The Journey: Community
Health Improvement in
Yellowstone County
Webinar Presentation
Rural Health Initiative
April 10, 2014
Heather R. Fink, MA, Community Health Improvement Coordinator
On behalf of the Alliance: Billings Clinic, RiverStone Health, St. Vincent Healthcare
Objectives
• Present a brief overview of The Alliance and its recent work
• Provide an overview of the current Yellowstone County
Community Health Needs Assessment and Community
Health Improvement Plan and explain how these inform the
work of Healthy By Design
• Offer information on the existing Healthy By Design
structure and efforts
The Alliance
Our Journey
Cover the Uninsured Week
Medication
Assistance Program
Healthy By Design
Health Communications Team
Health Insurance Marketplace Outreach &
Enrollment
Timeline
2000
-Convened to address uninsured, underinsured, or underserved
2002
-Alliance members met to develop a mission and shared vision
2003-04
-Primary Health Care Access “Cover the Uninsured” week activities
2005
-Public Health Assessment conducted-NPHPSP
2006
-Community Health Assessment completed
2007
-Awarded Robert Wood Johnson Foundation grant
-Healthy Places Initiative
-Health Impact Assessment of Yellowstone County/City of Billing Growth Policy
-Birth of Healthy By Design Recognition program
2008
-Community Health component adopted into Growth Policy
2009
-Awarded NACCHO ACHIEVE Healthy Community grant (promote PSE)
-Community Action Plan focused on “Complete Streets” policy
-Roll out of the Recognition program
2010
-National Association of County City Health Officials Model Practice Award
-Healthy Weight Collaborative and 5-2-1-0 development
-CHNA completed, developed PITCH, revised to CHIP
2011
-Complete Streets policy adopted
-Worksite nutrition and Physical Activity being developed
-Women and Children’s Health work began pending grant funds
2012
-Healthy By Design structure and workgroups
2013-14
-CHNA completed, CHIP update underway
How many of you use a local
community health needs assessment in
your work?
Community Health Needs Assessment
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Completed every 5 years, now every 3
Sponsored by the Alliance
Randomized telephone survey of 404 Yellowstone
County adults
Secondary Data
 Public health data & vital records statistics
Focus Groups
 Physicians & other Health Professionals
 Legislators
 Social Service Providers
 Educators
 Employers
South side neighborhood residents
Trends: 2005-06 to 2013-14
General Health
POSITIVE TRENDS
Physical limitations to activity
Mental Health
Disease
Preventive Care
Deaths from:
Cancer, Heart Disease, Stroke,
Diabetes, Pneumonia/Influenza
Incidence of Tuberculosis
Cholesterol Screening
Health Risk Behaviors
Access to Health Services
Breast Cancer Screening
Influenza Immunizations(65 & up)
Fruit & Vegetable Consumption
Maternal & Infant Health
NEGATIVE TRENDS
Self-Evaluation-Overall Health
Self Evaluation-Mental Health
Teen Suicide Attempts
Kidney Disease, High Blood
Pressure Prevalence, Pertussis,
Hepatitis C, Alzheimer’s Disease
Current Smokers, Cirrhosis/Liver
Disease
Low Birth Weights
Unintentional Injury Deaths,
Adult Obese Prevalence,
Children’s Screen Time
Chronic Drinking, Drug Induced
Deaths, Smokeless Tobacco
Births to Unwed Mothers
Infant Death Rate
Routine Check-Up in Past Yr.
Difficulty Finding Physician
2013-14 CHNA Results
Yellowstone County residents were struggling with
these modifiable health risks:
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65.7% were overweight or obese
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Only 42.1% met physical activity
recommendations
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Only 40.1% consumed the
recommended five+ servings of fruits
and vegetables daily
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81.7% presented one or more
cardiovascular disease risk factors
Current Community Health
Improvement Plan
IMPROVE ACCESS TO HEALTHCARE
• Goal: Increase percentage of people who have a specific
source of ongoing healthcare
IMPROVE HEALTHY WEIGHT STATUS
• Goal: Increase the percentage of people in Yellowstone
County who have a healthy weight
IMPROVE MENTAL HEALTH
• Goal: Increase percentage of people reporting their mental
health status as being good, very good or excellent
The Alliance
Healthy by
Design
Health
Equity
Healthy
Weight
Community Health Improvement
Recognition
Program
Worksite
Wellness
Built
Environment
Healthy By Design Coalition
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Better Billings Foundation
Big Sky EDA
Big Sky State Games
Billings Clinic
Billings Family YMCA
Cancer Control Coalition
Chamber of Commerce/CVB
City-County Planning Dept.
community health advocates
League of Women Voters
MET Transit
McCall Development
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MSU Billings
MSU Extension Service
Northern Plains Resource Council
Nutrition for the Future
Parks and Rec
Peaks to Plains Design
RiverStone Health
Safe Routes to School
Salvation Army
St.Vincent Healthcare
School Health Advisory Council
United Way
Healthy By Design’s
Current Initiatives
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Health Equity
Built Environment
Worksite Wellness
Healthy Weight Collaborative
Healthy By Design Recognition Program
Focused on Policy, Systems and
Environmental Change!
