Improving the Health of a Community Through Partnership: The UNC - PowerPoint PPT Presentation

Improving the Health of a Community Through Partnership: The UNC Charlotte Experience Leadership North Carolina BCBSNC Health and Human Services Session February 6, 2019 Charlotte, North Carolina Mark J. DeHaven, Ph.D. Dean W. Colvard Distinguished Professor Director, Academy for Research on Community Health, Engagement, and Services (ARCHES) Co-Developer and Director, UCITY Family Zone University of North Carolina at Charlotte

So c ial Sc ie nc e is a Gr e ate r Co ntr ibuto r to He alth T han Me dic al Sc ie nc e “. . . the e mpiric a l e vide nc e indic a te s [tha t] the o ve rall c o ntrib utio n o f me dic al c are to impro ving he alth is mo de st and at the marg in . . . e duc a tio n, life style , the e nviro nme nt, a nd inc o me [a re ] the ma jo r c o ntrib uting fa c to rs” (Sa nte rre a nd Ne un, He alth E c o no mic s, 2000, p. 69) 2

Rudolf Ludwig Karl Virchow (1821-1902) Father of Pathology and Community Medicine “The physician is the natural attorney for the poor.” Medicine should be reformed along the following lines: 1. Health is socially determined - Social and economic conditions have a sustained and cumulative effect on health and disease . . . 2. Disease is due mostly to poverty, unemployment, malnutrition, under education, disenfranchisement, and poor access to medical services . . . 3. Measures taken to promote health and to combat disease must be social as well as medical . . . (Virchow, Th e Medical Reform, 1848 )

Causes of Death - Molecular Event 25% 20% 15% Heart Disease Cancer 10% COPD Accidents 5% Stroke Alzheimer's Diabetes 0% Causes of Death Leading Causes of Death, 2015; www.cdc.gov .

Causes of the Causes Behavior and Lifestyle 50% 40% Environmental Exposure 30% Genetics 20% Health Care 10% 0% Lee and Paxman. “Reinventing Public Health.” Annual Review of Public Health 18: 1-35, 1997.

Causes of the Causes of the Causes 20% 15% Low Education 10% Low Social Support Poverty 5% Racial Segregation Income Inequality Area-level Poverty 0% Causes of Death Galea S, et al. Estimated Deaths Attributable to Social Factors in the United States. Am J Public Health. Ahead of Print on June 16, 2011

“T he re is a dir e c t, c ausal, and me asur able pa thwa y b e twe e n the c o nditio ns in whic h pe o ple live , g ro w, le a rn, a nd wo rk; a nd the ir physic a l, so c ia l, c o g nitive , a nd e mo tio na l de ve lo pme nt a nd he a lth” De Have n MJ and Gimpe l NE . Re ac hing Out to T ho se in Ne e d. Jo urnal o f the Ame ric an Bo ard o f F amily Me dic ine , 2007; 20(6):527-532. De Have n MJ. Multimo rb idity, c hro nic dise ase , and c o mmunity he alth sc ie nc e . J E val Clin Prac t . 2017;23:219–221.

Improving Community and Family Wellbeing Through Dynamic Process Intervention

Ho w c a n a unive rsity with a la rg e numb e r o f so c ia l sc ie ntists a nd stude nts c o ntrib ute to impro ving the he a lth o f its c o mmunity in a wa y tha t is a lig ne d with its missio n o f te a c hing , re se a rc h, a nd se rvic e ? UNC Cha rlo tte , 2015 - 2019

Ac ade my for Re se ar c h on Community He alth, E ngage me nt, and Se r vic e s (ARCHE S)* To be a central and focused point of contact, catalyst, incubator, and facilitator for working ‘with” (not just “in”) the local community for sustaining and measuring community health improvement at scale and consistent with UNCC’s teaching, research, and service missions T ao o f L e ade r ship Go to the pe o ple L e a rn fro m the m Sta rt with wha t the y ha ve Build o n wha t the y kno w L ao T ze , 600 BC – 531 BC * Currently about 60 faculty members and 60 students from across UNCC (5 colleges, Urban Institute, Academic Affairs)

T he Co mmUnive r sity Whe re the he a lth ne e ds o f the c o mmunity c o nve rg e with the re se a rc h, tra ining , a nd se rvic e missio ns o f the unive rsity.

“E quipping Pe o ple to L ive He althy, Ho pe ful, and Pr o duc tive L ive s” Sinc e 2004 Pro viding ho listic he a lth, in b o dy, mind a nd spirit, to o ve r 20,000 pe o ple a nnua lly.

Camino / UNCC CommUnive r sity

Sample CommUnive r sity Ac tivitie s (2018- 2019) De ve lo pe d a he a lth risk a sse ssme nt pro g ra m a nd sta ffe d a • we e kly e xe rc ise pro g ra m funde d b y BCBSNC • On-site c o urse s re a c h hundre ds o f fa milie s thro ug h “So c ia l Wo rk Pra c tic e with L a tino Co mmunitie s,” “Afro -L a tin Da nc e ,” “Re a ding fo r E ng lish L a ng ua g e L e a rne rs” Pla y the ra py pro g ra m fo r wo rking with c hildre n a nd fa milie s to • impro ve c o mmunic a tio n a nd me nta l he a lth Stude nts in the Bo nne r L e a de rs Pro g ra m pro vide pe rso nne l a nd • re se a rc h suppo rt fo r he a lth e duc a tio n, lite ra c y, fo o d se rvic e s, inte rpre ta tio n, a nd multiple so c ia l a nd he a lth suppo rt se rvic e s.

