How To Build Healthy Places Through Cross-Sector Collaboration


By M. Gabriela Alcalde
Kentucky state legislator Susan Westrom summed up her experience at the Foundation for a Healthy Kentucky’s recent Bost Health Policy Forum in the following tweet: “This Foundation is pushing the envelope to improve lives of Kentuckians by building healthy places to live and work.”

On September 28, the foundation held its thirteenth annual Bost Health Policy Forum in Bowling Green, Kentucky, a town of about 60,000 people in the western region of the state.

This year’s event, titled “Building Healthy Places,” brought in local, regional, and national speakers who shared their knowledge and experiences in building healthy communities, with a focus on transportation and housing, education, food systems and policy, and workplaces. The forum attracted more than 230 community leaders, advocates, educators, and health providers from around the Bluegrass state.

Lieutenant Governor Crit Luallen (D) provided remarks on Kentucky’s nationally recognized success in enrolling previously uninsured Kentuckians in health insurance—through either Medicaid expansion or the state-based health benefit exchange, kynect, as well as the state’s ongoing efforts to improve Kentuckians’ health status. Luallen reminded us that health is everyone’s issue, with poor health directly affecting every challenge Kentuckians face.

Foundation CEO and President, Susan Zepeda, introduced four TED-style speakers: Andrew Dannenberg, University of Washington, Department of Environmental and Occupational Health Sciences and Department of Urban Design and Planning; Vera Oziransky, lead author of Beyond the Four Walls: Why Community Is Critical to Workforce Health, a report funded by the Robert Wood Johnson Foundation; Mary Gwen Wheeler, 55,000 Degrees; and Margo Wootan, Center for Science in the Public Interest. Each spoke about the various sectors that contribute to making a community healthy and how each of these sectors interact with, contribute to, and benefit from a healthy community. These TED-style speakers would later join a panel of local experts to address the day’s focus areas: Transportation and Housing; Education; Food Systems and Policy; and Employer and Workplace.

For the Transportation and Housing panel, which was moderated by Theresa Trimble—a construction company owner, four panelists joined Andy Dannenberg. He tailored his presentation to Kentucky by particularly focusing on rural planning and development. He connected planned, community-driven growth with health equity and health-promoting environments. Dannenberg also urged community engagement: “You can influence the health of your community simply by getting involved in policy discussions and decisions.”

Among the speakers was Jeff Moore of the Kentucky Transportation Cabinet. He spoke of the different vocabularies used by health and engineering professionals and the need to bridge that gap so as to engage in long-term planning together and to coordinate efforts to benefit community health. Cathy Hinko of the Metropolitan Housing Coalition spoke explicitly and through examples about the links between housing and health—such as asthma triggered by housing conditions, or housing discrimination, which leaves communities of color and low-income communities in areas without access to public transportation, healthy food resources, and safe places to walk and exercise. She called the attendees to action: “As health advocates, healthy housing is your first barrier” to cross.

Jackie Jones, Kentucky Office of Local Programs, provided an overview of various federal and state funding opportunities, overseen by her office, for local communities to develop transportation projects that improve the health and quality of life of communities. Tim Dunn, a professor at Hazard Community and Technical College, is a volunteer with the nonprofit Pathfinders of Perry County, which has spearheaded creation of a River Arts Greenway in the town of Hazard, Kentucky. He described this project, which encourages exercise, community building, art, and revitalization of downtown Hazard.

The Education panel was moderated by Terry Brooks of Kentucky Youth Advocates. Among the panelists was Terry Tolan of the Governor’s Office of Early Childhood,who presented work done by the Governor’s Task Force on Early Childhood Education and discussed the role of the KIDS NOW program in improving such education so that children reach kindergarten healthy and ready to learn.

Jamie Sparks of the Kentucky Department of Education described ways in which his agency partners with the Kentucky Department for Public Health to strengthen whole-child wellness strategies in Kentucky’s public schools. Sparks identified ways in which community members can become involved in local school systems and healthy policy development.

The Foundation for a Healthy Kentucky’s President and CEO, Susan Zepeda, moderated the Food Systems and Policy panel. Margo Wootan continued the themes from her morning TED-style talk on food marketing and health and underscored the effects of consumers eating more meals outside the home: “How many of you have appetizers at home before dinner? Yet, restaurants serve them and their calories.”

Among the panelists was Martin Richards of Community Farm Alliance who talked about the connections among health, food, and farming from a policy perspective. Established in 1985, the alliance is focused on “family-scale agriculture” and takes a holistic approach to farming, by considering its social, health, economic, and environmental impacts.

Jeff Henderson of the Jackson Regional Food Center discussed how it is designed to help farmers have a longer sales season for their produce, through processing, canning, bottling, and spreading out when the produce is released into markets.

Mike Muldoon of Health Enterprises Network hosted the Employer and Workplace session, in which speakers discussed how employers can play a role in improving not just their employees’ health, but the health of the community where they are located. Vera Oziransky talked more about the findings of her July 2015 report, Beyond the Four Walls, published by the Vitality InstituteShe addressed how the health of the community has a direct impact on the health and productivity of the workforce, thereby affecting profitability and sustainability. In other words, if employers invest in community health, they make the community healthier and thereby make their workforces healthier.

Teresa Lovelybusiness coordinator, Worksite Wellness, for the Kentucky Department for Public Health, spoke about the work of the Kentucky Cabinet of Health and Family Services to raise awareness of and support for healthier workplaces and the state’s employer recognition program. Cecilia Watkins, Western Kentucky University, talked about its professional certificate program on worksite wellness, in which students are introduced to evidence-based programs to create healthier workplaces, and about how that university is integrating health promotion and health protection (which is both disease prevention and injury prevention).

Ashli Watts of the Kentucky Chamber of Commerce shared the evolution of its role in health issues, with wellness now a priority dimension of economic development. Specifically, Watts talked about the chamber’s ongoing support for statewide smoke-free legislation.

Tony Iton, who concluded the day as the keynote speaker, is senior vice president of Healthy Communities at the California Endowment. His presentation, entitled “Place and Health: Is Your Zip Code More Important Than Your Genetic Code?” focused on the importance of place in health outcomes. Iton interlaced his own experiences as an immigrant, lawyer, physician, and public health professional into his slide presentation, which stemmed from the research literature, on the way our environment shapes our options and health. Recognizing that “80 percent of what influences your life expectancy happens outside the health care industry,” Iton described the California Endowment’s commitment to working in the community.

Citing growing research on how inequality influences health outcomes, Iton said, “It’s not how much you spend but how it’s distributed in society that impacts life expectancy.” The United States has a high degree of inequity and has been seeing a widening gap in life expectancy among racial and ethnic groups, he reported. At the same time, life expectancy as a whole is relatively low in the United States, given the high investment in health care services and given the cost of living. The fact that it is primarily factors outside of the health care system that influence health and life expectancy is illustrated by looking at social services expenditures in other developed nations as compared with those in the United States: compared with other developed nations, the United States spends significantly more on health care, while spending significantly less than other nations on social services. Creating healthy and fair places to live, work, and learn is essential to improving community health, Iton said.

See the forum’s agenda, conference materials, related links, and presentations here.

You can learn more about this and other Foundation for a Healthy Kentucky initiatives by visiting its website:


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