Statewide Health Improvement Partnership

County ProfilePopulation: 538,133 •under19:25% •under64:63% •over65:12%

Grant SnapshotSHIP grantee:4consecutiveroundsoffundingsince2008.ThisreportreflectstheworkdoneinSHIP4,Year1.

FY 2015-2016 Award: $968,157In-Kind Labor: $83,767In-Kind Non-labor: $267,145Leveraged Funds: $262,283Total Match: $613,195whichconstitutesa63%matchinour128 partner sitestotheawardedamount.

OverviewTheSaintPaul-RamseyCountyStatewideHealthImprovementPartnership(SHIP)*continuestodeveloprelationshipswithcommunitypartnersandworktowardssustainablesolutionsinourdiversecountytoimprovethehealthofresidents.SHIPsupportscommunitypartnerships,projectsandpoliciesthatfocusonincreasingtobacco-freeliving,healthyeatingandphysicalactivityinworkplaces,schools,communityorganizations,childcarefacilities,andhealthcaresettings.Additionally,SHIPsupportsmakingchangeswithininstitutionstomakethehealthierchoicetheeasierchoice.

*EffectiveNovember2016,thegrantnamechangedfromProgramtoPartnershiptodemonstratetheworkwithcommunitypartners.

Community Leadership Team

S A I N T P A U L - R A M S E Y C O U N T Y P U B L I C H E A L T H

2016 Annual Report

Theoverallpovertyrateis16.8%, ofthat 24.6%arechildren. 2015USCensus

64%White

13.7%Asian

13.1%Black/AfricanAmerican

1.9%AmericanIndian

7.3%HispanicorLatino

www.ramseycounty.us

Inearly2016,SHIPworkplanswereadjustedaccordinglytoalignandsupportgoaltwoofthe2014-2018 Saint Paul - Ramsey County Community Health Improvement Plan (CHIP):Promotepropernutrition,healthybodyweightandtobacco-freelivingforallpeopleinRamseyCounty.SHIPsucceedsbyencouragingandsupportinghealthylivingandaddressinghealthdisparitiesthroughcommunityengagement,localdecision-makingandsustainable,evidence-basedstrategies.SHIPwillcontributetothefollowingCHIPobjectives: •IncreasethepercentageofRamseyCounty9thgraderswhoeat4or moreservingsoffruits(notincludingfruitjuice)perday.

•IncreasethepercentageofRamseyCounty9thgraderswhoeat4ormoreservingsofvegetablesperday

•IncreasethepercentageofRamseyCounty9thgraderswhoget moderatephysicalactivityfor60+minutesfor7daysperweek.

•IncreasethepercentageofRamseyCountyadultswhoeat5ormore fruitsandvegetablesperday.

•IncreasethepercentageofRamseyCountyadultswhogetmoderate physicalactivityfor150+minutesperweek.

•ReducethepercentageofadultsmokersinRamseyCounty.

SHIPstaffrevisitedtheSHIPCommunityLeadershipTeam(CLT)Chargewiththecurrentteammembers,inorderfortheCLTmemberstotrulyunderstandtheirvitalroleinhelpingtheSHIPgrantbeeffectiveinRamseyCountyanddirecttheworktomeetCHIPgoals.Thisalignmentwasfundamentalinourdepartmentachievingpublichealthaccreditationin2016.

Tobacco Cessation

Child CareInpartnershipwithMinnesotaProvidersCollaborative,morethan100providersparticipatedinSHIPchildcaretrainings.Roughly66%participateintheChildandAdultCareFoodProgram,indicatingthatthefamiliesofthechildrenintheircareareatorbelowthenationalpovertylevel.Afterattendingthesetrainings,20providersdevelopedpoliciesforhealthyeating,physicalactivity,andbreastfeedingsupporttoimplementintheirearlychildhoodprograms.Thishelpscombatchildhoodobesityatayoungageandensuresthattherearesustainablepolicyandenvironmentalchanges.

•2016CountyHealthRankingsindicatethat16%ofRamseyCountyadultssmoke.

•Almost25%of18-34year-oldsinRamseyCountyreportedsmokinginthe2013CommunityHealthAssessment.

•ThereisstillworktobedonetoensurethatRamseyCountywillmeetthe2020HealthyPeoplegoalforadultsmoking:lessthan12%.

