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Recap: LHAB Quarterly Meeting Q1 2019

Recap: LHAB Quarterly Meeting Q1 2019

On February 27 the Louisville Health Advisory Board (LHAB) held its first quarterly meeting of the year at the Louisville Metro Department of Public Health & Wellness. Over forty LHAB members representing twenty-two organizations from across Louisville attended and participated in the collective forum.

The keynote speaker - Dr. Robert Bailey, Director, Population Health Research, Real World Value & Evidence, Janssen Scientific Affairs - presented on his experience as a researcher in population health management and highlighted case studies that address social determinants of health. He also shared Janssen’s perspective, as a pharmaceutical company, on why addressing the social determinants of health are important.

Following a discussion with Dr. Bailey, attendees reflected on the work of the past three and a half years and began to discuss strategic direction moving forward.

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Quarterly Meeting Highlights included:

  • Dr. Robert Bailey discussed the nature of population health research and how healthcare has evolved in recent years. Historically, allocated spending has been focused on clinical care, including access and quality of care. However, clinical care only has a 10% effect on outcomes whereas genetics have 20% and external factors have 70%. The external factors are further broken down into health behaviors, physical environment, and social/economic factors.

    Additionally, Dr. Bailey called attention to several case studies that addressed social determinants of health and emphasized the importance of physicians being aware of how these factors affect certain populations. One referenced study examined the relationship between hypoglycemia hospitalizations, food security, and income. It found a connection between these hospitalizations and the pay cycle and food expenditures of low-income households.

    To maximize the effectiveness of population care outcomes, Dr. Bailey provided a 3-part equation to deliver the right care to the right patient at the right time. This includes working to make better predictive models so treatment can be proactive rather than reactive.

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  • Louisville Metro Department of Public Health and Wellness Director and LHAB co-chair, Dr. Sarah Moyer, reflected on the accomplishments and value the LHAB cultivated over the past several years and raised the question of whether the LHAB should stay on same course or evolve its direction to focus more on systems. She shared the direction the health department is taking towards addressing the social determinants of health, or root causes, rather than focusing on specific diseases. This shift means that the department is relying on community partners to provide health services, such as vaccinations, while the health department focuses on addressing inequities and system changes. When thinking about the future, it is important to consider how LHAB’s goals and the community at large will be affected by this shift in priorities, in addition to the recent budget cuts that will also impact health services in our city.


  • Members brought up ideas and opportunities for LHAB to consider moving forward. These included:

    • Capacity building within the committees around storytelling,

    • Improved engagement of the entrepreneurial ecosystem to infuse new ideas and approaches into the approach,

    • Further maximizing efforts by intentionally connecting to other collective impact and multi-stakeholder groups working in Louisville,

    • Putting a stronger focus on making sure that LHAB represents the many stakeholders we touch because investing in diversity and taking inclusive approaches are the fuel of community transformation.  

  • The need to connect to and understand other local collaboratives. When informally polled, only 2-4 individuals knew of the following programs/initiatives: Health Enterprise Network (HEN), Kentuckiana Health Collaborative (KHC), Foundation for a Healthy Kentucky, Louisville Resiliency, Worksite Wellness Council and Louisville Entrepreneurship Accelerated Program (LEAP).

  • London Roth, Humana, shared that other Humana Health Advisory Boards have evolved their structure and many committees no longer meet monthly; also the Clinical Town Hall has transformed in other cities and there is an opportunity for us to re-design that forum to better meet the current LHAB focus.


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Formal committee updates weren’t presented, however, during the larger conversation about the LHAB, several members provided updates on the committee work that helped inform the conversation. The Behavioral Health Committee is focused on expanding Question, Persuade, Refer (QPR) training, specifically to businesses and parents. They are examining methods to prevent mental health issues that lead to suicide ideation. Jan Sherrell co-chair of the Community Coordination of Care Committee gave an update on United Community and Tom Walton, co-chair of the committee, shared the research being done on best practice business models that could be useful in the committees work and highlighted the pilot being led by Family Health Centers to utilize the PRAPARE survey.

The LHAB looks forward to sustained strength and impact in the community. Stay tuned for an invitation to our next quarterly gathering on July 18.

By Brianna Bragg, Bellarmine University Student and LHAB Communications Committee Intern with additions/edits suggested by Josh Miller, London Roth, Alicia Ariatti

CEO Roundtable Held During World Diabetes Month

CEO Roundtable Held During World Diabetes Month

Louisville Health Advisory Board & CEOs Come Together to Prevent Diabetes

Jenny Goins, Commissioner, Department of Employee Insurance, State of KY.

