FORCES OF CHANGE DISCUSSION WITH THE
ALAMEDA COUNTY PUBLIC HEALTH COMMISSION
June 12, 2014
San Leandro Library
Agenda
Overview and introductions
Agenda review
Description of Forces of Change Discussion: A way to see the forces of change at work
Review notes from AC Health Improvement Advisory Committee (large group)
Review notes in small workgroups
Large group discussion
Summary
End
FORCES OF CHANGE AT THE BOUNDARY AREAS OF THE WAVE:
Data Driven Collaboration
 Health in all Policies Task Force
 Role of big data
 Collective Impact
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Increasing Equity
Social Impact Bonds
Funding for Insurance for those excluded from health care reform
Immigration reform
Universal Pre-school
Reform of drug-crime enforcement
Living wage & employment reform
Healthy Communities Movement
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Mindfulness
Youth Leadership
Walkability, biking
Local food movement
Corporate awareness of HEAL
Diabetes Self-Management
Investing in Prevention
 Mindfulness
 Gun control
 Mental health funding
 Social impact bonds
Insurance companies investment in prevention
FORCES OF CHANGE AT THE EMERGIN AREAS OF THE WAVE:
Community Health Initiatives
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Diabetes, obesity
Increasing involvement of neighborhood org’s
Soda tax?
More cmmty based eval.
Tobacco use reduction (pre-natal nutrition for moms/babies
More attention to obesity epidemic & ramifications for chronic disease
ACA Ramifications
 ACA/Obamacare
 Actual impacts of ACA on Safety Net?
 State takeback of funds
 Funds for health care for undocumented
Health Inequities/Disparities Awareness
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Disparities awareness, health inequities
Health inequities, disparities awareness
Aging Population
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Aging population
Aging population
Patient Centered Medical Homes
 Access to primary care docs –ACA
 Community schools – health clinics, soc. servs
 Telehealth
Emergency Preparedness
 Emergency preparedness
Individual Items
 Big data empowering communities
 Restorative jusice
 Hep-C flourishing
Consumers – changing mindset re Co. servicess
FORCES OF CHANGE AT THE ESTABLISHED/ CRESTING AREAS OF THE WAVE:
Reactive Bio-Medical Model
 Medical model
 Not universal
 Medical model
Inadequate Workforce
 Low high school graduation rate
 Not enough diversity& #s in workforce
 No pipeline for increasing workforce
Resource Allocation NOT Need Based
 Old/broken infrastructure
 Lack of transportation
 No universal access to food
 Programs follow dollars - $
VIOLENCE
Fragmentation
 Departmental Divisions (Silos)
Income Inequality
 Housing costs
 Urban blight
 Wealth gap
Environmental Conditions
 Climate change
 Air Quality
Health care sales tax ????
FORCES OF CHANGE AT THE DISAPPREARING/ UNDERTOW AREAS OF THE WAVE:
Shift Away from Medical Model
 Long term hospital stay
 Focus on just acute care
 Medical model emphasis
ACA/Access to Care
 Access to care for undocumented
 ACA unknowns
Changes in Data Use
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Privacy
Anecdotal
The use of public health research data
Less program specific evaluation – decrease
Individual Items
 Political collabation
 Schools only for education
 Affordable housing
 Unsafe medical buildings
 Personal provider contact
 Bio-terrorism $s