1. Doing Things That Matter
June 13, 2018
Presenting To
Annual Arizona Biomedical Research Commission NAU-Center for Equity Research | Yuma Forum
B. Michael Nayeri, NMD, FABMP, FACFE
Director, Healthy Aging

2. (On Being a Catalyst for Community Change!)
Improving Health Equity Through Collective Community Action Doing Things that Matter!
(On Being a Catalyst for Community Change!)

3. Head & Heart Head Stuff….. Heart Stuff….. Where’s the evidence?
Where’s the funding?
Who are my partners?
Measured outcomes?
Sustainability?
Heart
My commitment?
My confidence?
Making a difference?
Staying focused?
My resilience?

5. Un-equal Opportunity

9. Before we drill down…
Population aging is unprecedented, profound and pervasive
Population aging presents enormous social, economic and political challenges for societies

10. Proportions Aged 65+ and Under Five: 1950-2050
Japan
Italy
Germany
USA
China

11. Chronic Disease Costs in Arizona
Charges
Diabetes
$7,887,188,974
Lung Disease
$3,810,191,045
Coronary Heart Disease
$1,652,315,698
Stroke
$1,231,308,356
Total
$14,581,004,073
Source: Arizona Hospital Discharge Database

13. Hospitalization & ED d/c 2015
County
Diabetes-related discharges
Diabetes as 1st listed diagnosis
Apache
1,839
189
Cochise
5,474
558
Coconino
5,114
373
Gila
3,252
287
Graham
2,527
188
Greenlee
391 22
La Paz
844 82
Maricopa
180,647
14,296
Mohave
15,848
1,098
Navajo
5,207
390
Pima
48,644
3,778
Pinal
23,817
1,631
Santa Cruz
2,505
182
Yavapai
10,598
819
Yuma
11,881
766
Total
318,588
24,659
Hospitalization & ED d/c 2015

19. In 2015, Apache County had the highest proportion of respondents consuming vegetables three times and fruits twice daily, 19.4%. Coconino County had the lowest, 4.3% (see Figure).

23. Know the Level of Engagement
The Spectrum of Prevention
Influencing Policy & Legislation
Changing Organizational Practices
Fostering Coalitions & Networks
Educating workforce including Healthcare Providers
Promoting Community Education
Strengthening Individual Knowledge & Skills

24. Healthy Aging Falls Prevention Alzheimer’s Disease Chronic Disease
Self-Management
Alzheimer’s Disease
Falls Prevention

25. Take Home #1 Know what works! Where’s the evidence? What holds promise?
Comprehensive (360 degrees) approach
Bold, High-Impact Messaging (formative research)
Are there models that are relevant to the local context [Community-Centric]?
Integration of National, State and Local Efforts – Who shares in our endeavor?
Crossing traditional boundaries (new ways of thinking & doing)

26. Know what works….and remember:
Achieving community health is everyone’s business.
Evidence-Based (EvB) programs do NOT always work across all providers and communities.
No one size fits all!

27. Fun/Challenge Opportunity or Dangerous?

28. Take Home #2 Listen……so that others will talk
Take Home #2 Listen……so that others will talk! What does the community want?
People’s experiences shape their perceptions
Be quick to hear…..slow to speak
Identify, develop & disseminate resources
Address gaps in service/education
e.g., De-structuring of resettlement programs [impact on non-profits]
Develop & incubate pilot projects
Change systems
Advocate

29. “By joining together around an issue of mutual interest, organizations and agencies reduce competing and duplicative efforts. Also, there is strength in numbers; therefore, coalitions can be especially effective in addressing issues relating to policy changes and the enforcement of existing policies & laws.”
- Organizations Working Together in Tobacco Control

30. Take Home #3 Leave a Legacy. Thinking beyond our lifetime. (urgency …
Take Home #3 Leave a Legacy! Thinking beyond our lifetime! (urgency ….with a long view)
Measured impact! What does success look like?
Scalability
Sustainability
Change systems, not people!
Create policies, not services!
Take programs to people…..not the reverse!

32. A Catalyst for Change… (in countless present moments)
Informed by the past…..and
Anticipating the future……but
Performing in the NOW!

33. Recapturing the Soul of Medicine
In the daily toil of “getting things done:”
We can describe what we do……and
we can describe how we do it.
But we can easily lose track of the “why.”

34. Are people suffering and/or dying of causes that could have been prevented or managed in a timely manner?
Are people who are at risk of, or living with _____ better off because of our work?
Do we deeply experience the privilege of serving these people?

36. https://youtu.be/Kq65aAYCHOw

38. Resources The Community ToolBox http://ctb.ku.edu/en/Default.htm
Healthy Cities/Healthy Communities
Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities
Healthy Rural Communities Tool Kit
Berkowitz B, Wolff T. The Spirit of the Coalition (2000)
Coalitions Work

39. THANK YOU Dr. B. Michael Nayeri | Director, Healthy Aging|
azhealth.gov
@azdhs
facebook.com/azdhs