S a i n t P a u l - R a m s e y C o u n t y P u b l i c H e a l t h

SHIP in Saint Paul Public School

SaintPaulPublicHousingAgency(PHA)ispartneringwithNationalAllianceonMentalIllness(NAMI)Minnesota,WalgreensandAmericanLungAssociation(ALA)toprovidepracticalandculturallyappropriateworkshopstoresidentslivingatall20ofthePHAhousingsites.Approximately70%ofresidentshaveamentaland/orphysicaldisability.NAMIMinnesotacessationhostedworkshopswhichwereopentoallresidentsandweretailoredtoaddressthespecialneedsofpeoplelivingwithmentalillnesswhoareaddictedtotobacco.Reflectingthe

diversityofPHA,110residentsattended,including10whoneededtranslationservices.Inaddition,Walgreenspharmacistswhoaretrainedcessationspecialists,providedcessationworkshopshighlightinghowtousecessationmedicationeffectivelyandwheretoobtainitaffordably.ALAisprovidingcessationresourcesandtrainingforPHAmanagersandresidentstoprepareforthereleasedHousingandUrbanDevelopment(HUD)banonsmokinginpublichousingby2018.

SafeRoutestoSchool(SRTS)isacomprehensiveprogramtohelpencourage,educateandcreatesystemstosupportphysicalactivity,includingwalkingandbicyclingtoandfromschool.SaintPaulPublicSchools(SPPS)isoneofmultipleschooldistrictsimplementingSRTS.Only62.7%ofSPPSstudentsin5thgrademeetthePhysicalActivityGuidelines(60minutesofactivityperday)in4orfewerdaysperweek.Infact,18.5%of5thgradersmettheguideline0daystheweekprior(MinnesotaStudentSurvey,2016).Encouragingwalkingorbicyclingtoschoolwouldbeawayforstudentsandfamiliestoaddextra

physicalactivityeachday,whichisalsolinkedtoastudent’sabilitytolearn.ThankstothepartnershipbetweenSHIP,theCityofSaintPaulandtheschooldistrict,therehavebeenseveralsuccessfuleventswhereover6,000studentshaveparticipated.SHIPstaffhavealsoleveragedfundingwithintheCityofSaintPaultosupportbothaschoolstaffworkingtowardsSRTSeffortsandinfrastructurechanges.SPPShasalsoreceivedseveralfundingawardsfromMnDOTfortheircontinuedworkinSRTS.SHIPhasplayedasolidroleinsettingthestageforSafeRoutestoSchooltocontinuelongintothefuture.

InpartnershipwiththeSaintPaulAreaChamberofCommerce(SPACC),theworkplacewellnessstrategyfocusedonexpandinghowworkplacewellnesscanbearealisticstepforsmalltomediumsizedbusinesses.SPACCworkscloselywithlocalchambers,smallbusinessassociationsandsmallneighborhoodassociationstoengagethediversebusinesscommunity.Mostsmallbusinessesdonothavethecapacityofsupportingworksitewellnessefforts.SPACCcreatedasimpletouseworkplacewellnesstoolkitthatwasdownloadedover1,600timesandisavailableinEnglish,HmongandSpanish.Thetoolkithaseasyactionsforaworkplacewellnessnovice,suchassupportingnursingmothers,offeringtobaccousereduction,increasing

healthyeatingandopportunitiesforemployeestobemoreactive.SPACCalsocreatedpartnershipsforchangethroughamicro-grantopportunity,fundedbySHIP.Twenty-oneworkplacesappliedtoreceiveamicro-grant,whichwasasmallamountofmoneytohelpsupporthealthyworkplacechanges.Overall,thepartnershipsformedthroughthemicro-grantopportunityhelpsupportsustainablechangessuchas:•Creatingorenhancingwellnesspoliciesinuppermanagementoremployeehandbooksat15sites.•Creatingawellness-based“culture”orsystemtosupportwellnessefforts(likeformingwalkingclubs,rewardsprogramsorflexiblehours)at16sites.•Changingphysicalenvironments,

Workplace Wellness

suchasinstallingaMother’sNursingRoomorbikerackstosupporthealthierbehaviorsat17sites.

Ofcourse,thisisinadditiontothecountlessothersthatdownloadedthetoolkitandtookstepstochangeontheirown.

AccordingtotheMetroSHAPE2014AdultSurvey,RamseyCountyreported:

•48.8%ofthepopulationengagedininsufficientphysicalactivityonaregularbasis(lessthan74minutesperweek).

•17.5%ofthepopulationarepre-diabeticorhavebeendiagnosedwithdiabetes.

•34.4%ofthepopulationareoverweightbasedontheirBodyMassIndex(BMIof25-29.9).

•26.7%ofthepopulationareobesebasedontheirBodyMassIndex(BMIof30andabove).

