Community prevention: Where the rubber meets the road

We’re all waiting with baited breath for the Supreme Court to hand down its ruling on the Affordable Care Act on Thursday morning, but essentially we’ve been implementing it for the past two years. And a huge component of the law is all about prevention.

In a Wednesday afternoon session, “Innovations in Community Prevention,” panelists shared just how they’ve been putting prevention to work. As we’ve heard throughout this meeting, assuring the future health of the next generation relies on innovation and building community partnerships. So, let’s hear how the experts are doing just that.

“Local relationships are where it’s at,” presenter Jeffrey Engel reminded attendees.

According to Engel, the policy director of North Carolina’s state health department, the Tarheel state has received the fourth largest Community Transformation Grant award in the nation. It’s been using the money to develop policy addressing tobacco-free spaces, active living by design, healthy eating and clinical preventive services.

In 2006, one out of 60 of the state’s community colleges was tobacco-free. Ironically, Engel pointed out, that campus happened to be located in the tobacco-rich Raleigh-Durham area. Now, thanks in no small part to the state’s prevention grants, virtually all are tobacco-free.

But Mary Balluff was quick to point out that some states and cities don’t have such a grand cache.

Balluff, of the Douglas County Health Department, shared how they’ve applied their grant dollars in Omaha, Neb., a city that at one point was ranked 142 out of 183 largest cities in terms of health risks. Balluff saw this as room for improvement.

Through the work of its Communities Putting Prevention to Work Grant — most appropriately branded “Douglas County Putting Prevention to Work” — the county recruited 19 partners across nine initiatives, from a traffic safety campaign to a healthy corner store initiative.

Balluff touted the steps she and her colleagues employed for community engagement: a common agenda, shared measurement, mutually reinforced activities and continuous engagement.

Next up was Terrence Roach, who spells prevention: “Y-M-C-A.”

“The table had been set, but we weren’t there,” said Roach, senior director of organization and community change of YMCA of the USA, referring to the important role the “Y” could play in community prevention.

“The Y's strength has historically been in the primary prevention stage. But, with the rise of chronic disease, we needed to move the Y’s focus further down,” he said. (Think more secondary and tertiary levels of disease prevention.)

So through its Healthy Communities Initiatives, which Roche said served as a basis for Community Transformation Grants, the Y developed diabetes and childhood obesity prevention programs. 

“If you weren’t overweight or didn’t have risk factors, you weren’t eligible to be a part of that program,” he told attendees.

The Y now boasts a robust policy program and lobbying arm. Through its work, it has helped create hundreds of healthy corner stores, more than 1,000 safe routes to school and community parks, and more than 2,000 tobacco-free buildings in communities across the country.

“When we first started, the table was set and we weren’t there,” he said. “Now over a decade later, we’ve set the table and are asking others to join us.”