Jenny Goins, Commissioner, Department of Employee Insurance, State of KY.

Did you know? 

  • Kentucky is 4th in the nation for deaths related to diabetes,
  • 1 in 8 Kentucky adults are estimated to have diagnosed diabetes (138K undiagnosed),
  • 1 in 3 KY adults are estimated to have prediabetes (1.1M); 90% do not know they have it,
  • Diabetes leads to many complications including stroke, heart attack, cataracts, glaucoma and amputation,
  • One-third of Kentucky adults with prediabetes will develop diabetes within 5 years,
  • Individuals with diabetes have a medical expenditure 2.3x higher than people without diabetes,
  • The American Diabetes Association estimates diabetes costs KY $3.85 billion in total medical costs, lost work and lost wages.

As a part World Diabetes Month in November, the Louisville Health Advisory Board (LHAB) Diabetes Committee sponsored a CEO Roundtable on November 2, bringing together 30 community leaders from 18 local organizations to discuss the prevalence of diabetes and prediabetes (a condition that can ultimately lead to diabetes).

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The morning’s event included speakers who addressed the employer audience on the growing epidemic of diabetes in Kentucky. Two large employers - the Kentucky Employee Health Plan and Humana – shared what they are doing to help their employees avoid prediabetes and manage diabetes, as well as reducing medical expenditures for the employer health plan and improving their employee’s Healthy Days*.

Both employers identified the U.S. Centers for Disease Control and Prevention (CDC) Diabetes Prevention Program (DPP) as an excellent resource for their employees who currently have prediabetes. A research-based prevention program like DPP shows that a lifestyle change program is a proven way to prevent or delay diabetes.

Jenny Goins, Commissioner, Department of Employee Insurance, for the state of KY was very passionate about the DPP results generated for their employees. The KEHP’s DPP program has 416 employees actively enrolled in classes. Overall their employees have had an average of 5% weight loss and an average of 196 minutes of physical activity per week. DPP is a covered benefit for their plan. Jenny said, “DPP is making a big difference for our KEHP employees.”

You too can join the fight against prediabetes and diabetes in Louisville! Here are 6 ways how:

  1. Learn about the potential opportunity for addressing prediabetes in your organization with the CDC’s employer calculator.

  2. Provide education to your employees about prediabetes and/or host a screening event at your worksite.

  3. Consider covering the cost of a Diabetes Prevention Program in your workplace.

  4. Look for approved DPP providers in your area. A statewide list of CDC recognized programs can be obtained here.

  5. Learn more about Louisville’s activation of World Diabetes Day on November 14.

  6. Join the LHAB Diabetes Committee. To learn more about our work visit the Louisville Health Advisory Board website and Facebook page.

*Healthy Days is a tool created by the U.S. Centers for Disease Control and Prevention (CDC) that tracks quality of life by measuring individual physical and mental health in a 30 day period. The LHAB is using Healthy Days to track progress toward our Bold Goal – to make Louisville 20% healthier by 2020.

Post authored by members of the LHAB Diabetes Committee.

Culture, policy and data as key drivers of community health.

Culture, policy and data as key drivers of community health.

One Poem At A Time billboard as part of Project HEAL.

One Poem At A Time billboard as part of Project HEAL.

It’s time for Louisville to lead in health, and that means taking three steps.

The first is to ensure that everyone can afford to see a doctor when they’re sick.

The second is to make preventive care, like screening for cancer, available to people who otherwise won’t or can’t go in for it.

The third is to stop thinking of health as something we get at the doctor’s office but instead as something that is rooted in the culture of our families, neighborhoods, schools, and workplaces.

The more health is seen this way, the more opportunities are available to improve it. This is why the Louisville Health Advisory Board’s Cultural/Social Impact Committee is focused on culture, policy and data as key drivers of community health.

Some may think that culture, policy and data aren’t related. However, it is the intersection of these three things that we often find breakthrough solutions that drive social innovation.

