Part 1 of this article introduced our interview with David W. Pluymers, Assistant Director of Rock County Health Department in Wisconsin. We asked David to expand on his presentation at the February 2018 Wisconsin Association of Local Health Departments and Boards (WALHDAB) Operations Conference and talk to us about Public Health Modernization and Public Health 3.0.
Part 2 continues that interview and discusses creating a Public Health Strategy as part of Public Health 3.0.
Creating A Public Health Strategy
Once you have the information, the next step is to use it to create a strategy.
An obvious resource for this is a Chief Health Strategist, but many public health agencies don’t have one and don’t feel they have the funds to hire one.
We asked David what advice he would give to agencies who find themselves in that position.
“You can’t afford not to have a public health strategist”
He said, “Part of my argument would be that you can’t afford not to have a public health strategist.”
But that doesn’t necessarily mean an agency has to hire a public health strategist.
David explains, “Even prior to PH 3.0, there was a push through the RESOLVE work group and others, for leaders of public health agencies, and even the public health agency itself, to act as the community health strategist. It comes down to core functions, essential services, upstream thinking, prevention, and social determinants of health.
“If your public health agency isn’t strategic in its approaches, you aren’t going to improve community health outcomes in a meaningful and lasting way.”
“If your public health agency isn’t strategic in its approaches, you aren’t going to improve community health outcomes in a meaningful and lasting way. We need to be thinking about policy systems and environmental changes and how we can make lasting improvements in community health outcomes.
“We should ask how people within public health agencies can take on that public health strategist role in their own work and in how they position their agency in the community.”
David referenced an infographic from the Baldridge Performance Excellence Program: “From Fighting Fires to Innovation: An Analogy for Learning”.
“This points to how people can get away from fire-fighting to go through systematic evaluation and improvement and come up with learning and strategic improvement and organizational analysis and evolution.
“Public health is supposed to be about innovation and prevention, not just reacting to problems.”
“That’s what we need to be doing in public health. Public health is supposed to be about innovation and prevention, not just reacting to problems.”
He also recommended another infographic from the Baldgridge Program: “Steps towards mature processes”. “[This] shows how we can move from reacting, to integrated approaches. Integrated approaches are what we’re really looking for, bringing all the data together rather than putting out a fire here or there.”
Going To The Source
Part of this strategy, David says, is upstream thinking.
One Canadian nonprofit working to improve their country’s community health, Upstream, described upstream thinking very well, “If health for all is our goal, then upstream thinking is about addressing the things that have the greatest influence on our health, including income, employment, education, early childhood development, housing, nutrition and the wider environment.”
“If health for all is our goal, then upstream thinking is about addressing the things that have the greatest influence on our health, including income, employment, education, early childhood development, housing, nutrition and the wider environment.”
David’s description agrees, “We can think about it as ‘upstream thinking’ or, in the language of continuous quality improvement world, ‘root cause analysis.’
“What are the root causes of poor health outcomes in a community? We need to engage in upstream thinking about social determinants of health if we are to successfully make changes.”
“What are the root causes of poor health outcomes in a community? We need to engage in upstream thinking about social determinants of health if we are to successfully make changes.”
As an example, David shared, “This is what we’re learning through considering Adverse Childhood Experiences (ACEs). The toxic stress and trauma in a community – that can be brought about by income inequality, underfunded education, institutional racism – are linked to poor health outcomes later in life.
“The toxic stress and trauma in a community – that can be brought about by income inequality, underfunded education, institutional racism – are linked to poor health outcomes later in life.”
“If your public health agency isn’t strategic in its approaches, you aren’t going to improve community health outcomes in a meaningful and lasting way. Research has shown that one’s zip code has a greater influence on one’s health and life expectancy than does their genetic code.”
The Robert Wood Johnson Foundation website offers several map infographics displaying the health disparities or life expectancy disparities due to zip code differences.
Their site explains, “Across America, babies born just a few miles apart have dramatic differences in life expectancy… life expectancy values alongside common geographic landmarks such as subway stops and highway exits to show how opportunities to lead a long and healthy life can vary dramatically, by neighborhood, in communities across the United States.”
“We need to work on the social determinants of health, health equity, and reducing toxic stress and trauma in our communities,” David said.
It’s Time To Take Action
Public Health 3.0 offers current, practical standards public health can strive for in order to tackle the foundational goal of public health, the core values that are public health’s credo.
“Public Health 3.0 calls for public health agencies to not just have the data or be repositories of the data, but to be analyzers of the data and turn those data into information and intelligence that we can use for decision making,”
“Public Health 3.0 calls for public health agencies to not just have the data or be repositories of the data, but to be analyzers of the data and turn those data into information and intelligence that we can use for decision making,” David stated.
Quoting a May 2014 report by RESOLVE David said, “The demands of the future are unavoidable. Governmental public health must be ready to meet them.’ We need to be ready to adapt and evolve and address emerging health demands. Unless we recognize these new circumstances and adapt accordingly, public health will not just be ineffective, we’ll run the risk of becoming obsolete.”
“Unless we recognize these new circumstances and adapt accordingly, public health will not just be ineffective, we’ll run the risk of becoming obsolete.”
What Will Public Health 3.0 Mean For You And Your Community?
Whilst the underlying aim of public health has not changed, the tools and knowledge at public health workers’ disposal are growing evermore sophisticated to help them accomplish that aim.
David is passionate about encouraging public health workers to use these tools and knowledge:
- To act
- To adapt
- To modernize
- To embrace Public Health 3.0
Conclusion
We’d like to thank David for his time and really appreciate his passion for improving public health.
If you want to make better use of your data and empower your public health department to be the chief health strategist for your commnity, why not see how Nightingale Notes EHR software can help?
Contact Us at (507)-388-4141 now and tell us how we can help you.
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