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In This Section
|The health status of community residents is not the sole responsibility of the public health agency or health service providers. While public health agencies may bear responsibility for leading community health improvement efforts, their success hinges on their ability to establish and maintain effective partnerships throughout the state. The public health agency needs to identify and work with all entities that influence community healthfrom other government agencies to businesses to not-for-profit organizations to the general citizenry. Healthy People initiatives should begin with a commitment to collaboration among diverse constituencies so that everyone feels a sense of ownership in the state plan.|
Below are examples of approaches that the nation and states used to identify and involve partners in the Healthy People planning process.
From the National Initiative
Healthy People Consortium
Established in 1987, the Healthy People Consortium is composed of more than 350 national membership organizations and the state public health, mental health, substance abuse, and environmental health agencies. The Consortium includes organizations that are national in scope and whose members (individuals, institutions, or affiliates) are interested in improving health and well-being for all. Consortium member organizations represent older adults, racial and ethnic coalitions, educators, businesses, providers, scientists, and many others.
The Consortium uses the Internet, quarterly newsletters, and annual meetings to support ongoing communication and collaboration. In the initial stages of the Healthy People 2010 development process, Consortium members were asked to renew their commitment to Healthy People and to the development of year 2010 objectives. See a copy of the pledge. Visit the Consortium web site for how to join, as well as the most current listing of members, newsletters, and summaries of annual meetings: http://odphp.osophs.dhhs.gov/pubs/hp2000/consort.htm.
Consortium members engage in a broad range of activities that support achievement of the national health objectives. Nearly all members have publicized the objectives to their members; and many have used their newsletters and journals to solicit comments on the draft Healthy People 2000 and 2010 objectives. Many others have highlighted the objectives at their annual conferences or devoted sessions to discuss how the organization and individuals can help achieve the objectives.
In 1996, the Consortium used professionally facilitated focus group sessions with key partners to examine the perceived value and functions of Healthy People objectives, both current and future. The findings from the Consortium focus groups can be found in Chapter Two of the report, Stakeholders Revisit Healthy People 2000 to Maximize the Impact of 2010, at the following web site: http://www.health.gov/hpcomments/stakeholder.
Clear themes and suggestions emerged from the analysis of the focus groups. Consortium members were unanimous in valuing Healthy People 2000 as a "voice for public health." The value of the document was not debated, only the extent and nature of revisions to be made for the next version. Although most Consortium members did not want major changes in the structure and content of the document, they did want to take advantage of new information and communication technology to create not only a single "reference" document, but also a flexible "database" that would permit multiple versions of the document to be produced.
Healthy People State Action Contacts
The Healthy People State Action Contacts are the states' representatives to the Healthy People Consortium. They receive national Healthy People resources and communicate to the nation information about state activities. An updated list is available in Appendix A and at the following web site: http://www.health.gov/healthypeople/contact/statecontact.htm.
Business Advisory Council
In 1997, with funding from the Robert Wood Johnson Foundation, the Partnership for Prevention (a Healthy People Consortium member) created a Healthy People Business Advisory Council. This Council is engaging the leaders of Americas businesses, both large and small, in evaluating Healthy People as a tool for both worksite based and general community health promotion. The Council also participated in Healthy People 2010 development. For information on Council activities, visit: http://www.prevent.org
From State Initiatives
Form a statewide coalition of partners
In 1991 South Carolina formed the Healthy People Coalition as an independent organization with members elected to a governing council. The Coalition's mission is to promote an environment where all South Carolinians have the ability to achieve and maintain maximum health and well-being. The Coalitions strategies included raising public awareness of the national health objectives, identifying the focus for action in communities throughout the state, and focusing attention on reducing health status disparities among population groups. The Coalition worked with the Department of Health and Environmental Control and other organizations to track changes in health status, behaviors, and other indicators against the national Healthy People objectives and promoted their findings. Local communities also formed their own coalitions, which meet annually to learn about activities in other localities.
Formed in 1990, the Healthy West Virginia Coalition is composed of 18 organizations representing public health, health care providers, school health programs, universities, worksites, and networks. The Coalition fosters collaboration among various sectors to help advance the goals of Healthy People 2000 and 2010 in West Virginia. West Virginia also planned a two-day Summit, scheduled for summer 1999, to bring together hundreds of West Virginians for a meeting on the Healthy People goals and objectives. Another instrumental group for pulling together key partners has been the State Health Education Council, founded in 1977, an organization of more than 300 individuals working in the areas of health promotion and health education in the state of West Virginia.
