Read original blog post in Forbes
By Rob Waters
August 18, 2014
The contestants in a unique health contest I wrote about last month have now been chosen. Technology investor Esther Dyson is sponsoring a competition called the Way to Wellville aimed at charting a path to better health in the U.S. based on the real-world experience of five small cities and towns.
Last week, Dyson and her team announced the five participants: Muskegon, Michigan; Lake County, California; Spartanburg, South Carolina; Clatsop County, Oregon; and Niagara Falls, New York. These five cities, each with a population under 100,000, were chosen from 42 contestants and will spend the next five years working to improve the health of their community.
All of the cities will aim to improve children's nutrition, reduce rates of chronic disease, improve social conditions and the overall environment, and assure that high-quality medical services are available to all. Each city also will pursue unique local goals, from expanding a time-banking system in Clatsop County that helps residents barter services to improving kindergarten readiness and community connectedness in Spartanburg. The five cities will share their ideas and experiences with each other as they go.
To manage the initiative and provide technical assistance and advice to the five cities, Dyson created a small organization called HICCup, the Health Initiative Coordinating Council. She hired Rick Brush, a former health insurance executive with Cigna, whose work in recent years has focused on the development of sustainable market-based methods that incentivize improvements in the health of communities, not just individuals.
I spoke yesterday with Brush about the five chosen communities. Here's what he had to say about each of them:
Lake County, California. While Lake County currently ranks last in health rankings among California counties, Brush says it is poised to make major gains in the next five years. When members of the HICCup team visited recently, they were impressed by the way community leaders and county officials were working together-especially the efforts to change the lunch programs of local schools.
"They completely redesigned the kind of food they're serving by asking what it would take to serve healthy food that kids would actually eat," Brush said. "The students said: ‘If you go about this without involving the kids, it won't be effective."
The students were given a chance to test different options, then to vote on different menus. When Dyson and Brush visited a school recently, they were served stuffed bell peppers and zucchini with kale chips. Brush also was impressed by the work of Lake County Tribal Health Consortium, a local clinic that serves American Indians and other residents with a "completely integrated approach to health and is making great progress with chronic conditions, including diabetes."
Clatsop County Oregon. Oregon is home to one of the most interesting efforts in the country to expand healthcare access to low-income residents. The state's Medicaid program is contracting with coordinated care organizations (CCOs), which are working to improve health outcomes and lower costs by integrating physical health, behavioral health and community services.
The CCO that serves Clatsop spearheaded the county's application to the Wellville contest and will lead the five-year effort, Brush said. The CCO's mandate to lower costs and improve health gives it an incentive to invest in efforts to improve community improvements and services, including by hiring social workers and community health workers.
Clatsop organizers also hope to strengthen their local time-bank, a coordinated barter program that encourages people to provide free services to neighbors. "You help me repair my car and you might get 3 hours of massage therapy," Brush explained. "You drive me to the grocery store, and someone will care for your dog when you go on vacation. It's a great way to make community connections and build social capital."
Greater Muskegon, Michigan. The application from greater Muskegon came together through collaboration between the local public health department and the Rotary Club, with links to the local business community. A strong partnership with the business community wasn't seen in most other places that applied to the Wellville contest, Brush said.
The farming community also figures strongly in Muskegon's plans for improving local health, Brush said. "The presence and influence of the farm community around Muskegon was stronger than anywhere else we went," Brush said. The city's farmers market recently moved to a new, more permanent facility downtown. It includes a commercial kitchen where entrepreneurs hoping to start food-related businesses can test their products. Involvement of local small-scale farmers offers an opportunity to promote healthier food and eating habits to the community.
Spartanburg, South Carolina. The group that put together Spartanburg's application focused its submission on addressing social conditions in the community that contribute to high rates of obesity, diabetes and chronic disease. The team included representatives of a local foundation, the regional health system, the city and a local university-and impressed Dyson and Brush with its breadth of experience.
The Spartanburg team made the case that to achieve significant improvements in community health, they need to take on broader goals such as improving young children's readiness to attend kindergarten and increasing community pride and engagement, Brush said. "They believe their effort will only be successful if they shift the culture and increase involvement from the entire community," he said.
Niagara Falls, NY: This city's application also takes a broad view of health and seeks to improve public transportation, housing, the food environment and employee health, Brush said, goals that are shared by the city's largest employer, the Seneca Nation's casino in Niagara Falls.
"Can a casino be a force for health in Niagara Falls?" Brush asked. Perhaps so, he said, since the casino's CEO wants to support community health efforts, improve workplace wellness and consider the return on investment that could come from investing in health.
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Now that the five cities have been chosen, the real work will begin. Representatives of the five cities will come together with the HICCup team for the first time in Tampa, Florida next month to begin planning their route to Wellville. It should make for an interesting five-year journey.