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Health Improvement in a
Rural Community:
Overcoming the Odds
Workshop #9
Matthew Kuhlenbeck, MHA
Program Director, Missouri Foundation for Health
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Overview
• Who is MFH
• What is the Social Innovation Fund
• Story of Unionville in Putnam County, MO
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Who is MFH?
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• An independent philanthropic foundation dedicated to improving the health of people in our region
• A changemaker, educator, and partner to promote community health and increase access to care for the uninsured and underserved
Missouri Foundation for Health
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Where We Are
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• Created with proceeds from the conversion of a major Missouri health insurance company from non-profit to for-profit status
• As an independent foundation, MFH is governed by its board of directors
• Not part of state, local, or federal government, nor part of a company
Independent
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What is the Social
Innovation Fund (SIF)?
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Funding Social Innovation
• 2009 Edward M. Kennedy Serve America Act• Reauthorized the Corporation and its activities
• Introduced the Social Innovation Fund grant program
• Social Innovation Fund grant program• Establish public/private partnerships with
philanthropy
• Healthy Futures, Economic Opportunity, Youth Development and School Support
• $50 million available nation-wide
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Who is “The Corporation”?
Nation’s largest grant maker supporting service and volunteering
Strengthening public-private partnerships
Programs include: Senior Corps, AmeriCorps, Serve.gov
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Social Innovation for Missouri
So what did this mean for Missouri?
• Missouri was one of the first states to benefit
• MFH - Intermediary of Federal Funds
• 3 years of funding
• Grant funds available to organizations throughout Missouri
• Allowed for an integrated approach to prevention
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How
does the
SIM
Process
work?
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Social Innovation for MissouriSeeking to integrate efforts to address the two
leading causes of preventable death in MO.
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Community Health
Improvement Model
• Community assessment – community resources, capacity, and strategic overlap
• Community capacity building – organizing, branding, and connecting communities to issues
• Technical assistance – support to implement project plans and navigating policy changes
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Model Basis
“It is unreasonable to expect that people
will change their behavior easily when so
many forces in the social, cultural, and
physical environment conspire against such change.”
- Institute of Medicine
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What’s health have to do with…
Indoor Environment Built Environment
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Menu of
Strategies
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DomainsSelection of complementary activities from each domain
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Measuring Capacity
Coalition Core Competencies
Checklist
• Self assessment of
strengthens and
weaknesses.
• Focused on duel use for
tobacco, healthy eating,
and active living policies.
• Available on RWJF
County Health Rankings
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Long-Term
Outcomes
• Healthy vibrant communities
• Decreased rates of diabetes, asthma, and high blood pressure
• Decreased reports of fair or poor health status
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The “It Factor” of Partners
• Strength of partnerships and
community engagement
• Project builds off of previous
accomplishments or existing
resources
• Evidenced based strategies
• Experience with local policy
• Clear target population
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Highlight: Unionville in
Putnam County Missouri
• County Population: 4,979
• Unionville: 1,865
• Median Income: $26,282
• 26.6% of total jobs are
agriculture related
(MO=2.9%).
• 10.9% over the age 25 have
a bachelors degree
• Classified as “Isolated” by
the USDA
• Politically Conservative
Unionville
STL
KC
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Commitment to
Change
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Catalyst for Change
• Long-standing health coalition, Putnam
County Partners in Prevention (PCPP).
• ACHIEVE grant in 2010.
• 10 members – Action Institute
• New stakeholders engaged
• Conducted 15 CHANGE tool
assessments.
• Focused on tobacco, physical activity,
and nutrition
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LOWER CHRONIC DISEASE
Increase Physical Activity
Increase Healthy Eating
Lower Tobacco
Use
Eliminate Exposure to Secondhand
Smoke
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Community
Partnerships
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• Putnam County Health Department
• County of Putnam- Commissioners
• Missouri Foundation for Health
• City of Unionville
• Utility Safety Design Inc
• Northeast Rural Telephone Co
• Dr Joel Pratt
• Unionville Rotary
• Hy-Vee
• Putnam County State Bank
• Great Western Bank
• Lions Club
• Donna Neighbors
• Putnam County Foundation
• Walmart
• McCutchen & Son
• Dr Dawn Fairley
• TICO Manufacturing
• Incarnate Word Foundation
• Lace Image
• Putnam County R-1 Schools
• Monsanto
• Casey’s
• Duane Crawford
• PC Café and Resource Center
• Putnam County Memorial Hospital
• Kids Castle Play School and Nursery
• All- Weather Track Supporters
• Unionville Park Board
• Putnam Co Fair Board
• Appleseeds
• Kernal Carriers
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Healthy
Family
Specific to
Health Topic
Campaign Branding
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PHYSICAL ACTIVITY
Master Park Plans
City Park and McCalment
Park Improvements
Prairie Trail Improvements
PCR-1 All Weather Track
New Sidewalks
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Livable Street: A livable street is safe, efficient and useful for all people
Bike Lane
Wide,
ADA
sidewalks
Greenery
Curb cut
into
pedestrian
crossing
Driving lanesLivable
Streets
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1. Did you have room to walk?
