San Diego, California
"Healthy People in Healthy Communities"
October 28, 1995
James Harrell, Office of Disease Prevention and Health Promotion, U.S. Public Health Service, welcomed the participants. He noted that since the first Consortium meeting in 1987, the Federal government, States, communities, and private organizations have been partners on a course toward the beginning of a new century with a vision of healthier life for all Americans. We should congratulate ourselves at the midpoint of this 10-year race toward the year 2000. Although the Consortium organizations represent many categorical interests, we know we are stronger together than apart. We need to look for connections and new opportunities to collaborate.
The first speaker was Len Duhl, Executive Director of the International Healthy Cities Foundation, who noted that the Healthy Cities movement has its roots in history: the Koran talks about the need for clean water and privacy; the Jewish ghettos of Venice had housing codes to ensure safety; and the London settlement houses had sewage systems that improved the public's health. These and recent efforts provided the roots for the La Londe report, released 1974 in Ontario, which stated that medical care is not enough and public health and environment must be emphasized. A community is like an individualall parts must work together to make the whole vital and healthy. Strong physical and social infrastructures are essential.
Tyler Norris of Tyler Norris Associates, Inc. suggested that efforts to improve health in communities must go beyond projects, interventions, or infusion of dollars. Communities must take ownership of the diseases, poverty, and environmental hazards that plague them. A civic culture of shared responsibility is essential to affect and sustain positive change. A Healthy City mobilizes the community's resources and creativity for local action. Participants in a successful Healthy City initiative have a clear vision of what they want and set benchmarks meaningful to the community to measure progress. There are as many ways to build a healthy city as there are communities.
Joan Twiss, Facilitator and Director of the California Healthy Cities Project; Doug Clark, City Manager of Escondido, California; Robert Ross, Director, San Diego County Department of Health Services; and Tracy Ream, Executive Director of the Escondido Community Health Center, described EscondidoOne California Healthy City. As the first statewide Healthy Cities program in the United States, California Healthy Cities Project provides technical assistance, brokers resources, develops products, sponsors educational programs, and conducts awards programs. Escondido, a California Healthy City, is committed to promoting prevention. The city government has been the convener, facilitator, collaborator, and broker of alcohol prevention efforts with the city's not-for-profit agencies, supplying feedback and monitoring to service providers as needed. The city has banned alcohol from its public parks and utilizes a not-for-profit sobering service for public inebriates. The community health center offers clients screening for alcohol and drugs and boasts a refusal rate of less than one percent. Dr. Ross defined leadership as collaboration. For government agencies, this means blending public dollars (e.g., probation, education, health, and social service dollars), giving the money away, and getting out of the way. Another role is to provide data on what is being done and evaluation of the difference programs are making.
Richard Wittenberg, President and CEO of the American Association for World Health, announced that the 1996 theme for World Health Day is "Healthy Cities For a Better Life." AAWH offers a free action kit to promote World Health Day, April 7, and the Healthy Cities/Communities program.
Philip R. Lee, Assistant Secretary for Health, remarked that Healthy People 2000 identifies measurable objectives in health improvement, while the Healthy Cities/Communities movement inspires the coalitions necessary to achieve these goals. The nexus between the two is performance measurement, which clarifies what we want to achieve, documents the contributions that coalition members make, and demonstrates returns on our investment in public health. A partnership process is underway involving the Federal government, States, and localities to develop a performance-based system for federally funded grant activity with mutually agreed-upon objectives. This collaborative process will empower communities to determine how best to address their health needs and priorities. A performance-based system, with an incentive-based focus on outcomes, will enrich both the Healthy People 2000 and Healthy Cities movements.
Dr. Lee also reviewed the Nation's progress on its disease prevention and health promotion objectives, sharing the challenges that remain in meeting Healthy People 2000's three overarching goals:
For more information, contact Ashley Coffield, (202)260-2322.
| A COALITION IS... In facilitated discussion sessions, Consortium members offered their perspectives on coalition-building and keeping projects on track. They defined what they believe a coalition to be and to have, and they discussed how Healthy People 2000 can serve as a basis for building and sustaining coalitions. |
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| A coalition is: Citizens participating collectively around issues through trust and commitment Inclusive Community-owned Culturally sensitive Process-centered and outcome-driven Empowerment to the community An integrator and catalyst People who recognize the problems and want solutions A coalition has: A coalition should: |
Using Healthy People 2000 as a framework for coalition
activities: Is a place to start in setting community-level objectives Provides a model for training coalition members to set measurable objectives Helps the coalition acknowledge progress and members' contributions To keep projects on track a coalition must: Evaluation of a coalition and its activities involves: |
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