Recognition Program Workgroup
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Create
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Educate
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Encourage
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Recognize
…a new standard of excellence
that will shape our community’s future!
Recognition Program Workgroup
Five Standards
 Safety
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Nutrition
Physical Activity
Environmental Stewardship
Prevention & Overall Wellness
Built Environment Workgroup
Consequences of our built environment decisions
Dan Burden photo
1969: 48% of all children walked or biked to school
2009: 13% of kids walked or biked to school
Built Environment Workgroup
Compare these streets…
Designed for cars only
Designed for all users
Built Environment Workgroup
We once had Complete Streets
Downtown Billings intersection in 1915
Photo courtesy of Western Heritage Center
“Complete Streets” passed unanimously
by City Council. Adopted by Billings
August 22, 2011
Complete streets are
designed and operated to
enable safe access for all
users. Pedestrians,
bicyclists, motorists, and
public transportation
users of all ages and
abilities are able to safely
move along and across a
complete street.*
* Source: National Complete Streets Coalition
www.completestreets.org
Zimmerman Trail near Poly Drive
Healthy Weight Workgroup
After just 20 minutes of physical
activity, brain activity improves, yet
only 25% of high school students are
active for the recommended 60
minutes each day
Students who eat breakfast have
better attention and memory, but
only 38% of all teens say they eat
breakfast every day of the week
http://www.nationaldairycouncil.org/ChildNutrition/Pages/Heal
thy-Students-are-Better-Students-Wellness-ImpactInfographic.aspx
Healthy Weight Workgroup
Healthy Weight Collaborative Project
Worksite Wellness Workgroup
Centers for Disease Control (CDC) Definition
Workplace health programs are a coordinated and
comprehensive set of health promotion and protection
strategies implemented at the worksite that includes
programs, policies, benefits, environmental supports, and
links to the surrounding community designed to
encourage the health and safety of all employees.
Worksite Wellness
Worksite Wellness
www.cdc.gov/workplacehealthpromotion/businesscase/benefits/index.html
Benefit to Employers
• Lower health care and disability costs
• Enhanced employee productivity
• Reduced employee absenteeism
• Decreased rates of illness and injuries
• Enhanced corporate image
• Improved employee morale
• Improved employee recruitment and retention
• Increased organizational commitment
• Creation of a culture of health
www.cdc.gov/workplacehealthpromotion/businesscase/benefits/index.html
Benefit to Employees
• Increased well-being, self-image, and self-esteem
• Improved coping skills with stress or other factors
affecting health
• Improved health status
• Lower costs for acute health issues
• Lower out of pocket costs for health care services
(e.g., reduced premiums; deductibles; co-payments)
• Increased access to health promotion resources and
social support
• Safer and more supportive work environment
• Improved job satisfaction
Wellness Program ROI
Presence ≠ Effectiveness
A well designed, customized program that is
integrated, comprehensive, diversified, and
championed by senior leadership and
management can average an ROI of over 3 to 1
on health care costs and well over 2 to 1 on
absence and lost productivity
after about 3 years.
www.shrm.org/hrdisciplines/benefits/articles/pages/wellness-roi-design.aspx?homepage=mpc
Health Equity Workgroup
Research shows that economic, social, and environmental
factors -- like income, gender, race, and housing -- influence
health. Health equity refers to a standard to improve the
health of those who have experienced economic, social, or
environmental disadvantages. A community that is healthy by
design actively works to achieve the highest level of health
possible for all groups, especially those most at risk for facing
barriers to healthy lives. Better health equity enables more
people to participate in the economy, decreases public costs,
and supports social unity.
Health Equity Workgroup
Gardeners’ Market
Begins June 12th.
Thursdays
5-7pm
Moving to South
Park in 2014!
Gardeners’ Market
Report on 2013…
 Average of 50 customers each
week
 Average of 5 sellers weekly
 $1,117 of produce sold
 Flowers, seeds
and plants donated
 Master Gardeners
Table
 Southside
Neighborhood
Task Force Table
Increasing Physical Activity for Women in Yellowstone
County via a Gender Based Approach
Gender Analysis Results
Gender-based Constraints
Gender-based Opportunities
Health Equity Workgroup
Increasing Physical Activity for Women
Currently using
Active Living Every
Day classes to
address identified
constraints and
provide education
Health Equity
Workgroup
Also offering a
targeted message
social media
awareness
campaign…
Health Equity
Workgroup
Healthy By Design
www.healthybydesignyellowstone.org
The Journey Continues…
Healthy By Design’s mission is to collaborative with
partners across sectors of the community to promote
and improve health.
Creating a community that is Healthy by Design.
Making the Healthy Choice the Easy Choice
THANK YOU
Heather Fink
Community Health Improvement Coordinator
On behalf of the Alliance: Billings Clinic, RiverStone Health, St. Vincent Healthcare
heather@healthybydesignyellowstone.org
406-247-3272
www.healthybydesignyellowstone.org
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