Working further upstream
The modern public health agency is responsible for reacting to disease after it happens as well as preventing disease before it starts. Prevention of disease requires an “upstream” analysis of public health problems that attempts to identify the source of health problems. The language of upstream public health is credited to medical sociologist, Irving Zola. In his parable, a person on a bank witnesses someone caught in a river current. The witness saves them, only to find more people drowning in the current. After everyone has been rescued, the witness walks upstream to investigate why so many people have fallen into the river. This is a perfect illustration of the tension between public health’s duty to respond to emergencies (the people caught in the current) and its prevention and health promotion duties (to stop people from falling into the river).
There’s substantial evidence to suggest an upstream approach to public health will benefit everyone. Additionally, researchers are finding that disease and poor health is less determined by our individual, daily decisions, but rather the opportunities and environments available to us. Public health professionals call these the “social determinants of health” and they include factors such as the health of our homes, the livability of our wages, the meaningfulness of our jobs, our proximity to nutritious food and the strength of our neighborhoods.
Wyandotte County succeeding through partnership, prioritization, and planning
Wyandotte County’s Community Health Improvement Plan (CHIP) is a shining example of health workers and stakeholders addressing the upstream causes of poor health. Released recently after 18 months of collaboration by the Wyandotte County Unified Government, the United Way, and several other community partners, the CHIP details the 5-year strategy for improving the health of Wyandotte residents. Through data-driven analysis of the 2017 Community Health Assessment as well as resident satisfaction survey responses, the CHIP authors were able to identify four top priorities for Wyandotte County’s health:
Access to living wage employment
Access to medical, dental, and mental health care
Safe and affordable housing, and
Even deeper, the committee found three themes consistently exacerbating each issue: poverty, discrimination and adverse childhood experiences (ACEs).
On the CHIP dashboard, you can dive deeper to see the issues surrounding and contributing to each priority. For example, Wyandotte County knows that, for working parents, access to quality, affordable child care is a critical factor in their ability to earn a living for their families. Because of this, community partners including The Family Conservancy and the Wyandotte Economic Development Council have committed to adding 300 additional full-day, full-year child care spots by 2021. Each issue has measurable goals that can be tracked in real-time. In addition, dashboard viewers interested in becoming active in their community can explore the partners and stakeholders working towards each goal.
VIEW THE WYANDOTTE COUNTY CHIP DASHBOARD HERE: https://dashboards.mysidewalk.com/wyco-chip-dashboard
Wyandotte County’s history is varied and complex, but it’s also consistent: people come to build a good life, full of opportunity. The authors of the CHIP view the county’s rich cultural diversity as a strength but recognize the specific health barriers felt within their community. In the CHIP, they’ve devised a research-based, measurable path to better health that values all residents in their pursuit of that good life.
We at mySidewalk believe in the power of data to empower community transformation, and are deeply grateful for the opportunity to partner with Wyandotte County to bring together the the tools and visualizations presented in their CHIP dashboard. Great communities are a group effort, and we hope to continue to do our part here at home. To learn how your community can harness data to track and improve equity, reach out on the mySidewalk website.