Be Healthy Denver

Published every five years, a community health assessment measures progress toward improving Denver’s health and identifies areas of health concern. The findings help guide Denver’s public health agencies, in collaboration with local organizations and community stakeholders, on where to focus resources and efforts in future years.

In early 2015, the 2014 Health of Denver Report was published. The 2014 report highlights three themes about Denver’s health:

• Equity – Differences in health exist between some neighborhoods and demographic groups
• Prevention – Many of Denver’s leading causes of death, disease and injury are preventable.
• Importance of Place – Health is linked to the places where residents live, work, learn and play.

Community Health Assessment efforts, especially in the 2014 iteration, place a high priority on concepts of healthy equity and the social determinants of health. Recognizing that social and economic factors – income, education, housing and transportation – cause differences (inequities) in health outcomes for Denver residents helps us understand how health is affected by events outside of a doctor’s office and sheds light on how health varies based on where one lives and on socio-economic background.The information gathered through a health assessment helps public health and community stakeholders identify and implement strategies to work with communities to improve well-being of all residents.

Feedback from previous health assessment efforts highlighted a strong interest in focusing on youth and developing resources to better understand the health experience of youth in Denver.

In early 2018, Denver’s public health agencies published a youth-focused health assessment. Different from past assessments which worked to capture the health experience of all Denver residents, this youth health assessment focused entirely on young people in Denver between the ages of 13 and 25.

This assessment took a community based participatory research approach, in which young people between the ages of 13-25 who live, learn, work, play, or pray in Denver were hired to drive the process of assessing health. By engaging young people directly, this Youth Health Assessment (YHA) ensured that identified issues and opportunities aligned with youth-defined needs and desires for improvement and change. The YHA is structured around opportunities to support youth success while also highlighting some key challenges affecting youth health in Denver.

Following the release of the 2011 Health of Denver Community Health Assessment, DDPHE and DPH convened a diverse group of partners to form Be Healthy Denver (BHD), Denver’s health assessment and improvement planning initiative, to help create the city’s first public health improvement plan. Health assessment and improvement planning are inextricably linked; assessments produce baseline information that is used to frame improvement planning activities and target resources. Improvement plans use health issues and disparities identified in the assessment to address Denver’s greatest health needs. The purpose of Denver’s improvement plan is to devote five years of focused effort toward developing high-performing collaborative programs where none are already in place.

Based on the findings from the 2011 assessment, Denver developed its first formal community health improvement plan (CHIP) in 2013 that set five-year goals for health improvement and identified strategies to be implemented through 2018. Through outreach efforts, Denver residents identified two priority areas: access to care and healthy eating active living (HEAL). In each priority area, the following goals were identified.

By December of 2018:

• At least 95 percent of Denver residents will have access to primary medical care, measured by those reporting insurance coverage.
• The percentage of school-aged children [2-17 years] at a healthy weight will have increased by 5 percentage points (from 69 percent to 74 percent).

BHD is in year five of its five-year CHIP cycle and has published a midterm report (below) that describes the CHIP process and progress in detail. DDPHE and DPH are currently developing the next CHIP plan to be implemented starting in 2019.

• 2017 Mid-term CHIP Report

Significant progress has been made in achieving access to care goals, which has focused on two areas:

1. Creating a health alliance to address access issues across sectors.
2. Supporting the expansion of Colorado’s Medicaid program and health insurance exchange.

The Mile High Health Alliance(Alliance) was initially convened in 2013 to lead BHD’s access to care activities and formally launch in January of 2015.

Three workgroups were convened to focus on an individual’s first access to care, high utilizers and specialty care access. The first Access to Care Working Group  set an aggressive goal to enroll 40,000 uninsured Denver residents in Medicaid. This goal was met and exceeded in 2016 when coverage reached 95 percent. Consequently, work on this priority has been suspended. The High Utilizer Working Group  leads metro-wide efforts to better serve the needs of high utilizers of the health care system, such as residents who frequently use emergency departments or are re-admitted to hospitals. The Specialty Care Access Working Group  addresses barriers to accessing specialty care for low-income residents of Denver.

BHD’s initial HEAL work plan spanned a broad continuum of prevention strategies and interventions. However, the group reframed its focus in 2016 to three key HEAL domains: increasing healthy food and beverage environments, improving the healthfulness of the built environment, and creating consistent HEAL messaging.

As a member of the Healthy Beverage Partnership, Denver set a goal to increase the number of healthy food and beverage policy and practice changes adopted in public venues and retailers. Progress towards this goal includes 33 policy/practice changes adopted reaching more than 5 million visitors, customers and employees annually at these locations. As part of this effort, 13 childcare centers caring for 173 children received technical assistance to review internal food and beverage and physical activity policies and identify opportunities to incorporate best practices. In January 2017, a Hidden Sugar campaign was launched and promoted on TV, online, radio and billboards through metro Denver communities. Progress towards this goal will be tracked by evaluating web site traffic, social media metrics, media mentions, and the participation in the pledge to drink fewer sugary beverages opportunity provided on the campaign’s website.

Monitoring CHIP Progress

BHD set two aggressive goals: Achieving a 5 percent increase in childhood healthy weight and a roughly 15 percent increase in access to healthcare in five years. These goals are ambitious but important to set the tone of systems change with community partners. In the first three years, BHD has achieved significant progress and remains committed to these goals.