Contributors: Dr. Sandra Delgado and Pattie Dale Tye
To learn more about Sandra and Pattie Dale, click here
What does it require to improve the health of a population facing significant health challenges? Some will point to medical care or the importance of collaboration among public and private entities. When it comes to these types of unhealthy populations, it’s important to also examine types of behaviors that lead to these issues.
Consider San Antonio: ranks 45 out of 50 on the American College of Sport Medicine’s (ACSM) 2014 American Fitness Index and has higher per capita rates of obesity (28.9%) and diabetes (11.3%) than the national average (27.6% and 9.7% respectively). Smoking, lack of exercise, low health insurance coverage rates, and a less-than-ideal diet only contribute to the low ranking. In addition, nearly 28 percent of San Antonio area deaths each year are attributed to cardiovascular disease according to the American Heart Association.
We have faced these health challenges firsthand in San Antonio and know them very well. Humana has served the health needs of the San Antonio community for more than 35 years, and today 500,000 people in the San Antonio area use a Humana insurance benefit. For over a year, a team within Humana has been focused on partnering with the San Antonio community to make health easier for local residents; this effort has become known as Project San Antonio.
Given the challenges, we realized a multi-pronged approach to population health, built on a foundation of both new partnerships as well as strengthening existing ones, would be necessary to improve health in San Antonio.
Where We Started
If you want to make an impact in population health, the research literature has demonstrated that a community-based, participatory approach to engagement - reaching out to the local community right from the start - is one key to success. It’s not just about getting the right clinical care; it’s about making it easy for people to access the resources they need. A comprehensive population health approach also looks at healthy behaviors, nutrition, health literacy, and connectivity.
In order to succeed at making health easier, it takes collaboration with local influencers of health and well-being (all politics are local, as the saying goes), a key first step in addressing these health challenges. We convened a Clinical Town Hall as part of Project San Antonio and made it a priority to secure the participation of San Antonio clinical and community leaders, healthcare providers, and leaders of healthcare organizations in order to move the needle.
The Town Hall – an Exercise in Collaboration
Our first step was to hold a gathering of local community leaders, including SA 2020, Bexar County Medical Society, San Antonio Food Bank, and the Mayor’s Fitness Council, among others, to map out an approach to address the health challenges we faced as a collective. We also sought to identify individuals who would be potential long-term partners.
A primary objective was to start a dialogue among these local community leaders about how to make health easier. In advance of the Clinical Town Hall, we hosted a series of focus groups. We discovered an array of great programs offered in San Antonio, but realized greater awareness was needed if these programs were to be optimally effective in improving the population health of San Antonio.
We also surveyed Town Hall attendees – primarily local physicians – about opportunities for collaboration between community programs and about barriers to health in San Antonio that community programs didn’t address.
Steps Taken to Jointly Address the Issues
After we surveyed these Town Hall attendees, we held a Clinical Town Hall, which brought together community health and well-being leaders with clinicians for two days of discussion, insights, and education. Panel discussions on population health and leveraging well-being resources in the community were highlights of the event, which paved the way for future collaboration.
The event was a prime example of collaboration in action fostered by the engagement from the local community. Those community health and well-being leaders, and a wide assortment of clinicians, stepped up to the plate and actively engaged about ways to make health easier in San Antonio and about how to improve collaboration among local resources.
Feedback after the Town Hall revealed these groups had worked independently for years on how to improve the health of local residents, but they had never come together to explore this level of collaboration.
The ideas and insights shared and the terrific partnership are crucial components to our collective efforts to make health easier for San Antonio. Working alongside public health leaders helps everyone involved achieve our objectives.
Expanding the Partnership
To continue the work of the Town Hall, we convened the San Antonio Health Advisory Board (SAHAB), a smaller working group of 26 health and well-being leaders.
The Board is chaired by Dr. Sandra Delgado, Chief Medical Officer for Humana Government Business, with Dr. Peter Wald, the Enterprise Medical Director for USAA, serving as Vice Chair. It was important to us that our Vice Chair was a community leader to make sure the San Antonio community’s needs are at the heart of everything we do. Despite its relatively humble beginnings, the SAHAB has the potential to improve the city’s health for generations to come.
Late last year, the SAHAB convened to solidify the Board’s mission and desired outcomes and to discuss the proposed actions that originated at the Clinical Town Hall. The group is currently pursuing several of these ideas and has established subcommittees to support them:
- Fit City SA – partner with San Antonio Parks and Recreation and the Mayor’s Fitness Council to build upon their Fit Pass program and raise awareness through marketing to Humana’s 500,000 members in San Antonio.
- Community Resource Center – develop a one-stop-shop for consumers to access health-related community resources (e.g. nutrition, physical activity, social services, transportation, behavioral health, etc.).
- Diabetes Resource Co-Op – develop a comprehensive guide for consumers to access diabetes community resources.
- Data Analytics – define what success looks like for the SAHAB.
Although early in development, the SAHAB has significant potential for improving the lives of local residents by focusing on resources and conditions that affect the San Antonio community the most.
We have no doubt that a year from now, probably sooner, we’ll see the needle start to move in the right direction. As with any major initiative, it will take time.
While we have the right people and relationships in place to improve the health of San Antonio, improving population health takes a collaborative effort that is not only steadfast in its resolve, but has the flexibility to adapt and capitalize on new opportunities.
To contact Dr. Sandra Delgado: [email protected].
To contact Pattie Dale Tye: [email protected]