Transforming a rural health department to address chronic disease prevention and health equity

Building on a history of innovation, Shasta County Public Health initiated the organizational changes and created the culture required to redefine themselves as a department focused on health outcomes and chronic disease prevention. Through committed leadership, engagement of community partners, use of data and planning, and strategic use of funding and resources, this health department in far northern California has become a rural model for other counties. Through a 2010 Strategic Plan, developed in collaboration with community partners and their Public Health Advisory Board, the department worked on changing organizational practices and policy development around ten health priority areas. Recently the department focused efforts on identifying health disparities and contributing social factors through a series of community forums and data analysis. A county-wide analysis of life expectancy by census tract found a 14-year difference in life expectancy between the least healthy and the most healthy census tracts. Census tracts with the lowest life expectancy had the lowest income, levels of educational attainment, owner-occupied home values, rates of home ownership, and the highest proportion of single mother households. The department's 2020 Strategic Plan initiatives will focus upstream on social determinants, to address the health inequities plaguing this rural, poverty stricken community. Building capacity, both internally and with external community partners, will be the cornerstone of this health equity work, and include enhancing community organizing skills, mobilizing community advocates, and supporting the selection of neighborhood-driven projects with sustainable funding streams. Lessons learned and next steps will be shared with session participants.