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HomeMy WebLinkAbout2018-09-17 CHC PacketAgenda Community Health Commission City Of Edina, Minnesota Community Room, Edina City Hall - 4801 West 50th St. Edina, MN 55424 Monday, September 17, 2018 6:30 PM I.Call To Order II.Roll Call III.Approval Of Meeting Agenda IV.Approval Of Meeting Minutes A.August 13, 2018 Minutes V.Community Comment During "Community Comment," the Board/Commission will invite residents to share relevant issues or concerns. Individuals must limit their comments to three minutes. The Chair may limit the number of speakers on the same issue in the interest of time and topic. Generally speaking, items that are elsewhere on tonight's agenda may not be addressed during Community Comment. Individuals should not expect the Chair or Board/Commission Members to respond to their comments tonight. Instead, the Board/Commission might refer the matter to sta% for consideration at a future meeting. VI.Reports/Recommendations A.Comprehensive Plan Chapter Review VII.Chair And Member Comments VIII.Sta) Comments IX.Adjournment The City of Edina wants all residents to be comfortable being part of the public process. If you need assistance in the way of hearing ampli-cation, an interpreter, large-print documents or something else, please call 952-927-8861 72 hours in advance of the meeting. Draft MINUTES Community Health Commission August 13, 2018 at 6:30 PM City Hall, Community Room I.Call To Order II.Roll Call Present: Andrew Johnson-Cowley, Christy Zilka, Julia Selleys, Amanda Herr, Greg Wright, Om Jahagirdar, Staff Liaison Jeff Brown. Guest: Jeff Jorgensen, Edina Public Schools. III.Approval Of Meeting Agenda Motion by Andrew Johnson-Cowley to approve meeting agenda with addition of update from Member Wright regarding opioid resources.. Seconded by Amanda Herr. Motion Carried. IV.Approval Of Meeting Minutes Motion by Greg Wright to approve meeting minutes. Seconded by Amanda Herr. Motion Carried. A.July 9, 2018 Draft Minutes V.Community Comment VI.Reports/Recommendations A.Edina Public Schools Presentation Presentation from Jeff Jorgensen regarding wellness program at Edina Public Schools and need for additional resources specific to chemical dependency. Request for additional funding from City similar to past funding in 2016. Request to be brought to City administration. B.Comprehensive Plan Chapter Review/Process Discussion of comprehensive plan draft Public Health chapter. Members to review prior to September meeting for any edits or comments. VII.Chair And Member Comments Member Wright reported out on Opioid resources/recommendations, attached. VIII.Staff Comments IX.Adjournment Date: September 17, 2018 Agenda Item #: VI.A. To:Community Health Commission Item Type: Report and Recommendation From:Jeff Brown, Community Health Administrator Item Activity: Subject:Comprehensive Plan Chapter Review Action CITY OF EDINA 4801 West 50th Street Edina, MN 55424 www.edinamn.gov ACTION REQUESTED: Review and comment on draft Public Health chapter of 2018 Edina Comprehensive Plan. INTRODUCTION: ATTACHMENTS: Description Draft PH Chapter Page 1 I. Health Chapter Highlights • Edina has a high standard of health overall, although specific concerns and racial and economic disparities exist that need to be addressed. • Understanding of health concerns is limited somewhat by issues with the availability of community-specific data. • Changing demographics and aging in the community will continue to change health outcomes and needs. • Public health is impacted by a range of social and environmental factors that require a multi-faceted approach across all of the city. • Health in all policies provides an approach to comprehensively address health concerns across the full city government, in cooperation with partners. Introduction Public health is the art, practice and science of protecting and improving the health of the population. Public health is about what makes us healthy, what makes us sick, and what we can do together about it. When we think about health, what often comes to mind is the individual and ways he or she can stay healthy. Public health shifts the focus to the population – from me to all of us. Research suggests that around 80% of health outcomes are influenced by the environment and by human behavior. As a result, comprehensive planning can have a significant impact on the factors that contribute to health, by shaping the environment and helping to positively impact behavior in ways that lead to healthier communities and people. There are a number of principles underlying public health: • Public health is about prevention. This means intervening early and keeping people from getting sick or injured. • Public health is about populations. This means focusing on groups of people rather than single individuals. • Public health is about health. This means the broadest possible view of what makes and keeps us healthy including our mental health, everyday health choices, and our surroundings – not just health care services. • Public health is about local needs. This means identifying what a community needs to improve health and assuring effective action which uses local assets to solve unique challenges. The mission of the Edina Public Health Department is to protect the health and promote the general well-being and welfare of the City’s residents, and to prevent disease and illness in the community. Accomplishing this mission involves a range of programs and initiatives, run directly by the City and through its public partners. This chapter provides a policy framework for continued progress on the department’s mission and goals. Edina Comprehensive Plan Health Chapter 070818 Draft Page 2 However, the vision for a healthy community in Edina is bigger than just the charge to one department. This chapter also outlines a “health in all policies” approach, wherein health is systematically addressed and included in policies throughout the plan. Addressing health and wellness is essential to ensuring a sustainable community, and to maintaining the high quality of life enjoyed by Edina’s residents. Background The city has long had a Public Health Department, and the promotion of public health is a core value which is promulgated through numerous regulations and initiatives – both directly through the City and in partnership with others. This new focus at the comprehensive plan reflects an expanded understanding of how The City of Edina is designated as a Community Health Board (CHB) by Minnesota Statute 145A. A CHB is the legal governing authority for local public health in Minnesota, and community health boards work with the Minnesota Department of Health (MDH) to promote the public's health. The City Council acts as the CHB governing body and is responsible for fulfilling the statutory duties of a CHB, which are to: 1. Assure an adequate local public health infrastructure by maintaining the basic foundational capacities of a well-functioning public health system that include: o Data analysis and utilization o Health planning o Partnership development and community mobilization o Policy development, analysis and decision support o Communication o Public health research, evaluation and quality improvement Example: Assess health priorities with community input; develop community health improvement plans to address identified needs and monitor progress. 