This is the first of a three part series regarding Addressing Social Determinants of Health and Health Disparities.
I live and work in Jacksonville, FL, a large city in Duval County, northeastern Florida where the St. Johns River meets the Atlantic Ocean. We are a regional business center, with many museums and cultural offerings. Swimming, fishing and surfing are popular at nearby barrier island beaches such as Jacksonville Beach and Neptune Beach. Championship golf courses in the area include Ponte Vedra Beach’s TPC Sawgrass, headquarters of the PGA Tour. I personally enjoy the quiet and natural beauty of Amelia Island.
Slightly more than two years ago, headlines screamed about Jacksonville, FL. Mayor Curry and other community leaders gathered to focus on the challenging work ahead of them to address health disparities and other health-care concerns in Jacksonville. A “health disparity” refers to a higher burden of illness, injury, disability, or mortality experienced by one group relative to another. A “health care disparity” typically refers to differences between groups in health insurance coverage, access to and use of care, and quality of care.
Addressing Social Determinants of Health
Much of the discussion focused on local social determinants of health that are contributing to health disparities. Social determinants of health are the conditions in which people are born, grow, live, work and age that shape health. Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. Addressing social determinants of health is important for improving health and reducing longstanding disparities in health and health care.
Leaders and residents were alarmed to learn that out of 67 counties across the state, Jacksonville was ranked number 42 for quality health outcomes. It was a consensus amongst; government leaders, health care providers, community organizations, employers and residents, this ranking was unacceptable. The City of Jacksonville and partners throughout Duval County set the ambitious goal of improving the state ranking from 42, all the way to number one in Florida.
Jacksonville Community Health Improvement Plan
In Jacksonville (Duval County), the Community Health Improvement Plan (CHIP) identifies community specific focus areas for improved health that have been chosen by members of the community. The 2017-2018 CHIP also defines how public health system partners will work together to address health priorities. The result is a well-crafted roadmap of strategic priorities and goals:
Strategic Priority 1: Healthy Families and Healthy Babies
Goal: Reduce infant mortality and morbidity
Strategic Priority 2: Healthiest Weight
Goals: Increase the percent of children and adults who are at a healthy weight and increase access to nutritious and affordable food
Strategic Priority 3: Behavioral Health
Goals: Reduce deaths due to suicide and reduce opioid use related deaths
Strategic Priority 4: Access to Care
Goal: Decrease barriers to accessing care
Examples of the CHIP at Work
- Mayor Curry’s City of Jacksonville Journey to One, an initiative aimed at improving the health and well-being of citizens and communities. The Mission is stated as “Every one in every zip code lives well.” The Journey to One Goals are to (a) improve the health behavior of citizens, leading to greater outcomes in countywide health rankings, (b) increase access and availability of quality health offerings and conditions in communities throughout the city, and (c) build or expand partnerships with organizations whose missions are aligned with City efforts to improve personal and community wellness.
- The Florida Department of Health – Duval County launched Healthy Jacksonville to improve the health of Jacksonville residents through progressive health promotion, disease prevention and treatment efforts. The vision of Healthy Jacksonville is to ensure quality of life for all people in the communities of Jacksonville.
- All of Jacksonville’s leading hospitals are active participants in the battle against health disparities.
Examples of Community Partnerships in Action
- Volunteers in Medicine, Jacksonville (VIM) has roughly 230 volunteers that annually provide about $1.2 million worth of primary and specialty care, dental and eye care, mental-health and nutritional counseling, among other services. They have seen 15,000 patients over the years and demand for the clinic’s services had already grown 26 percent in a year. The nonprofit has a new initiative called the PEACE Project that targets medically underserved low-income populations in Jacksonville, such as resettled refugees, English for Speakers of Other Languages students at local colleges and other minority groups. VIM is a free healthcare clinic that focuses care to Northeast Florida’s working, low-income, uninsured individuals and their families.
