effectively and evaluate results more accurately. A community health data focus requires that we engage the community in the process; this increases the resources available and the options for approaching solutions.
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Why Use Community Data To Drive Improvement Efforts?
A community-health focus meets mission and values, along with bottom-line concerns. If our goal is to improve the health of the community we serve, while or with the objective of reducing costs of care and improving viability of the institution, then community data is essential.
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Why Community Strategies Fail (WHO)
Failed to encourage people to think and act for themselves. Let people depend on external resources for answers. Have not paid attention to the question of sustainability. Inadequate training. Reluctance to base programs and services on local resources and knowledge. No involvement in the design and implementation of programs. Medically directed needs conflict with health related needs of people. Lack of community accountability for health improvement.
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Best Community Health Practices
Operate from a broader definition/understanding of “health” Focus on many levels of social functioning: individual, family, neighborhood, institutions Citizen involvement strategies Utilization of existing resources Truly collaborate: exchange ideas, information and resources Skills building Health education/health promotion Implementation focus Multiple, simultaneous interventions Process/outcome evaluation Commitments for the long-term (no quick fixes) Understand differences in service utilization/perceptions of services within a culture (e.g., within the Hispanic population there may be differences)
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Best Community Health Practices Have These Focus Areas on the Radar Screen
Resources Education and Communication Training and Technical Assistance Information and Resource Exchange Evaluation and Monitoring
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Best Community Health Practices
Organize Prioritize Implement Evaluate Sustain
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Organize And Prioritize
Develop a purpose Size of the problem Seriousness of the problem Effectiveness of interventions Community involvement and contribution Support of leadership Model mutual respect Encourage people to think and act for themselves
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Organize And Prioritize
Utilize local (existing) resources and knowledge Incorporate elements of education and training Incorporate policy level changes Able to be evaluated Attention to sustainability Demonstrate the exchange of information and resources Demonstrate benefit to the entire population Increase capacity in the community for health status improvement activities Impact on health status
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Implement People Process Practices Policies Resources
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Evaluate And Sustain Information and resource exchange
Training and technical assistance Resource development Monitoring and evaluation Multiple community demonstration sites
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Southern Delaware Health Partnership
Community Guiding Community Principles Inviting & inclusive Community oriented Strengthen & enhance Doable Partnership Coordinates Partnership Activities Implementation Team Access to Health Care Youth Development Communication & Education Primary care Mental & dental health Transportation Physician recruitment Provider network/system Community participation Recreational activities Peer/mentoring programs Youth boards Volunteer Fair Managed care Medicaid & Medicare Broader determinants of health Discussion groups Prevention education Insurance education Community health resources Community
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