Core Cultural/Social Impact committee strategies include:

  • Health in All Policies Ambassadors – This networking opportunity organized by the Institute of Healthy Air Water & Soil brings together everyday citizen’s who have made the health of their communities a priority. The group shares learnings, and best practices.
  • One Poem at A Time – a policy initiative stemming from IDEAS xLab’s Project HEAL that seeks to mitigate the negative impact of the predatory, high-density messages on billboards and posters in low-income neighborhoods with significant health disparities like the Smoketown neighborhood.
  • Health Impact Assessments – the committee is playing a supporting role in promoting the use of Health Impact Assessments in Louisville.
  • Creating a Wellbeing Index for Louisville – through an innovative partnership with the City of Santa Monica's Office of Civic Wellbeing (CA), the committee is in the early stages of developing a create a "wellbeing index" for Louisville as part of IDEAS xLab’s Project HEAL. This new data, which will be open-source, development and planning tool for all Louisville neighborhoods, assesses 5 factors (data, impact, equity, culture, policy) of community readiness for change across 5 dimensions: Community; Place + Planet; Learning; Health; Economic Opportunity. 
  • Louisville Sports Commission – the committee is engaged in finding new ways to build active lifestyles into the culture of Louisville’s many diverse neighborhoods. Example of projects include: Louisville Active; Kids Finish First; Corporate Games; and Play It Forward.

Our understanding of what creates healthy communities is in a period of significant change. Grappling with the authenticity that makes each community unique; ensuring equity for the most vulnerable; and actively creating new models for wellbeing, inclusive economies and civic engagement; these are the challenges that may also present significant opportunities to accelerate the pace of positive impact in community health.

Thanks to the work of the LHAB Cultural/Social Impact Committee, a cross-sector team is coming together for a learning exchange and to create innovative approaches to policy change and new data tools that can support the social, economic, and environmental health of Louisville communities. The unique approach being deployed by this committee is also geared toward building civic trust, opportunities to increase transparency, and nurture a shared desire to make government more accessible and responsive to the needs of all people.

About the authors:

Theo Edmonds and Grace Simrall co-chair the Cultural/Social Impact Committee for LHAB.

Theo Edmonds, JD, MHA, MFA is Chief Imaginator + Co-Founder of IDEAS xLab. He is a futurist, artist, poet and social entrepreneur. A former healthcare executive and champion clogger, he was named as one of "50 People Changing the Face of the South" by Southern Living Magazine.

Theo Edmonds, JD, MHA, MFA is Chief Imaginator + Co-Founder of IDEAS xLab. He is a futurist, artist, poet and social entrepreneur. A former healthcare executive and champion clogger, he was named as one of "50 People Changing the Face of the South" by Southern Living Magazine.

Grace Simrall was named Chief of Civic Innovation and Technology for Louisville Metro Government in August 2016 and in that role is responsible for advising the Mayor and leading Louisville Metro’s initiatives on emerging technologies and breakthrough innovations.

Grace Simrall was named Chief of Civic Innovation and Technology for Louisville Metro Government in August 2016 and in that role is responsible for advising the Mayor and leading Louisville Metro’s initiatives on emerging technologies and breakthrough innovations.

Respiratory health... Let's breathe better.

Respiratory health... Let's breathe better.

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  Veronica Combs of the Institute for Healthy Air, Water and Soil describes the work of AIR Louisville during LHAB quarterly meeting.

Veronica Combs of the Institute for Healthy Air, Water and Soil describes the work of AIR Louisville during LHAB quarterly meeting.

The Respiratory Health sub-committee is the youngest of the Louisville Health Advisory Board (LHAB) sub-committees, having formed in August 2017. Many of our committee members have been involved with other committees or have been interested in serving since LHAB launched in fall 2015. 

We remember at the inaugural Clinical Town Hall, Humana shared data about the many health conditions that were driving unhealthy days and lung health was one of the major contributors. Sadly, at the kickoff meeting when committees formed, there were not enough folks interested to get a workgroup going at that time. Fast forward a few years and a number of developments have occurred that allowed us to rekindle the flame. 

For example, the community asthma intervention project called AIR Louisville launched two years ago, and today, under Veronica Combs' (Institute for Healthy Air, Water and Soil) leadership, there are many community stakeholders that are excited to tackle asthma and make our city a place that promotes lung health. Similarly, a short time ago, Ben Chandler took the reigns at the Foundation for a Healthy Kentucky and made “Smoke Free Kentucky” a major focus of their work. The clinical science is definitive that reducing smoking is one of the best ways to get more healthy days in Louisville and surrounding counties.

Beyond this new energy, the committee is trying to embrace the best of the ideas of the Bold Goal effort. The idea was always to align the stakeholders in the community to work together to make more progress. We have taken that to heart. For example, we know the Foundation for a Healthy Kentucky needs help getting their policy and program ideas shared across communities that simply have not taken steps to reduce smoking. We are working together to rally the networks of AIR Louisville, supporting employers and the great grass roots of the ALA to move advocacy to the next level. Similarly, the American Lung Association has partnered with Revon Systems to help the Community Health Clinic in Butchertown, and now holds regular lung screening clinics for those without health insurance. These are just some examples of how we are trying to maximize the common interests of our committee members.

