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

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

·  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

·  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

·  Disparities awareness, health inequities

·  Health inequities, disparities awareness

Aging Population

·  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

·  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