ABOUT THE CHA AND CHIP
Community Health Assessment (CHA)
What does a healthy community look like to you? Some people picture a community where obesity rates are low, where vaccination rates are high, but most picture a community where everyone can feel safe, active, and productive. When asked, community members tend to talk about a healthy community as one where jobs are readily available, where their voice and values are respected and appreciated, and where navigating services is simple. In 2015, the City of Worcester Division of Public Health as the lead agency of the Central MA Regional Public Health Alliance, in partnership with UMass Memorial and Fallon Health, sought to answer this question and others about the health status of the communities of Greater Worcester through a Community Health Assessment (CHA). That process revealed a number of priorities our community needs to address in order to best improve health. Some of those priorities were more immediately apparent such as substance use. Some were more complicated, like economic opportunity. Using the information that was gathered in the CHA, including the input of over 1,500 individuals who live, work, learn, or play in the Greater Worcester region, a process began to create the 2016-2020 Community Health Improvement Plan (CHIP).
In 2018 The 2018 Greater Worcester Regional Community Health Assessment (CHA) was developed collectively by the City of Worcester Division of Public Health, Fallon Health and UMass Memorial Medical Center. These three organizations worked in close association with the Central Massachusetts Regional Public Health Alliance (CMRPHA). Since 2009, these entities have joined forces every three years to conduct a regional CHA and align their associated strategic implementation plans or community health improvement plans (CHIPs). Together, members from each of these groups make up the CHA Steering Committee, called the Facilitating Partners in this report. This CHA Report is the culmination of yet another successful assessment effort. The 2018 CHA will inform the next iteration of the Community Health Improvement Plan. Stay tuned for details onto how to be involved in this process.
Community Health Improvement Plan (CHIP)
A CHIP is used as roadmap for health improvement over a 3-5 year period and guides the investment of resources of not only the health department, hospitals, and health plans, but of any and all organizations that have a stake in improving health for the residents of Worcester and the surrounding communities. This CHIP for the towns of Grafton, Holden, Leicester, Millbury, Shrewsbury, West Boylston, and the City of Worcester, was developed using a 6-month planning process. Shortly after the completion of the 2015 CHA, the planning process for the 2016 CHIP began. The CHA identified 9 priority areas. Subsequently, 8 working groups were established each with 2-3 conveners who volunteered or were nominated as leaders of a four session planning process. Conveners and staff of WDPH recruited members of those groups who went through a standardized process to set actionable objectives and strategies using the data in the CHA. Once completed, the Worcester Partnership for Racial and Ethnic Health Equity convened two roundtables to assess all proposed objectives and strategies through a lens of health equity. After refinement from the staff of the Worcester Division of Public Health and members of the Coalition for a Healthy Greater Worcester, 9 overarching aims, 31 measurable objectives, and 100 actionable strategies, within the framework of 1 overarching goal and 3 core principles were finalized.
One Goal: Health Equity
The Robert Wood Johnson Foundation defines health equity as meaning “that all people, regardless of ethnicity, socio-economic status, sex or age, have equal opportunity to develop and maintain health through equal access to resources.” At the outset of the CHA and CHIP process, partners agreed that success in community health improvement is defined as equity, and therefore all initiatives under the CHIP must work towards this shared goal. Community members who participated in the CHA and partners alike agree that every member of the community deserves the opportunity to be healthy. To that end, health equity is not one goal among many, it is the goal.
Three Core Principles
Invest first in the community. Whether access to food, the built environment, or job readiness; over and over, the solution to many of the barriers to health appears as investing first in the community. This means that in order to improve health, jobs should be available first to those who live in the community; food should be bought first from growers from the area; and gaps in the workforce should be addressed through training and education of local residents, rather than attracting professionals from elsewhere.
Empower, listen to, and respect community voice. In every discussion of how to improve health, residents and partners discussed the critical need to allow more input from all members of the community into health-related decisions as broadly as transportation planning and school lunch menus. In order to drive an equitable and responsive public health system, community voice must be at the center of all decisions.
Eliminate gaps between services. The greatest strength of the Greater Worcester region identified through this process is the abundance of high-quality social, health, and associated services in the area. One of the most frequently cited frustrations, however, was the difficulty in navigating between these services. For that reason, a “no wrong door” approach to services is needed, meaning that when an individual presents in one place for one service, that person should be seamlessly connected to a different needed service regardless of the scope of the agency’s services.
Nine Priority Areas
The CHIP is intended to be a living document, with adjustments and course corrections being made on an annual basis to maximize impact and success of implemented initiatives. The Coalition for a Healthy Greater Worcester, in partnership with the Worcester Division of Public Health, holds the responsibility for ensuring implementation of this Plan, though success will not be achieved without the commitment of hundreds of organizations and decision-makers. The objectives of this CHIP are intended to provide a framework for health improvement through 2020, providing a roadmap to becoming the healthiest city and region in New England by 2020.