Our committee recognizes that this is a bit of an experiment. Engaging around respiratory health at this point is new territory, and we hope to benefit from the pioneering work of the other LHAB committees, who share in the philosophy of a Bold Goal that is not time-bound and is inclusive. We care about the health of our community in 2017, 2020, 2040 and beyond.

We will work hard to raise awareness for the many important and simple things that our community can do to breath better and promote the good health of future generations, and welcome others to join us.

About the authors:

As co-chairs of LHAB’s Respiratory Health sub-committee, Deena Adams brings the full force of the American Lung Association, and Ted Smith brings the health tech entrepreneurial community to the table.

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Deena Adams is Development Manager for American Lung Association in Kentucky and advances the capacity for the organization to deliver health- promoting programs.

 

 

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Ted Smith is CEO of Revon Systems which develops lung health tools for those suffering from COPD and Asthma and he has many years of community-based civic health tech experience.

 

 

Our Target - Zero Suicides.

Our Target - Zero Suicides.

Photo from the 2016  Bold Moves Against Suicide  Summit in Louisville, KY.

Photo from the 2016 Bold Moves Against Suicide Summit in Louisville, KY.

We as a society have a difficult time dealing with the subject of death. When someone takes their own life, that conversation proves even more difficult. No other situation can elicit such immense grief and remorse as the subject of suicide. Losing a loved one to suicide forever changes a family. For those left behind there is the litany of, if only I had… I should have… I could have… etc. 

Louisville ranks 8th for the highest rate of suicide compared to peer cities.

It is for this reason that the Louisville Health Advisory Board’s Behavioral Health sub-committee (LHAB) decided to take on the challenge of addressing suicide in our city.

This Behavioral Health sub-committee reviewed the suicide data in our city and at first looked at reducing the incidence of suicide in Louisville Metro, but after much discussion agreed that not even one suicide is acceptable. We decided that the Zero Suicide Initiative was the only real option for our city. This initiative does not settle for the reduction of suicide, but its elimination. This is our only target. 

In November, 2016, LHAB and the Behavioral Health sub-committee sponsored the “Bold Moves Against Suicide Summit” where community partners, clinicians, educators, social service providers, and faith-based organizations convened to raise the level of awareness for this issue. 

The goals were to:

  1. Increase the sense of responsibility in our community to eliminate suicide,
  2. Provide tools and resources to address the issue of suicide,
  3. Discuss the goal of Zero Suicide,
  4. Create a community approach to eliminate suicide.

At the close of the summit, the attendees were asked to pledge their commitment to Zero Suicide and to continue meeting to explore ways to implement it throughout the city. On June 26, 2017, about 25 organizations rose to this challenge and met to develop their 90-Day Action Plan to implement Zero Suicide in their organization.

We are in the process of meeting again in early October to discuss and encourage these organizations to continue their implementation of Zero Suicide. We invite any organization wanting to assist us in this initiative to join us. Together we can become a city where not even one suicide is acceptable.   

About the author: Wayne Crabtree serves as the Director of the Office of Addiction Services at Louisville Metro Department of Public Health and Wellness. He has served there for over 26 years with some great community partners in order to increase the health and well-being in Louisville metro citizens.

Graphic Recording by Katalyst Creative Consulting. 

Four parallel, interrelated ways to approach Community Coordination of Care

Four parallel, interrelated ways to approach Community Coordination of Care

Catalyzed by the Robert Wood Johnson Culture of Health Prize, the Louisville community has decided to hold itself accountable to looking at health as encompassing more than clinical care and health behaviors, but also the social, economic, and environmental factors that collectively have more impact on the health of individuals. Photo by Tyrone Turner, courtesy RWJF.

Catalyzed by the Robert Wood Johnson Culture of Health Prize, the Louisville community has decided to hold itself accountable to looking at health as encompassing more than clinical care and health behaviors, but also the social, economic, and environmental factors that collectively have more impact on the health of individuals. Photo by Tyrone Turner, courtesy RWJF.

There is an emerging consensus in the public health community that the only way to meaningfully impact health outcomes at a community level is to focus outside the traditional definitions of health. Catalyzed by the Robert Wood Johnson Culture of Health prize, the Louisville community has decided to hold itself accountable to looking at health as encompassing more than clinical care and health behaviors, but also the social, economic, and environmental factors that collectively have more impact on the health of individuals.