T u no e stás so lo (Yo u are no t alo ne ) • 14 we e k Spa nish a nd E ng lish me nta l he a lth c o unse ling pro g ra m • UNCC c o unse ling , he a lth psyc ho lo g y, so c ia l wo rk stude nts with fa c ulty supe rvisio n • Pilo t study (N=79) de mo nstra te d sta tistic a lly sig nific a nt impro ve me nts in stre ss, a nxie ty, a nd de pre ssio n using the De pre ssio n Anxie ty Stre ss Sc a le s (DASS). • L e ve ra g e d the pro g ra m suc c e ss into o ve r $500,000 (2018-2019) o f g ra nts fo r impro ving me nta l he a lth a t Ca mino ; me nta l he a lth dire c to r is a UNCC stude nt who he lpe d to de ve lo p the pro g ra m • NPR All T hing s Co nside re d fe a ture sto ry – June 2016

“a zip c o de is a stro ng e r pre dic to r o f a pe rso n’ s he alth than a g e ne tic c o de ” A Place-Based Partnership for Improving Social Determinants of Health and Quality of Life in the University City Communities Go to the pe o ple . . .

T he Unive rsity City a nd Surro unding Co mmunitie s – Pla c e Ma tte rs (Po p. 45,426) • Ho use ho ld inc o me - $38,961 (Co unty, $56,854) • Ra c e a nd e thnic ity - Afric a n-Ame ric a n (44%), White (22%), a nd L a tino (30%) • Ag e o f de a th - 65 ye a rs (Co unty, 71 ye a rs; Hig he st 79 ye a rs) • Ba c he lo r’ s De g re e - 30% (Co unty, 42%) T e st pro fic ie nc y in E le me nta ry Sc ho o l - 36.6% (Co unty, 51.2%); • Middle Sc ho o l - 26.8% (Co unty, 44.4%); Hig h Sc ho o l - 30.2% (Co unty, 50.4%) • Ho me o wne rship - 33% (Co unty, 57%); Sing le F a mily Ho using - 36% (Co unty, 60%) Pro pe rty c rime - 61.4 c rime s pe r 1,000 pe o ple (Co unty, 31.8) •

Sample Ac tivitie s o f UCity F amily Zo ne 2018-2019 • Co nduc te d (funde d b y the K nig ht F o unda tio n) a n a sse t-b a se d c o mmunity de ve lo pme nt (ABCD) a sse ssme nt o f the lo c a l c o mmunity • I mple me nte d the “K ids E a t F re e ” pro g ra m in pa rtne rship with Atrium He a lth – pro vide d 3600 fre e summe r me a ls to c o mmunity c hildre n Ho ste d the 2 nd a nd 3 rd Annua l L • a tinx Me nta l He a lth Summit (a tte nd e d b y 400 c o mmunity pa rtne rs) I mple me nte d the “I n the Mo o d fo r F o o d” a fte rsc ho o l pro g ra m in • c o lla b o ra tio n with He a l Cha rlo tte a nd Orc ha rd T ra c e Co mmunity • Cre a te d Cha rlo tte ’ s first e ve r c o mmunity e c o syste m ma p o f 80 o rg a niza tio ns wo rking in the UCity c o mmunitie s to impro ve c o o rdina tio n • Urb a n De sig n Ma ste rs Stude nts pre se nte d a c o mpre he nsive site pla n o f the pla nne d Me c kle nb urg Co unty Co mmunity Re so urc e Ce nte r (CRC)

Ne xt Ste ps - T o ta l syste m c ha ng e – g e tting to sc a le F o c us o n c hildre n, yo uth, pa re nts, a nd fa milie s (“Go to the fo undatio ns, go to the NIH . . .”) What • Improve the availability and quality of services - housing, hunger, education, health, and workforce (already doing) • Strengthen the community through a focus on relationships 1. Social connectivity 2. Citizen-led engagement 3. Neighborhood connectivity How • Identify and develop a coordinated response to the needs and assets of the community in the following areas: 1. Nurturing parents 2. Good health – social, emotional, physical, spiritual 3. Financial stability 4. Educational success

Co mmunity Ac tio n Re se ar c h Sc ho lar s (CARS) Co mmunity T r aining Pr o gr am “Driving Co mmunity Co mpassio n” • Unde rg raduate and g raduate stude nts re c e ive training in the so c ial de te rminants o f he alth c o -taug ht b y c o mmunity me mb e rs and g raduate stude nts wo rking in the c o mmunity • Co mple te c o mmunity se rvic e -le arning , te ac hing , and re se arc h e xpe rie nc e s with a c o mmunity partne r (minimum 40 ho urs) • Re c e ive a Ce rtific ate o f Kno wle dg e in Co mmunity He alth me mb e rship in a natio nal pro fe ssio nal o rg anizatio n - Co mmunity Campus Partne rships fo r He alth and vo lunte e r 40 ho urs annually with a lo c al no n-pro fit o rg anizatio n Go to the pe o ple . . .