Be Healthy Denver imagines a community where all residents are healthy, regardless of their race, ethnicity, income level, or neighborhood in which they live. The initiative is a joint effort between Denver Environmental Health, Denver Public Health, and several partner organizations and individuals throughout the city.
Be Healthy Denver collaborates on two major efforts to improve public health in Denver. These are:
Be Healthy Denver also participates in ongoing initiatives to improve the health of all Denver residents.
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:
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, a youth-focused health assessment will be published. 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 takes 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 align with youth-defined needs and desires for improvement and change. The YHA highlights some key challenges facing young people in Denver while also illuminating the ways in which young people are thriving.
Following the release of the 2011 Health of Denver Community Health Assessment, Denver Environmental Health and Denver Public Health 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:
BHD is in year four of its five-year CHIP cycle and has published a midterm report (below) that describes the CHIP process and progress in detail.
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 (MHHA) 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 Workgroup set an aggressive goal to enroll 40,000 uninsured Denver residents in Medicaid. The High Utilizer Workgroup 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 and are re-admitted to hospitals. The Specialty Care Access Working Group addresses barriers to accessing specialty care for low-income persons in Denver. Progress towards this goal was tracked using publicly available Medicaid caseload data and surveys collecting information about insurance coverage.
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.
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 less sugary beverages opportunity provided on the campaign’s website.
BHD set two aggressive goals; achieving a 5 percent increase in childhood healthy weight and roughly 15 percent increase in access to healthcare in five years is 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.
According to the Colorado Medicaid Agency reports from January of 2017, the Denver Medicaid caseload grew steadily following the Medicaid expansion; from 127,579 Medicaid members in December 2013 to 210,783 Medicaid members, a 65 percent increase. The Colorado Health Access Survey* estimated that the percentage of uninsured Denver residents dropped from 18.4 percent in 2013 to 9.5 percent in 2015, a 48 percent drop. Despite remarkable reductions in uninsured, some Denver residents still struggle to gain insurance coverage and access care.
In the years leading up to 2014, Denver’s childhood obesity prevalence had increased, especially among children under five years of age. During the three years of BHD activities, Denver’s obesity prevalence has remained flat at 16 percent. While the percentage of school-aged children (2-17 years) at a healthy weight has remained static at 64 percent, the absence of annual obesity prevalence gains is a promising trend. The decline in obesity prevalence among young children is positive sign, obesity prevalence dropped from 11 percent in 2012 to 9 percent in 2016 in children 2-5 years of age.