Forum to Design Health Enhancement Community (HEC) Initiative

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The United Way of Coastal Fairfield County & The Health Improvement Alliance Co-Host Forum

As part of its State Innovation Model program, Connecticut’s Office of Health Strategy (OHS) and Department of Public Health (DPH) are working with stakeholders across the state to design the Health Enhancement Community (HEC) Initiative. The proposed Health Enhancement Community (HEC) Initiative is aimed at supporting the health and well-being of individuals and families in communities across the state by improving community health and healthy equity and preventing poor health. This will be achieved through having Health Enhancement Communities (HECs) form and/or operate throughout the entire state. The HECs would work collaboratively to improve the social, economic, and physical conditions within communities that enable individuals and families to meet their basic needs, achieve their health and well-being goals, and thrive throughout their lives.

What are Health Enhancement Communities?

  • HECs will be collaboratives that include community members and partners from multiple sectors, such as community-based organizations, health care providers, local health departments, local government, social services agencies, schools, housing agencies, and others.
  • HECs will work to improve community health and healthy equity, prevent poor health, and reduce costs and cost trends.
  • Each HEC will have a specific geographic area that it serves.
  • HECs will have formal structures, defined ways of making decisions together, and multiple ways of ensuring community member ownership and involvement.
  • HECs will select and implement strategies that address social determinants of health, health inequity, and other root causes that create or contribute to poor health and preventable costs.
  • HECs will be sustainable, including through financing that rewards HECs for prevention, health improvement, and the savings and economic value they produce.

Health Priorities

HECs will work to improve outcomes at community and state levels.  All HECs will focus on the following two health priorities:

  1. Improving child well-being in Connecticut pre-birth to age 8 years
    • The focus would be on preventing and reducing the impact of Adverse Childhood Experiences (ACEs), which are stressful or traumatic events or situations experienced by children.
    • ACEs are strongly related to developing a wide range of health problems throughout the lifespan.
    • More than half of adults in Connecticut report experiencing at least one ACE and 21.3% report experiencing three or more.
       
  2. Improving healthy weight and physical fitness for all Connecticut residents
    • The focus would be on preventing overweight and obesity across the lifespan and the related risks of developing serious health conditions such as diabetes and cardiovascular disease.
    • More than a quarter (25.3%) of Connecticut adults are obese and there are higher rates among some populations, showing the serious health disparities that exist in Connecticut.

Interventions

HECs will select and implement interventions that span four key areas (Figure 1):

  • Systems
  • Policies
  • Programs
  • Cultural norms

While HECs will identify and implement interventions in each of these areas, HECs will have the flexibility to select interventions that are most relevant in their communities and among their partners. The expectation is that HECs will connect, improve, and/or expand existing interventions and implement new interventions to fill gaps.

Interventions are expected to be interrelated or mutually reinforcing. For example, an HEC could implement systems and policies to better support and sustain an existing program. Although the intervention framework will be a focus of the HEC Initiative, HECs will have the flexibility to select interventions in those categories that are most relevant in their communities and among their partners. The state also may sponsor interventions that could have statewide impact.

Figure 1