TheSaintPaulPublicHousingAgency(PHA)Mt.AiryHomesFamilySitehostedWalkwithaDocFamilyFunScavengerHuntinSeptember2016.Participantssearchedfor12goldenshoesalongthewalkingroute.Eachgoldenshoehadafunactivityforthegrouptodosuchasshapeyourbodyintoabananaorwalklikeanelephant.Thegrouphadalotoffunwhilebeingactive.WalkwithaDocisapartnershipbetweenPHAandAllinaHealthUnitedHospitaltoimprovecommunityhealthandsocialwellbeingbyinvitingPHAresidentstocometogetherformonthlygroupwalks.Aguesthealthcareproviderjoinseachmonthtochatabout

Walk with a Docacurrenthealthtopicandwalkwiththegroup.These30-minutewalksareforpeopleofallagesandabilitiestoincreaseaccesstoactivelivingopportunitiesforolderadults,peoplewithdisabilities,youth,andfamilies.ThewalkingeventrotatestoadifferentPHAsiteeachmonthtoincreaseactivelivingopportunitiesforresidentsatthatbuilding,promotewalkingroutesindifferentneighborhoods,andreducetransportationbarriers.Severalwalkinggroupshavebeenformedandhavebeenmeetingonaregularbasis.SinceOctober2015,atotalof118residentshaveparticipatedinsevengroupwalkingevents.

S t a t e w i d e H e a l t h I m p r o v e m e n t P a r t n e r s h i p 2 0 1 6 A n n u a l R e p o r t

Swim Time for Somali Women and Girls

www.ramseycounty.us

ThroughpartnershipwiththeSaintPaulPoliceDepartmentandParksandRecreation,theSomaliWomenandGirlsSwimProgramwascreatedtoaddresstheneedforaculturallyappropriateswimspaceforSomaliwomen/girls.ReligiousandculturalrestrictionspreventSomaliwomen/girlsfromswimminginthepresenceofmenduetotheexposednatureofswimwear.Thisprogramprovidesaccesstoaprivate,safespaceforSomaliwomen/girlstoswimandincreasetheirphysicalactivity.Theprogramissuccessfulandvaluedbythecommunity.

Participantsreportedincreasedself-esteemandappreciationforafemale-onlyspace.ItisalsoeffectiveatbuildingarelationshipwithlawenforcementbyfosteringpositiveinteractionsbetweenpoliceofficersandtheSomalicommunity.Duringthefirst3quartersof2016,atotalof360Somaliwomen/girlsattended15swimevents.Goingforward,theprogramwillcontinuetooperatethroughfundingfromtheSaintPaulPoliceDepartmentandexpanditstargettoallwomenandgirls.

Baraza Fitness ChallengePartnershipwiththeAfricanAmericanLeadershipForumandtwolocalchurchesledtothecreationoftheBarazaFitnessChallenge,a10-weekfitnessprogramtargetingAfricanAmericanwomen.TheChallengerespondedtoaneedforculturallyappropriatefitnessresourcesintheAfricanAmericancommunityandthefactthat1in4AfricanAmericanwomenovertheageof55hasdiabetes.Bybuildingintentional,genuineconnectionswiththesecommunitypartners/members,theChallengereached45womenthroughthebiweeklyworkoutsessionsandimprovedtheirrelationshipwithfitness.Sincetheconclusionofthe10-weeks,thetrainersaresustainingtheChallengewiththeparticipantspayingthetrainersafeeof$3persessiontocontinuebeingphysicallyactive.

Accordingtothe2010Census,thecityofSaintPaulhasthelargestHmongpopulationinMinnesota:roughly30,000.AcculturationtotheAmericanlifestylehasprovensuccessfulandnowtheHmongcommunityfacesthesamebehavioralandhealthchallengesmainstreamAmericadoes.Thesechallengesincludethelackofphysicalactivity,decreasedconsumptionofhealthyfoods,obesity,andchronicdiseasessuchasdiabetesandhypertension.YetthereisverylittleliteraturetobefoundonthesehealthchallengesintheHmongcommunity.TogetherwiththeHmongHealthCareProfessionalsCoalition,theCulturally Informed Clinical Practices for Healthy Hmong Lifestyles (CICP)wasdeveloped.Thedocumentprovidesa

Health CarehistoricalnarrativeofHmongbeliefsrelatedtohealthylifestylesandrecommendationsforclinicianscounselingHmongpatientsonhealthyeating,physicalactivity,andtobaccocessation.TheserecommendationsweremodeledaftertheInstituteforClinicalSystemsImprovement(ICSI)2013HealthyLifestylesGuideline.PartneringwithICSI,anactionplanbookletwasthencreatedfromtheCICPdocumenttobeusedasapatienthandoutattwomedicalclinics.Atotalof37cliniciansweretrainedtoincorporatethishandoutintotheirdailyworkflow.TheultimategoalofthepatienthandoutistoenhanceclinicaleffectivenesstopromoteequalqualityofhealthcareaccessfortheHmongcommunity.