2. Was it easy to cross the street?
3. Did drivers behave well?
4. Was it easy to follow safety rules?
5. Was your walk pleasant?
Walkability Audit Checklist
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Walkability Audit Results
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30
19
13 13
0
5
10
15
20
25
30
35
Ideally Bob's Hospital School
Key
26-30- Great for walking
21-25- Pretty good for
walking
16-20- OK, but needs
work
11-15- Needs a lot of
work
Walkability Scores
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Connectivity
Plan
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* Benches and Bike Racks
* ADA Sidewalks
* Cigarette Receptacles
* Crosswalks
* Signage
Sidewalks & The
Square
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Livable Streets
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McCalment Park
Master Park Plans
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McCalment
Park
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Master City Park Plans
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City Park
Project 2011
•Basketball
Court
•Trailhead
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City Park Project 2012
*Concrete Trail
*Relocate play
equipment
*Install new play
equipment
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2012 Construction
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Putnam County
School All
Weather Track
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Putnam County
R-I School
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PCR-1
Elementary
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Bike
Racks
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Pool
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Fall color route
posted around
town and on website to
encourage walking
to take in scenery
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Bike Blender:
Pedal your way to
a smoothie
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PCPP
Annual
Events:
Mother Son
Adventure
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HEALTHY EATING
Community Garden
Buy Locally
Farmers Markets
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Healthy
Options
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2013 Community Classes
• Spring Into Gardening – April
• Preservation – May
• Grilling Demonstration
with Local Premier Chef – June
• Future Options Discussed:
Recipes for Food Bank Items
• Shopping for Healthy Food on a Budget
• Growing, Preparing and Using Herbs
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TOBACCO Educate
Youth
Educate Users
Tobacco Cessation
Business Policies
Tobacco Tax
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21. Kid D Barn
22. Kid’s Castle
23. Knight Real Estate
24. License Bureau
25. Lockridge Lumber
26. Main Street Styling
27. McCalment Gym
28. McCutchen & Son
29. PC Café
30. Playle & Jones Funeral Home
31. Putnam County Care Center
32. Putnam County Extension
33. Putnam County Rural Health Clinic
34. Putnam County Health Dept
35. Putnam County Memorial Hospital
36. Putnam County Library
37. Putnam County R-1 Schools
38. Scout Building
39. SOAR
40. Unionville Print Shop
1. 4- Building
2. American Family Insurance
3. Appleseeds
4. Bob’s food mart
5. Casey’s
6. Cellular Today
7. CJ’s
8. Putnam County Courthouse
9. The Cutting Edge
10. Dollar General
11. Dunlap Manufacturing
12. Farm Bureau
13. Farmers Bank
14. Global Innovative Legal Solutions
15. Great Western Bank
16. H& R Block
17. Happy Hearts Daycare
18. Hart Abstract & Title
19. Hometown Medical
20. Hy-Vee
Smoke
Free
Places
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Smoke-free
Signage at
City Park
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So…is any of this working?
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1
8
1 2 3 456
7 8 91
0
1
1
1
2
1
3
1
4
1
5
1
61
7
System for
Observing
Play and
Recreation in
Communities
SOPARC
Study
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Putnam County Phone
Surveys
1. Does your neighborhood have sidewalks?
2. Are you a tobacco user?
3. Have you tried to quit before?
4. Do you support a community wide smoke free
ordinance?
5. Do you use our parks for recreation?
6. Do you exercise?
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ACHIEVE CHANGE Tool
Assessment 2010-2012
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HEALTHY EATING
16 School and community gardens
9 Schools with new nutrition/healthy snack policies
14 Schools with new fruit/vegetable bars
1180 People attended nutrition classes
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PHYSICAL ACTIVITY
285 Walking school bus participants
1021 New fitness center memberships
10 New sidewalks and trails (over 20 miles)
2 Complete streets policies passed
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TOBACCO FREE
217 Smoking cessation class participants
69 New places with tobacco-free policies
1 Community-wide smoke-free policy
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ACHIEVE (NACCHO) YR 1: $15,000 YR 2: $25,000
SIM (MFH) YR 1: Grant funds $100,000 Cash match $100,000
YR 2: Grant funds $272,323 Cash match $272,323
YR 3: Grant funds $319,792 Cash match $319,792
Healthy Lifestyle Initiative (University of Missouri Extension)
Missouri Institute for Community Health (MICH), Robert Wood Johnson, County
Health Rankings Initiative Funding
ACT Missouri mini-grants and regional development funds (tobacco emphasis)
Maternal and Child Health Contract (MCH): Priority issue is obesity
Previously held the Chronic Disease Primary Prevention (CDPP) contract
(funding eliminated)
Passed a half cent sales tax for funding to support new pool facilitied.
Funding Streams and Leveraging
Resources
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What does all of this mean?
• Community voice is essential in planning
process.
• Engagement and collaboration among key
stakeholders from various sectors works.
• Integration of policy and environmental
changes is effective in sustaining change
• Be prepared for opportunities and/or to
make your own.
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Missouri Foundation for Health415 South 18th Street, Suite 400St. Louis, Missouri 63103-2269
www.mffh.org
Please join our contact listwww.mffh.org/signup
Contact