By George J Huba PhD (Psychology)

As part of its Healthiest Communities initiative, the Aetna Foundation recently hosted a panel discussion on improving community health in order to serve individuals and residents with programs that could result in better health. The panel was broadcast on Facebook Live. A video copy of the event can be accessed HERE.

The panelists include:

• Dr. Garth Graham, President, Aetna Foundation
• Lauren Singer, Environmental Advocate and Zero Waste Blogger/Author of TrashIs4Tossers
• Dr. Pedro Noguera, Distinguished Professor of Education, UCLA
• Jane Sarasohn-Kahn, Health Economist and Founder of the strategic health consultancy THINK-Health

Each of the participants brings unique expertise in trying to understand and enhance service systems as it relates to their respective fields, including public health, education, and community resources and environment. The panelists’ diverse professional training and experiences also brought different viewpoints and ways of interpreting what they observe and understand about community health.

I found the panel to be a very valuable one – full of ideas, suggestions, experiences and planning topics for those who want to intervene to make their communities more responsive to local needs and better able to promote health among their residents.

In order to put the process of community change into context, I watched the video of the panel and prepared two mind maps to show major themes that were discussed. In case you have not read a mind map before it is a fairly easy thing to do. Start at the big graphic in the center and then follow each branch to its end to see a major idea unfold. Mind maps are often used to present complicated relationships ideas in a visual form that is relatively easy to understand and which promotes better information retention and analysis.

The first mind map shows a summary of some general steps and issues important in developing a plan for a community to change some of its services and procedures to support healthy behaviors and effective treatment and intervention.

Please click the mind map to increase its size.

This second mind map shows detailed steps that can be taken in order to implement system change. While the process seems complicated it really is a series of “baby steps” designed to allow community members and organizations feel RESPONSIBLE and EMPOWERED.

Please click the image to increase its size.

Systems change in communities is very hard because many traditional departments (of health, social care, law enforcement, mental health, housing, and supplying food) need to be involved. Many community members wish to help but not if a treatment facility or homeless shelter or parole center is located near their homes. Many professionals and workers at County service facilities want to help and increase services but they are already over-worked and largely underpaid. Creative solutions are needed.

I collaborated with the Aetna Foundation to share their work and research on community health tied to my own expertise in working with county-wide service systems dealing with drug abuse, mental illness, and issues of service access for disenfranchised individuals. These include: poor/homeless individuals, drug abusers (often addicted to heroin, amphetamines, cocaine, and other drugs), those involved in the criminal justice system, street sex workers, extremely physically ill individuals, those diagnosed with a number of behavioral and mental problems, as well as those incapable of accessing services themselves. Over several decades Dr. Lisa Melchior of The Measurement Group and I developed services for the poorest and most fragile members of our society. Dr. Melchior continues our work. 

Lessons Learned

Here are a few key lessons from the Facebook Live video and the broader Healthiest Communities research.

• Building a healthier community is a very complicated process that involves hundreds (if not, thousands) of agency and individual stakeholders representing a large number of constituencies. Short video conferences such as the one summarized here can prove to be extremely valuable resources for many groups focusing on systems changes. A website featuring video presentations, townhall meetings, and discussions will prove invaluable for many U.S communities throughout the country look better and will help them become better and more efficient by learning “the secrets” of building successful change processes from others who have attempted such changes earlier.
• Most communities that wish to develop and support change processes usually start with a “needs assessment” of where the community has already built important processes of developing and maintaining services and where the community would benefit from new efforts. A comprehensive database containing concise and valid rankings and research conducted by the Aetna Foundation and US News provides each county a “free needs assessment” or comparison of the community to its peer communities. Rather than requiring an investment of additional resources into expensive analyses of unmet needs, the presence of a mature and valid dataset will permit communities to very quickly review needs established in the existing work and then focus their own efforts and resources on developing plans for addressing the largest needs of the community.