- Baptist Health Jacksonville delivers innovative community initiatives including The Way and Tipping the Scales that address primary care for the poor and uninsured, and provide mentoring to at-risk teens respectively in neighboring Jacksonville counties. Melanie Patz, Baptist Health VP, Community Investment and Impacts and Audrey Moran, EVP and President, Baptist Health Foundation lead Social Responsibility & Community Health initiatives including; Wellness, Mental Health, Access to Care and other critical community health needs.
- Mayo Clinic Florida and New Town Success Zone, a Jacksonville community organization focused on education, social well-being and community sustainability, together, launched a 3 year community-led wellness effort called Wellness Rx focused on health disparities identified in the New Town community. “Wellness Rx provides education on health issues, empowers the community to take action, and encourages residents to develop healthier habits,” says Ann-Marie Knight, Public Affairs, who is the administrator of Community Engagement in Florida. Mayo Clinic is engaged in a wide range of activities to identify and address health disparities. Some of these projects are collaborations with community organizations, while others involve clinical and basic research studies through Mayo’s Office of Health Disparities Research (OHDR). Mayo Clinic physician and researcher Richard D. White, MD of ODHR discusses obesity in African-Americans and other health disparities in Jacksonville.
- UF Health under Program Director, Dr. Carolyn M. Tucker, the six colleges of the University of Florida Health Science Center, the UF Health family of hospitals and many community volunteer partners work together to act as a health care safety net for many of the most vulnerable citizens of north Florida. The National Cancer Institute has awarded a five-year, $16 million grant to establish a cancer health equity center at the University of Florida and partner institutions. The center will bring together researchers from the two states with the highest cancer incidence and mortality to create a bicoastal minority cancer research and training center. Florida and California also have uniquely rich and heterogeneous populations of Blacks and Latinos, who are the focus of this study. Additionally, Dr. Carolyn Tucker, UF Florida Blue Endowed Chair in Health Disparities Research, has received an $820,000 grant from the Humana Foundation to conduct year one of a three-year program to address food insecurity, social isolation, and loneliness among low-income senior citizens (age 65+) in Jacksonville, Florida.
- Humana is also attacking local health disparities in several other ways including an alliance with black churches to close racial health gaps, and Humana Bold Goal, helping Jacksonville working to become one of the healthiest cities in America (20% Healthier By 2020). Humana is working with community, physician and clinician partners to help solve some of Jacksonville’s toughest barriers to health.
- Florida Blue under Darnell Smith, Florida Blue Market President, North Florida’s leadership, the company is extensively invested in addressing social determinants of health and health disparities in the community. Florida Blue is partnering with health care professionals to improve cultural competence. Cultural competence better prepares health care leaders and workforce and other community leaders, to better understand the needs of a very diverse population and customize health care to meet the patient’s cultural, linguistic and social needs.
In 2017, Florida Blue, NFL’s Jacksonville Jaguars, and The 100 Black Men of Jacksonville, Inc. kicked-off National Prostate Cancer Awareness Month by partnering to launch the Men Tackling the Big C Prostate Cancer Awareness and Education (MTBC) initiative last year. The MTBC program will provide coordinated outreach to inform men and their families about risks factors, screening, diagnosis and treatment options related to prostate cancer.
Happy New Year! The New Attack Plan
Northeast Florida’s Healthy Start Coalition has a new five-year plan to address health disparities and social determinants of health through 2023. It aligns with three main areas of focus – saving babies, strengthening families and building communities to ultimately reduce Florida’s high infant mortality and improve the lives of pregnant women and their families.
Please join me Friday, February 15, 2019, for the annual review meeting of Duval County’s Community Health Improvement Plan (CHIP). At this meeting, the Jacksonville community will celebrate progress, identify opportunities, and plan for implementation of Duval County’s CHIP in 2019 and beyond.
Please continue to follow my blog for the next post in a three (3) post series on addressing social determinants of health and health disparities.