Our Strategic Program aims to create long-term, measurable, sustainable change in the health of our seven-county region. The key themes running through all the strategic priorities will be tackling any issue with a multi-faceted, community-based approach. The initiatives may last three to seven years with continual evaluation and measurement of success.
Empire Health Foundation's first two strategic issue areas are: 1) Obesity Prevention, and 2) Mental Health. To the extent possible, the team will look for opportunities to complement these two programs with each other and with our other efforts.
The obesity epidemic is a national crisis. In fact, 68% of our population is overweight and obese. We know that we need a complex solution to a complex problem. One that is multi-faceted, crossing many silos and sectors, and is adaptive. In order to be successful as a region at addressing the obesity crisis, we need to develop strong community partnerships and leverage that to foster community change and encourage healthy living.
In early 2011, the Foundation began the obesity prevention initiative with an evaluation of several rural communities in our region to understand the healthy living initiatives that were already taking place and meet the local leadership championing these efforts. Through that initial exploration, the Foundation is currently working with the community of Cheney to implement a significant pilot project with several multi-pronged, community-based interventions. In addition, five other rural school districts are participating in the obesity prevention initiative through significant reform of their school food programs. In 2013 and over the next 12-18 months, the Foundation will work together with these communities to support existing efforts in each community and assist in expanding the scope of involvement these groups have in creating healthier communities. A critical component of this work will be ongoing commitment of time, energy and resources from local leaders in each community. Our hope is to take this learning and apply it regionally, partnering with as many communities as we can in our seven counties over the next few years.
Systems, Policy & Environmental Changes
It is clear that the most effective, sustainable solutions to combat the obesity epidemic are systems and policy changes that ultimately affect the environment in which we live, work, and play. Programmatic and/or individual behavior changes are important to improving and individual’s health, but are not effective by themselves to change the health of a population.
Examples of evidence-based practices that contribute toward obesity prevention
Highlight: School Food Reform
Since fall of 2011, Cheney and Othello school districts have been working hard to completely reformulate their school food systems. In the summer of 2012, the school districts of Davenport, East Valley, Newport, and Wellpinit, along with the Community School of Spokane Public Schools, joined this effort. Ninety to 95% of all highly-processed foods that include unwanted ingredients such as high fructose corn syrup, preservatives and other chemicals are being removed, and instead wholesome, scratch-cooked food is being served for breakfast and lunch everyday. Nearly 15,000 K-12 students are enrolled in these school districts and will be positively affected by this change. This new model fits within the existing financial structure of the school food program, and some schools are even able to achieve a positive financial return on investment over time. Nutrition education integration is beginning to occur in the classroom and throughout the communities as well. We have partnered with consultants to conduct the training, technical assistance, and hands-on guidance through the change.
The Alliance for a Healthier Generation: "Eastern Washington Schools Tackle Obesity Head On"
Action for Healthy Kids: "Cheney School District Tackles Student Wellness Head-On"
InHealth Healthy Living in the Northwest: "Selling Healthy: Remaking school lunches to be healthier is a big challenge, but small victories are starting to emerge"
Working on the spectrum from prevention to treatment, the Foundation is currently focused on designing and promoting strategies to reduce Adverse Childhood Experiences (ACEs) as well as build resiliency among youth and adults who have experienced multiple ACEs throughout the course of their childhood. In addition, the team is working with local health providers to better integrate the behavioral health and primary care delivery systems and bridge gaps between the various other agencies that serve overlapping populations.
Bi-Lateral Integration between Primary Care and Behavioral Healthcare
The team is currently working with a group of local providers to help initiate a pilot that successfully integrates primary care and behavioral health care for a specific target population. The work is in the early formative stage, and we are continually learning on a daily basis. Some of the strategic principles and goals for this work include:
Reducing the prevalence and mitigating the effects of Adverse Childhood Experiences (ACEs)
The team is currently working to better understand the research relating to Adverse Childhood Experiences (ACEs) and the powerful relationships between life stressors during the first eighteen years of life, and the physical, emotional and behavioral health issues across a person’s life span. ACE-related health outcomes with substantial public costs include: depression, chronic illness, substance abuse, and teen pregnancy (Anda et al, 2006). We are currently in the early stages of developing a strategy for our role in helping take this powerful research and turn it into tangible interventions in our region aimed at reducing the prevalence of ACEs as well as building resiliency among individuals who have experienced childhood trauma.
Reference: Anda, R.F., Felitti, V.J., Bremner, J.D., Walker, J.D., Whitfield, C., Perry, B.D., Dube, S.R., & Giles, W.H. (2006). The enduring effects of abuse and related adverse experiences in childhood. European Archives of Psychiatry and Clinical Neuroscience, 256, 174-186.
Spokesman Review Editorial: "We need to nuture young brains"
* New Report Available!: Complex Trauma: Key Informant Perspectives, prepared for Empire Health Foundation by Clegg & Associates.