by Chuck Hoven
(Plain Press, September 2015) The Aetna Foundation is looking for community partners to work with in addressing health disparities in some areas and to help improve nutrition and healthy lifestyle opportunities in those neighborhoods. Dr. Garth Graham, president of the Aetna Foundation, says research indicates “your zip code matters more than your genetic code in determining health outcomes.” Even with a mobile population, Dr. Graham says people tend to stay within the same social economic strata when they move – moving to similar neighborhoods. He says social determinants in those neighborhoods, such as access to quality education, access to transportation, availability of health food options and availability of safe places to exercise, help determine health outcomes.
Dr. Graham, who has been involved in researching health disparities at the University of Florida School of Medicine, the U.S. Department of Health and Human Services, and the Office of Minority Health, agrees with the findings and focus of the Cuyahoga Health Improvement Partnership’s plan. For more information on the plan see Community Health Improvement Plan seeks health and wellness for all the people in Cuyahoga County in the July issue of the Plain Press at www.plainpress.org.
Of the seven neighborhoods with the lowest life expectancy (72.7 years or less) in Cuyahoga County, The Cuyahoga Health Improvement Partnership’s plan includes four neighborhoods in the Plain Press readership area: the Stockyard, Clark Fulton, Brooklyn Centre and Edgewater neighborhoods.
Dr. Graham says he recently looked at the Cuyahoga County Health Improvement Plan and was impressed that the plan was “focusing on a pretty robust strategy” that looked at some of the social determinants of health such as access to education, transportation and presence or absence of various community assets and resources.
Dr. Graham says for example that Cuyahoga County’s plan to track hypertension cases by zip code fits with the focus of the Aetna Foundation on disparities that occur because of where people live. One of the main goals of the Aetna Foundation is to fund programs that are working to tackle some of the health disparities related to geography, said Dr. Graham. The foundation also is involved in supporting related programs that work to improve healthy eating options as well as promoting healthy lifestyle opportunities.
The Cuyahoga Health Improvement Partnership calls for focusing on four areas: eliminating racism as a social determinant of health, improving coordination between clinical and public health, chronic disease management, and improving nutrition and physical activity.
In each of those areas the Cuyahoga Health Improvement Partnership’s plan sets some goals.
In addressing structural racism, the Cuyahoga Health Improvement Partnership calls for: “teaching organizations how to recognize and address structural racism; encouraging organizations to work closely with community members; and developing policies to create social and economic opportunities for all people in Cuyahoga County.”
In addressing the need for public health agencies to work more closely with clinical health care providers, the Cuyahoga Health Improvement Partnership calls for: “encouraging both systems to work together on shared goals; building public health and health equity training into the curriculum of health profession students; and identifying opportunities for combined data collection to better represent community health needs.”
In tackling the need for better management of chronic diseases, the Cuyahoga Health Improvement Partnership calls for: “recruiting residents to become trainers or participants in chronic disease self-management programs; training doctors to care for all patients with chronic disease in ways that are proven to work; and training doctors to be culturally sensitive and speak in plain language.”
In addressing the goal that “everyone should be able to eat healthy and be active if they choose to”, the Cuyahoga Health Improvement Partnership’s plan calls for: “making healthy food available in neighborhood stores; making sure new streets are built to encourage walking and biking; and encouraging schools and churches to open their doors so people can be active after hours.”
Dr. Graham said the Aetna Foundation’s focus on neighborhoods with health disparities includes addressing the issue of the availability of healthy food to purchase in neighborhoods without easy access to a grocery store. Dr. Graham talked of groups that have focused on creating options for purchasing healthy foods at an affordable price within those neighborhoods.
A lot of people are doing things in the community that help to address health disparities or help to improve the availability of nutritious food and positive lifestyle changes, and Dr. Graham said the Aetna Foundation would like to “connect with individuals doing these activities.” The foundation would like to “work with and support partners” working to reduce health disparities related to where a person lives. Dr. Graham says he hopes these individuals and groups involved in tackling disparities and improving neighborhood health will look to the Aetna Foundation as a source of funding and expertise to help to address some of these issues.
The Aetna Foundation funds a variety of programs, examples can be found on the foundation’s website at www.aetnafoundation.org. Among the initiatives, funded by the Aetna Foundation, is the National Reach Coalition’s Health Equity Leadership and Exchange Network (HELEN). According to the Aetna Foundation’s website, HELEN offers “a national forum for health equity champions. The goal: to advance racial and ethnic health equity in laws, policies and programs.”
The foundation’s website also has heading titled “local grants promote healthier lifestyles.” Under that heading the foundation describes some programs it funded to promote healthy eating through schools and after school programs as well as in neighborhood settings.
Dr. Graham says a favorite program funded in Cleveland involves the use of technology to help people to remember to exercise. He said a group of pastors are using text messages to encourage members of their congregations to exercise. Dr. Graham says there is no specific range of funding for programs, the foundation has funded programs to set up community gardens in the $25,000 to $50,000 range as well as much larger projects. Dr. Graham says the foundation has worked with school systems around the country on programs that promote healthy eating. He hopes that partners, working on the Cuyahoga Health Improvement Plan, will seek out the foundation as a source of funding. He says the Aetna Foundation is very interested helping to foster the “great ideas” that are being put forward in Cleveland.
Dr. Graham said the Aetna Foundation was very interested in working toward “more prevention on the front end” of the causes of chronic diseases such as diabetes and hypertension. He says providing a safe environment for walking and running is important as well as increasing hours available at recreation centers. Getting the message out to people about the importance of healthy eating and exercise is also an important priority. Dr. Graham says the Aetna Foundation sends out requests for proposals every five months. He hopes that Cleveland organizations working to address needs in the priority areas outlined by the foundation will seek the opportunity to partner with the Aetna Foundation.