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Vital Signs: A plan to improve community health

To register for The Built Environment, Lifestyle and Health conference April 10 and 11:
For more information on the 2014 Tarrant County Community Health Improvement Plan:

Living long and healthy lives

By Carolyn Poirot

How healthy are we and our neighbors?
Based on how long people live and how healthy they feel while alive, Tarrant County is the 28th healthiest place to live in Texas, according to a new report from the Robert Wood Johnson Foundation.
Neighboring Denton County placed fourth, Parker County was 25th, Dallas ranked 58th and Johnson County was 115th and among the 232 Texas counties that were included in the nationwide report. Insufficient data left 22 Texas counties out of survey, the fifth annual county health rankings compiled by the foundation and the University of Wisconsin Population Health Institute.

Rankings are based on two sets of measures:
* Health outcomes (length and quality of life);
* Health factors (health behaviors, access to and quality of clinical care, social and economic factors and physical environment).
In Tarrant County, measures of premature death, uninsured residents, air pollution, preventable hospital stays and diabetic screenings are getting better, according to the report.
United Way of Tarrant County pulled local data from the report and presented it at the March 26 Public Policy Committee meeting.
The goal of United Way’s “Live Well” initiative, now in its fifth year, is to enable 17,000 more adults with chronic disabling conditions to be living healthily at home by 2020.

“We have several strategies underway that enable adults to manage their chronic health conditions in order to feel better and avoid costly hospital, emergency room and nursing home options,” said Tim McKinney, United Way CEO. “Our local measurements indicate we’re making progress, and it’s good to learn that this national report confirms that conditions are trending in a positive direction.”
The national report found that physical inactivity, mammography screening and violent crime have remained about the same in Tarrant County, while measures of adult obesity, sexually transmitted infections (chlamydia), unemployment and children living in poverty are getting worse.
The county is way down the line at number 208 when it comes to the physical environment, which includes air pollution-particulate matter, drinking water violations, severe housing problems, driving alone to work and driving alone on long commutes.
The report underscores how social factors such as education and income affect health and well-being.

Carolyn Poirot

Tarrant County experts take “community” health personally.
They say that where and how we live, learn, work and play can affect our personal health and well-being as much or more than the best system of medical care in the world.
And a volunteer collaboration of more than 100 of those experts representing social services, health care organizations, neighborhoods, businesses, schools, faith-based organizations and local government found that ultimately health depends on several factors: education, environment, health care access and partnerships.

The collaboration was organized to help the Tarrant County community set priorities for health issues, identify resources and take action, said Lou Brewer, director of Tarrant County Public Health.
The volunteers, who organized as Tarrant County Voices for Health, worked for more than two years to determine what it takes to make this a vibrant and safe community where empowered people live healthily.

A year ago, in a Community Health Assessment, they identified these top health issues that must be addressed: appallingly high rates of chlamydia and other sexually transmitted diseases, obesity, smoking and asthma in adults; a tragically high infant mortality rate of 7.5 deaths per 1,000 live births; and incredibly high asthma and obesity rates among children.
On March 6, they debuted the 2014 Tarrant County Community Health Improvement Plan, a 48-page plan with proposals for “a lot of different stuff that’s gonna help,” said Tarrant County Judge Glen Whitley. “Stuff” includes more safe, clean, well-lighted places to walk and bike and better access to fresh, healthy, affordable food in every neighborhood.

“Health is a function of the determinants of health: genetics, environment, behavior, medical care, economic conditions, stress …,” said Richard Kurz, dean of the School of Public Health at the University of North Texas Health Science Center in Fort Worth.
“You are healthy because of community partnerships (among schools, outreach workers, primary care providers, medical specialists, pharmacists, third-party payers, and others with a comprehensive approach to improving health), not just because of the elaborate medical system in place,” Kurz said at the meeting to unveil the plan.
Among other points made by community leaders at the meeting:

• More companies are looking for wellness programs to address the precursors of major health problems such as diabetes, heart disease and lung diseases, including asthma. – County Judge Glen Whitley
• You don’t know what you have until you find out what you need. Some 70 percent of health is determined by our environment and the choices we make. – architect James Lawrence
• Our emergency rooms are very, very busy providing care that is not emergency care. About 25 percent of those who go to a hospital ER are admitted. Some 35 to 40 percent just don’t need to be there. – Kristen Jenkins, president of DFW Hospital Council Foundation
• Healthy students yield stronger educational outcomes. We need more partnerships with Tarrant County College and the University of Texas at Arlington to promote physical fitness and nutrition to get kids to fuel up to play for 60 minutes every day. – Aaron Perales, director of parent and community engagement, Arlington Independent School District
• People say teenagers don’t eat vegetables. They do if they grow them. Urban youth farms help address the nutritional needs of the community. Employing high school students to run the farms provides nutrition education, jobs and healthy food, whether they sell it at a farmers’ market, give it away to food banks or take it home and share it with neighbors. – Don Gatzke, dean of the UT Arlington School of Architecture
• We are barely scratching the surface of where we need to go to make these places where we live and work healthier, happier, more productive, safer, more nurturing. – Precinct 1 Tarrant County Commissioner Roy Brooks
The UNT Health Science Center School of Public Health in Fort Worth, a partner in the Community Health Improvement Plan, is presenting a two-day workshop, “The Built Environment, Lifestyle and Health” on April 10-11 on the school’s campus, 3500 Camp Bowie Blvd.

Attendees at this interactive, two-day conference will hear national and local speakers sharing best practices for creating healthier environments and will help develop recommendations for moving to the next level in Fort Worth and Tarrant County.
Joel Spoonheim, executive director for the Blue Zones Project, which helps develop community plans aimed at lifestyle changes that contribute worldwide to longer, healthier lives, will be a keynote speaker, Kurz said.
The Blue Zones Project focuses on designing buildings, roads, sidewalks, parks and other spaces for physical activity, grocery stores, restaurants, schools and workplaces that make it easier for people to choose healthy living habits.

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