Moving the NC 2010 Health Objectives Forward

How can the North Carolina 2010 health objectives be used?

Partnerships: Coordination and Collaboration

• Establish Healthy Carolinians partnerships. This is a mechanism to identify and unite organizations and groups that are engaged in like-minded efforts.
• Provide a guideline for developing or adding to community service projects.
• Serve as a catalyst to expand collaboration efforts between traditional health care providers and other community players.
• Provide a useful background for evaluating and prioritizing requests for funding.
• Serve as a focus for developing continuing education for health care providers.
• Facilitate community health improvement initiatives among community agencies, businesses, local health care providers, and community members.
• Service as a guideline for developing community wellness programs.
• Be a focus point for individuals and organizations from local, regional, and state to communicate, brainstorm, share ideas, and develop plans for meeting the objectives.
• Serve as the means to coordinate the collaboration and communication between state level and local agencies, partnerships, and organizations.
• Promote better participation from existing agencies and programs.

Funding

• Seek funds from foundations, businesses, and other sources for personnel, programs, assessment, and evaluation for community health promotion initiatives.
• Justify budget expansion for new directions in health and safety.
• Determine funding priorities.
• Identify needed resources for health and safety.
• Increase the opportunities for agencies and organizations to combine resources to effectively address a shared vision.

Policy

• Be influential in establishing school policies (e.g., physical fitness programs, improved nutrition in cafeterias, after-school intramural sports, tobacco-free schools and school activities).
• Service as a basis for community policies (e.g., bicycle helmets, tobacco-free public facilities, walking/bicycle paths).
• Serve as a basis for worksite policies (e.g., nutritious foods in vending machines, tobacco-free worksites, health promotion programs).
• Be influential in establishing access to health care policies (e.g., increase the income level for Medicaid eligibility; increase Medicaid payments to dentists to improve dental services to children; and provide greater access to teenagers, migrant workers, Hispanic/Latinos, and other minority and ethnic groups).
• Identify areas in which policy change is needed and target legislative education and advocacy.
• Mobilize for funding to address health priorities.
• Change service delivery in health departments, rural health centers, and hospitals.
• Mobilize community action.

Planning

• Establish Healthy Carolinians task force goals and objectives.
• Eliminate health disparities by targeting resources and developing effective health improvement plans.
• Develop strategic planning for community health improvement activities.
• Develop multilevel action plans that bring together state and local organizations, agencies, and community members.
• Determine targets, strategies, and outcomes of health promotion programs.
• Determine benchmarks for community health improvement goals.
• Understand the determinants or underlying issues of health.
• Plan clinic goals and protocols.
• Plan budget and resource allocation.
• Establish priorities for prevention.
• Determine measurable objectives with outcome evaluation and accountability.
• Adopt specific objectives to focus and mobilize community actions to improve health.
• Augment existing programs to meet new targets.

Evaluation and Assessment

• Guide community health assessment and project evaluation.
• Use for data comparisons: national, state, county, and local communities.
• Establish baseline data for community health projects.
• Establish measurable and comparable county objectives.
• Use as benchmarks for measures of local success.
• Determine progress and outcomes of community health improvement initiatives.
• Evaluate the health components of community-wide strategic planning.

Education

• Provide an educational opportunity based on each objective to community members, health care providers, employers and employees, parents, and students.
• Educate communities about the importance of prevention (using measures ordinary people can understand).
• Educate communities about health promotion initiatives and preventive services.
• Educate the public and community leaders about health disparities and health and safety needs in their community.
• Educate community members and leaders who will influence policy makers.
• Develop appropriate continuing education for health care providers.
• Educate community health improvement partners
• Provide a focus for community education campaigns about specific health promotion initiatives (risk factors, injury prevention, smoking cessation, improved nutrition, increased physical activity, chronic disease awareness and prevention, environmental health, etc.)
• Increase the knowledge of community leaders on health status and future objectives.
• Educate and mobilize "non-health" members of the Healthy Carolinians task force about appropriate goals.
• Empower ethnic and minority groups to better access health care.
• Educate funding sources (public and private) to think beyond incrementalism and short-term goals.

Media and Communication Strategies

• Publish updates that compare local goals and progress with those of the State.
• Plan public health communication activities.
• Provide media stories, spotlight health issues.
• Inform the community about Healthy Carolinians use of the objectives to improve community health.
• Use local media to increase awareness of objectives and community health needs.

Organizational Use

• Support strategic planning in health departments, hospital community outreach initiatives, and community-based agencies.
• Set organizational priorities and goals.
• Assure that the agency or organization stays on track to achieve desired outcomes.
• Align health agency initiatives with local and state targets.
• Provide a focus for an annual retreat – review agency/organization achievements.
• Determine organizational policy with regard to employee health and wellness.
• Expand health care services to reduce health disparities in thecommunity.

What Are the Barriers to Achieving the
North Carolina 2010 Health Objectives?

Logistics

• Geographical distance (transportation difficulties)
• Difficult to include all populations – faith, business, youth, seniors
• Community volunteers are difficult to recruit, train, and retain
• Lack of awareness of programs and "best practices"

2010 Health Objectives

• Confusing to have different national, state, and local objectives
• Some targets are too ambitious
• Too complex, difficult to grasp
• Competition, too many objectives
• Lack of ownership
• Community's view of needs differs from health data / 2010 Health Objectives
• Objectives do not include all the determinants of health (psychosocial, economic, spiritual, etc).
• Rural communities are not concerned with environmental health issues if the solutions will decrease economic development
• Objectives were developed top-down
• Communities feel there is too much government
• Too much focus on sick care vs.preventive health care

Politics-Politics-Politics

• In-fighting, agencies and organizations not willing to share due credit in community collaborative efforts
• Media and public pressure
• Some prevention issues are taboo topics ( e.g., sexual behaviors, smoking, air quality)
• Agencies and organizations are territorial, too much "turf-ism"
• Competing legislative mandates
• Local government is often impatient, needs immediate success
• Competing philosophies among agencies and community groups
• Short-sightedness (government doesn't see value of prevention)
• Lack of support for public policy change
• Opposition from traditional power brokers
• Competition for local funds
• Agency cooperation often difficult

How can these Barriers be overcome?

• Work with Governor’s Task Force for Healthy Carolinians to influence policy change at the state level and to continue Healthy Carolinians funding from the State.
• Identify funding in local agency budgets.
• Educate and advocate to community leaders on the need for and the benefits of North Carolina 2010 health objectives.
• Educate and garner support from foundations in North Carolina.
• Bring businesses into local partnerships to educate and mobilize their leadership.
• Educate funding sources (public and private) to think beyond incrementalism and short-term goals.
• Mobilize and activate new groups.
• Address the apathy of the majority of citizens by implementing media and education campaigns.
• Become astute in policy development and action (at all levels: organizational, political arena).
• Bring the community in at the decision making and planning level.
• Find community resources (e.g., corporate and business partners) to expand resource base.
• Implement strategies to achieve the North Carolina 2010 Health Objectives in churches, schools, hospitals, worksites, pre-schools, health departments/districts, health and human services agencies, civic organizations, policy arenas, organizations, media, neighborhoods, and community settings.