Matthew Guidry, PhD
Senior Advisor, ODPHP, DHHS

Drew O’Connor
Director, Healthy Communities Resource Center

Phillip Caillouet, PhD
Associate Professor, University of Southwestern Louisiana

Patsy Matheny
Director, VHA, Inc.

There are fewer public dollars available to address the pressing challenges of society, thus partnership and collaboration between government, for-profit, non-profits and citizens is the way of the future. Challenges and solutions are increasingly becoming the responsibility of local and regional communities. With more decisions made locally, there is a greater need for new strategies and tools for community action planning and implementation. Healthy People 2010 sets nation-wide health priorities to guide local planning and action. Healthy communities improves quality of life through cross-sectoral collaboration, strategic planning and development of community indicators. There are 22 States with HC Networks (Arizona, California, Colorado, Florida, Hawaii, Indiana, Louisiana, Maine, Massachusetts, Michigan, Missouri, Montana, New Mexico, New York, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington State, Wyoming). The principles of Healthy Communities are:

• Broad definition of health.
• Shared community ownership.
• Focus on systems change.
• Diversity of community participating in all phases of the process.
• Shared vision and values.

Key elements to a Healthy Communities program are: human resources, information technology and facility resources, partnerships and linkages, financial projections, and evaluation and performance. Healthy Communities initiatives must:

• Establish definitions -- agreement on terminology is critical in getting past rhetoric to action; e.g., "access to health care", "community health status".
• Review experience and conduct measurement -- understand existing data and public health agency experience; plan for ongoing measurement of program success.
• Engage leadership -- invite leaders of our healthcare and social services community; harness their intellectual capital and influence.
• Evoke commitment -- by seeking commitment from individual physicians, nurses, and clinics to see patients who do not now obtain regular care due to lack of means.
• Sustain coordination -- consider formation of a permanent "community health board" to sustain and coordinate.

Measurement helps identify community problems, understand the magnitude, prioritize solutions, and monitor progress toward becoming a healthy community. A Healthy Community health status report card shows:

• Categories of measurement indicators.
• Access to health education and primary care.
• Behavior and personal responsibility.
• Care services provided by private as well as public sources.
• Disability and occupational health.
• Environmental health.
• Maternal, child, and infant health.
• Morbidity and the leading causes of prevention.
• Mortality and the leading causes of long life.

Community health improvement is the ongoing process that encompasses the continuous efforts of the community’s key stakeholders to improve the community’s health status. Two community-based approaches for improving health status are: Community benefit programs and the healthy community process.

Community benefit programs are programs or services that meet community health needs and provide measurable improvement in health access, health status and use of health care resources. The product is a program. Community benefit programs are: issue oriented, disease management, short term outcomes, measured by process and outcome objectives, and usually health system owned. In this case, Healthy People 2010 objectives are useful for identifying the issue up front, setting direction, and measuring progress.

The Healthy Community process is about building relationships and trust, among multiple sponsors with community ownership. For the Healthy Community Process to work, the initiative must assess social capital, determine assets, look at secondary data, choose priorities, and develop action groups. Action groups start from scratch, build on and link existing initiatives, and work to strengthen an existing effort by refining its approaches and implementation strategies. Success is measured on whether trusting relationships were built across community systems and includes:

• Broad definition of health.
• Shared vision from community values.
• Quality of life for everyone.
• Diverse citizen participation.
• Community ownership.
• Focus on system change.
• Local capacity built.

The Healthy Community Process uses Healthy People 2010 Objectives in setting direction and measuring progress.

New Orleans Transcripts and Summaries