To successfully address those factors for the community as a whole will require a culture shift - an unprecedented level of coordination across traditional silos of education, workforce development, health care, social services, park systems, the arts community, faith communities, and others. To successfully focus on the needs of individuals across those domains, sharing and layering intersectional data sets and having caring and skilled individuals who can help people navigate the system will be crucial. To do this at scale, both resources and a willingness to disrupt the status quo will be needed.  

In order to create a demonstration case that will most dramatically show impact in terms of outcomes and costs, the Community Coordination of Care sub-committee as part of the Louisville Health Advisory Board decided to focus on chronic disease patients and high utilizers of the health care system. Chronic disease patients are faced with specific challenges due to the complexity of the care they need. These issues are often compounded by socio-economic status, geography, mobility, comorbidities, or family/social situation.

As a sub-committee, we have come together to pilot an assertive care model of medical care and disease management needs along with community needs navigation. This is being done by engaging medical staff in tandem with community, volunteers and social care professionals to meet the chronically ill where they are, working to improve health and quality of life, and thus help community members address their essential human needs.

We are engaged in four parallel and interrelated projects:

  • Adapting a common screening tool across the community that can be used to identify essential basic needs at multiple entry points into our medical, educational, and social services systems.
  • Rallying around a common directory of resources (Metro United Way 211) that can be used to direct people to appropriate services that are convenient to them.
  • Establishing a common set of legal agreements that can be the basis for allowing individuals to share appropriate data between organizations to help ensure the best outcomes.
  • Structuring our work to take advantage of existing research on impact and ensuring that these demonstration cases, if they have the desired impact, can be used to make the argument for scaling across the community.

What feels powerful about this model is that it is not about bringing additional resources to bear, but rather refocusing how we invest those resources in ways that support individual needs, barriers, and aspirations. We believe that in focusing on the whole person and the whole community, we can make our community a place in which every person can reach his or her full potential.

About the authors: Post written by the Community Coordination of Care sub-committee co-chairs Ben Reno-Weber, Greater Louisville Project; Dr. Fairouz Saad, Louisville Metro Department of Public Health and Wellness; and Tom Walton, Executive in Residence, School of Public Health and Information Sciences, University of Louisville.

Targeting diabetes through evidence-based programs and collaboration

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Targeting diabetes through evidence-based programs and collaboration

People find support in the Y's group-based  Diabetes Prevention Program.  Photo provided by the YMCA of Greater Louisville.

People find support in the Y's group-based Diabetes Prevention Program. Photo provided by the YMCA of Greater Louisville.

Diabetes is a terrible disease. Truth be told, it probably frightens me even more than cancer does. I spent 11 years of my professional life trying to improve outreach to and education of people living with diabetes, to improve their quality and quantity of life. It was frustrating work. This experience led me to join and participate in the Louisville Health Advisory Board’s Diabetes sub-committee.

As a group, our sub-committee made the courageous decision to focus on the ‘long game’ by choosing to target preventing Type 2 Diabetes with the CDC-approved, evidence-based Diabetes Prevention Program (DPP).

DPP focuses on lifestyle changes for people diagnosed with prediabetes, which is very common and tremendously underdiagnosed. Participants in DPP programs can often prevent or delay the onset of diabetes. In fact, research from the National Institutes of Health shows that DPP can reduce the onset of diabetes by 58%.

The YMCA of Greater Louisville has been a national and local leader in DPP programming, deploying dozens of specially-trained lifestyle coaches, who offer DPP in a variety of locations, including YMCAs across Jefferson County and in southern Indiana. The list of CDC-approved DPP providers across Jefferson County is growing, but demand for the class continues to lag.

So we’ve been busy working to build a pipeline to shepherd people with prediabetes from diagnosis to successful completion of a CDC-approved DDP program. This pipeline is taking shape—thanks to multi-sectorial collaborations highlighted by:

  • Private sector engagement of more physicians in the work of testing for and diagnosing prediabetes,
  • State and local government development of resource guides and training for referral center staff,
  • Non-profit innovations around employer engagement. 

Realizing a future without the debilitating effects of diabetes will require an ongoing commitment for each of us to share the best of our knowledge and resources. We’re on it!

Stay tuned for National Diabetes Month in November, when we’ll roll out two projects that demonstrate the power of collective action to improve health and wellness.

About the author: Leanne French serves as the Administrator for Maternal and Child Health at the Louisville Department of Public Health and Wellness, where for the past 13 years she’s worked with amazing community partners to develop infrastructure for better health for all.

French is a leader within the Louisville Health Advisory Board’s Diabetes sub-committee, which is co-chaired by Steve Tarver, CEO of YMCA of Greater Louisville and Andrea Dougherty, Community Health Supervisor for Louisville Metro Department of Public Health and Wellness.

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