To achieve its year 2000 objectives, the Rhode Island Department of Health initiated the Worksite Wellness Council of Rhode Island. Rhode Island focused on increasing health promotion and disease prevention activities in worksites, where most adults spend the majority of their time. The state Wellness Council entered into an agreement with the Wellness Council of America (WELCOA) to make Rhode Island the first Well State in the U.S. Through this agreement, Rhode Island aims to have 20 percent of its workforce in WELCOA-certified Work Well Sites. The Wellness Council obtained a nonprofit tax status and is governed by its own Board of Directors. While the Council works toward financial independence, the Council is staffed by the Department of Health and supported by financial and in-kind contributions of its business members. The Council will continue to be involved in Rhode Island's year 2010 activities.
Develop multiple levels of participation
Iowa organized multiple levels of participation in the development of year 2000 objectives. Iowas governor appointed a 19-member Healthy Iowans Task Force, composed of state agencies, academic institutions, voluntary agencies, consumers, health professional associations, and the state board of health. Iowa's governor assured gender and political party balanced the group. A consortium of 80 professional and voluntary organizations assisted in the development of sections and action steps. The state mailed several hundred copies of the draft Healthy Iowans 2000 to interested groups and individuals for comment. Written comments, as well as testimony at public meetings, informed the Task Forces final deliberations with the governor over the objectives.
According to the Iowa Department of Health, the private and voluntary sector has or shares major responsibility for 20 percent of the 338 action steps in Healthy Iowans 2000. The states year 2000 plan designated specific state agencies, voluntary organizations, and companies that would be involved in the realization of each objective.
In 1995 Vermont adjusted the states health status objectives to the community level. This created a document more meaningful to local organizations and helped to further engage the people at the community level.
In the spring of 1996, the Texas Department of Health, the Texas Health Foundation, and the CDC sponsored a two and a half-day conference entitled "Mobilizing for Health: The ABCs of Community Assessment." Over 700 persons attended the conference. The conference goal was to provide communities with the planning, data collection, community organizing, and policy analysis tools needed to successfully undertake the community assessment process. It attracted a wide variety of private, public, and nonprofit organizations and encouraged them to work together to improve the overall health of Texas communities.
Minnesota formed the Minnesota Health Improvement Partnership, a group of individuals representing a broad sector of both public and private organizations, including members from local departments of health. This group was charged with the responsibility to develop Healthy Minnesotans: Public Health Improvement Goals for 2004.
Influence strategic plans of external community organizations, both private and public
Maine and Tennessee were among several states whose year 2000 objectives influenced the planning and activities of private health organizations. As examples, the American Cancer Society in Maine redesigned their core activities to reflect the state's health objectives. Tennessees Health Facilities Commission incorporated the state's objectives into its Certificate of Need Process.
Since 1995, Minnesota law has required managed care organizations to submit Collaboration Plans to the state's Commissioner of Health. Plans must describe actions that the health maintenance organizations or community-integrated networks have taken or intend to take to achieve public health goals. The Minnesota legislation helps communities utilize the combined efforts of the public and private sectors to address priority health problems of shared concern.
In South Dakota individual programs seek input from partners within and outside state government. The states Public Health Alliance Program is a cooperative effort involving the Department of Health, local health care providers, and county government. These entities work together to ensure the delivery of public health services. Through this project, community councils are formed and actively participate in program planning and implementation. County-specific health indicators are presented to community health councils. During these presentations, the county-specific indicators are compared to statewide indicators, national measures, and relevant Healthy People objectives.
Methods of Community Input in the
Note: States may be counted more than once since some provide more than one type of assistance in objectives planning, development, and tracking.
Source: Public Health Foundation. Measuring Health Objectives and Indicators: 1997 State and Local Capacity Survey. March 1998.
Source: Dever, G.E.A. Improving Outcomes in Public Health Practice: Strategy and Methods. Aspen Publishers, Inc., Maryland, 1997.
Below is a partial listing of the many public, private, and voluntary sector partners that states have engaged in Healthy People initiatives. Which are most important to you?
Agency on Aging
Planning/ Regulatory Agencies
Health Education Center
q American Association of Retired Persons
Corps of Engineers
|Forming Partnership Agreements
How can partnerships effectively assist the development and implementation of the state plan? The following provides factors to consider when delineating the roles and responsibilities of partners.
What are partnership agreements?
What are essential components of partnership agreements?
What are potential roles for partners?
|µ National Association of County Health Officials. Assessment
Protocol for Excellence in Public Health (APEXPH), 1991.
µ Coalition for Healthier Cities and Communities, Norris, T. & Howell, L. Healthy People in Healthy Communities: A Dialogue Guide 1999.
µ Community Tool Box, http://ctb.lsi.ukans.edu/
µ Institute of Medicine (Committee on Public Health). Healthy Communities: New Partnerships for the Future of Public Health. National Academy Press, Washington, D.C., 1996. http://www.nap.edu/catalog/5475.html
µ U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC/ATSDR Committee on Community Engagement). Principles of Community Engagement. Atlanta, Georgia, 1997.
µ Civic Practices Network. http://www.cpn.org/sections/topics/community/index.html
Please see Appendix A for other resources about engaging community partners.
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