Operationalizing GHI

The health priorities identified in Get Healthy Idaho represent the focus of the division over the next five years. 2020 marks the first year of the new initiative, and the activities and measures include establishing a foundation within the department and building communication plans and operating infrastructure. Activities have included educating department staff and external partners about the the social determinants of health and focusing on communities through place-based initiatives; researching effective models from other states or communities; engaging with key partners; identifying opportunities for partnership and collaboration; and, identifying a funding model and funding sources to support this work both internally and in the first funded community.

The Get Healthy Idaho initiative has limited designated staff and funding so the division’s first step towards implementation was to establish an operational structure to begin this cross-cutting work. Many staff from across the department were involved in various workgroups charged with laying the groundwork and building the internal infrastructure needed to support this long-range initiative.

Calendar years 2021-2024 will focus on implementation, including awarding the first subgrant solicitation to one community. In years  three through five, with additional funding, a second community will be funded.  The effort will support each community for up to four years.

Identifying Communities

The division is using a data-informed approach to identify communities with poorer health outcomes where investments in upstream approaches will be most effective. To identify these communities, the division developed a data dashboard showing county-level health outcome measures (incidence, prevalence, mortality, etc.) combined with the health determinant indices. Indices are composite measures that combine multiple social determinant of health factors into one “score”. 

Two health determinant indices (the Social Vulnerability Index (SVI) and the Concentrated Disadvantage Index (CDI)) were selected based on their ability to provide county-wide estimates, support and promotion by the Centers for Disease Control and Prevention and range of individual measures which are used to develop the index score.

The SVI has two composite groups focused on Socioeconomic Status (SES) and Housing. The SVI-SES index considers poverty levels, unemployment, income and high-school graduation. The SVI-Housing index considers multi-unit structures, mobile homes, crowding, access to vehicles and group living.

The CDI considers poverty, those receiving public assistance, female-headed households, unemployment and those younger than 18. When these indices, in combination with health outcome data, are applied to the state population, counties of highest risk are identified, as seen by the dark blue shading in the Diabetes Prevalence and SDOH Risk by County map.

 

The division’s data dashboard (here) allows the counties to be ranked from 1- 44 (the number of Idaho counties).

As the division reviews competitive proposals received for Get Healthy Idaho funding, points based on a county's ranking in the dashboard will be added to each community proposal evaluation score.  Once a community is funded, the social determinants and other resource data will be reviewed, allowing for a more comprehensive, yet targeted assessment of the community’s greatest needs.

Community Engagement  

Through Get Healthy Idaho, the department will sustain investments in statewide partnerships to connect resources and opportunities for authentic engagement with the funded community  and its health collaborative members. This also reflects the department’s desire to ensure place-based initiatives are led and driven by communities. A fundamental component of this work is developing a model for authentic community engagement, led by a community leadership team, which will ensure open and ongoing dialogue with partners, residents, families, youth and community leaders. Authentic engagement will promote a positive culture built on a foundation of partnership and trust, where residents feel empowered to take leadership roles, build social capital and identify resources to help the community collectively work toward impactful solutions to cultivate health, safety and resilience.

The funded organization serving as the lead of the local Get Healthy Idaho effort will engage a diverse representation of community members and leaders in a community healthy collaborative. Collaborative members will be empowered to both lead and drive decision-making efforts. Community member engagement will include capturing qualitative feedback through key informant interviews to help the collaborative gain a better understanding of the known assets, barriers, challenges and opportunities that exist in the community. By combining population-level health and social determinant data with qualitative feedback from residents and organizations, the community will be tasked with selecting data-informed and evidence-based interventions that will support and enhance health, safety and resilience in their community. Through this process, the division will gain a better understanding of what matters most to the community’s health and learn about their experiences and recommendations for improvement. 


Community members will have opportunities to engage throughout the process and contribute to the planning and implementation of solutions. Continual engagement and feedback of residents will be vital to ensure the work is driven by, and meets the needs of, the community.

Plans for policy and system level change

Health happens where people live so the policies, systems and environmental interventions chosen must ensure they will reduce health disparities and increase healthy opportunities for everyone in the community. The department will provide technical assistance to the awarded community to support community members and leaders advance their collective capacity, knowledge of best practices and implementation of meaningful solutions. The action plan will be driven by the community collaborative and informed by data specific to the community's unique challenges, needs and opportunities. The department will support the community to identify relevant policy, system and environmental changes based on what is most critical to the community and will have the most impact on improving health outcomes. It is anticipated that community priorities will be just as diverse as the community itself, given the variation in local health outcomes, culture, geography, sociopolitical climate, capacity and allocated resources.

Health happens where people live so the policies, systems and environmental interventions chosen must ensure they will reduce health disparities and increase healthy opportunities for everyone in the community.

Indicators of Health Improvement and Priorities

for Action

The 2020 indicators focus on building and mobilizing the Get Healthy Idaho initiative. This work has no dedicated funding and limited dedicated staffing, so time is needed to lay the groundwork for engaging partners and communities in a way that will ultimately impact health improvement outcomes. The work began in calendar year 2019 through the department’s and division’s strategic plans; therefore, January 2020 through June 2020 of the health improvement plan indicators align with the metrics defined in those strategic plans:

1.       Develop a communication and education strategy

2.       Define and share the Get Healthy Idaho framework

3.       Develop a financial model framework

4.       Engage stakeholders and key partners in Get Healthy Idaho

 

From July 2020 through June 2021, the division will identify indicators that measure continued progress with establishing the infrastructure and implementation of the Get Healthy Idaho community subgrant.

Publication of the Assessment and Plan

This website was created to display the assessment and health improvement plan in an interactive format. It serves as the central location for all information related to this initiative.

At least annually, the division will convene the larger Get Healthy Idaho partner group to review the prior year implementation plan, present new data and modify the plan, as needed. Partnering agencies and the department team responsible for identified strategies will report progress. On a quarterly basis, strategy leads will meet to review progress, barriers and successes. 

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