By, Lisa Santora, M.D., M.P.H., Chief Medical Officer, Beach Cities Health District
Beach Cities Health District (BCHD) is a local primary prevention agency dedicated to creating a social environment that supports healthy behaviors in the communities of Hermosa Beach, Manhattan Beach and Redondo Beach. Our work aims to touch all 123,000 residents, from prenatal through adolescent to old age.
Reaching every resident involves many community-level partners. In reality, we see our work as a localized National Prevention Council, which, at the national level, brought together 17 federal agencies/departments to intentionally build health into all policy. So, locally, BCHD works with transportation, education, commerce, etc. to promote health everywhere. Somewhat surprisingly, we found partnerships with the fire and police departments to be incredibly fruitful in addition to the more “traditional” partnerships.
For example, we’d never have been able to create safe walking routes to schools without the help of the police. BCHD brought together the department, the Parent Teacher Association, city engineers and others to identify the safest routes to school that also made sense for families and police department resources.
Without the ability to bring these diverse, but necessary, partners together, we’d never have the robust Safe Routes to School Program that we do now. This is exactly how we see our role: as an integrator of all the various resources that can and should be benefiting the health of the community. We are a successful integrator because of our historical and trusted relationships with the traditional healthcare community and other community organizations at large. Basically, we intentionally placed BCHD at the intersection of the healthcare system and community.
As an integrator, we guide work with city governments, restaurants and others to create communities that make it easier for anyone who wants to be healthy do so. For example, we helped residents work toward an outdoor dining smoking ban and have actively advertised healthy messages.
As a result, we’ve seen smoking decline from 10.6 percent to 7 percent. In addition, 5.6 percent more Beach Cities residents reported engaging in regular exercise (at least 30 minutes, 3 times/week) and 6.2 percent more residents reported eating five or more servings of fruits and vegetables, on four or more days in the past week. In total, we have 1,645 fewer obese adults than we did in 2010.
While we know there isn’t a direct one-to-one casualty, clearly something is working and the savings on fewer smokers is enormous.
Supporting Healthy Behaviors throughout the Community
In 2010, 28.9 percent of boys and 25.3 percent of girls entered kindergarten overweight or obese in school year 2011 to 2012. In addition, only 42.9 percent of fifth graders in Redondo Beach passed fitness measures.
To address these systemic and life-threatening challenges, we created LiveWell Kids, an elementary school-based obesity prevention program that provides nutrition education, daily physical activity, funding for fresh fruits and vegetables in school meals and school-based gardens.
We have also funded physical education specialists. BCHD-funded physical education specialists provide mentoring and guidance to general education teachers, who often receive little training, on how to effectively teach physical education lessons.
Through increased walking, physical education, consumption of fresh fruits and vegetables and other initiatives, there was a 37 percent reduction in obesity rates among the fifth graders participating in LiveWell Kids since the 2004-05 school year. In addition, students are getting 40 percent more physical activity.
Going further, to reach children and families in neighborhoods, we created The Blue Zones Project, a community-wide initiative to improve the health and well-being of residents. By incorporating permanent, evidence-based environmental and policy changes, the project aims to make the healthy choice the easy choice and help residents live healthier, longer lives.
For seniors, we employ seven social workers to work with older/disabled adults to create care plans to provide support. We also partner directly with traditional healthcare organizations, most notably hospitals, to prevent readmissions. From the hospitals we learn of older adults who might benefit from home visits or even remodeling. Annually, BCHD organizes 200 community volunteers to provide wraparound care, friendly visits, run errands, and in-home personal training.
We also have connected with fire departments, so that when they get calls for senior falls, their first call is to us, not necessarily the hospital. We can then provide the appropriate care and increase fall prevention to hopefully stop another fall from happening.
Purposefully, Beach Cities Health District has become the largest preventive health agency in the nation. We intentionally focus on wellness, not sickness, to encourage people to make wiser health decisions. To that end, we offer comprehensive health and wellness programs, paired with innovative services and facilities to promote health and prevent diseases from prenatal to old age. As noted, our programs and services are aimed at making illness prevention an integral part of the classrooms, workplaces and homes of the beach cities.
As a public agency, BCHD is subsidized by district property taxes, program fees and healthcare business, lease and investment income. This forms the basis of our hybrid funding model, which enables us to return $4.79 to the community in services and programs for every tax dollar BCHD receives. Instead of relying on grants, we’ve created a sustainable model of prevention.