2. Promote healthy communities and healthy behavior through activities that improve health in a population, such as: o Investing in healthy families Definitions Chronic disease: A disease that is permanent, causes disability, is caused by a nonreversible pathological alteration, and/or requires a long period of supervision, observation or care. Behavioral risk factors: Behaviors that cause or contribute to accidents, injuries, disease, and death during youth and adolescence as well as significant morbidity and mortality in later life. Environmental hazards: Situations or materials that pose a threat to human health and safety in the built or natural environment. Health disparity: When a health outcome is seen to a greater or lesser extent between specific population groups. Health equity: Achieving the conditions in which all people can realize the highest level of health possible, without limits from structural inequities. Morbidity: Illness or lack of health caused by disease, disability, or injury. Mortality: A measure of the incidence of deaths in a population. Social determinants: Structural factors and conditions in which people are born, grow, live, work and age, that impact health. Edina Comprehensive Plan Health Chapter 070818 Draft Page 3 o Engaging communities to change policies, systems or environments to promote positive health or prevent adverse health o Providing information and education about healthy communities or population health status o Addressing issues of health equity, health disparities, and the social determinants of health Example: Minimize tobacco use and exposure among residents through policy change such as raising the purchasing age to 21 years (“Tobacco 21 Ordinance”). 3. Prevent the spread of communicable disease by preventing diseases that are caused by infectious agents through: o Detecting acute infectious diseases o Ensuring the reporting of infectious diseases o Preventing the transmission of infectious diseases o Implementing control measures during infectious disease outbreaks Example: Monitor immunization levels and perform outreach to high-risk groups; run immunization clinics; investigate outbreaks and conduct contact interviews with exposed individuals. 4. Protect against environmental health hazards by addressing aspects of the environment that pose risks to human health, such as: o Monitoring air and water quality o Developing policies and programs to reduce exposure to environmental health risks and promote healthy environments o Identifying and mitigating environmental risks such as food and waterborne diseases, radiation, occupational health hazards, and public health nuisances Example: Conduct restaurant and swimming pool inspections, respond to reports of unsanitary and uninhabitable housing conditions, and inspect indoor air quality of parking garages in multi- unit dwellings. 5. Prepare and respond to emergencies by engaging in activities that prepare public health departments to respond to events and incidents and assist communities in recovery, such as: o Providing leadership for public health preparedness activities within a community o Developing, exercising and periodically reviewing response plans for public health threats o Developing and maintaining a system of public health workforce readiness, deployment and response Example: Share resources with Bloomington and Richfield for Public Health Emergency Preparedness activities; hold events simulating natural disasters or mass dispensing of medication in response to an outbreak or other threat. Edina Comprehensive Plan Health Chapter 070818 Draft Page 4 6. Assure health services by engaging in activities such as: o Assessing the availability of health-related services and health care providers in local communities o Identifying gaps and barriers in services o Convening community partners to improve community health systems o Providing services identified as priorities by the local assessment and planning process Example: Identify barriers to health care service and gaps in service; implement strategies to increase access to health care. Current Conditions Municipal Structures The Edina Community Health Commission (CHC) is comprised of volunteer residents serving in an advisory capacity to the Edina CHB (City Council). A representative of the CHB is appointed annually to represent the City on the State Community Health Services Advisory Committee (SCHSAC). A CHC member has filled the SCHSAC seat in recent years. The Health Division of the Edina Police Department provides Environmental Public Health services to residents, such as regulation of food, pool, lodging, body art, and massage establishments, housing and code enforcement inspections, noise complaint response, and public health nuisance investigations. Additional Public Health services such as health education and promotion, communicable disease prevention programs, public health nursing services, home health visits, maternal and child health services, health assessments and public health emergency preparedness are provided to Edina residents through a contract with Bloomington Public Health. Population Health Status It is difficult to assess the health status of Edina residents at the population level. This is in large part due to a lack of Edina-specific health data. Where data is available (often because it can be aggregated by zip code following statewide data collection), there are frequently limitations to what can be inferred, in part related to data privacy concerns regarding the sharing of health information for individuals. Some examples providing key, albeit imperfect, information about Edina residents are below: Incidence of Chronic Disease. According to the Minnesota Department of Health, Edina has low rates of hospitalization from both chronic obstructive pulmonary disease (COPD) as well as asthma when compared to neighboring suburbs. While COPD predominantly affects the elderly, asthma hospitalization is a greater risk for pediatric populations, especially those living below federal poverty levels. In an effort to maintain strong respiratory health at all ages by preventing tobacco use, exposure and addiction, in 2017 the City passed an ordinance limiting tobacco sales to those over age 21. Edina Comprehensive Plan Health Chapter 070818 Draft Page 5 Youth Health The Minnesota Student Survey is another rich data source. The survey is administered every three years of middle school and high school grades with voluntary participation. Data are available at the school district level, including Edina School District. More information about the survey and recent results can be found in Appendix XX. Consistent with other health data, Edina students typically are above statewide averages in terms of their well-being. Reflecting broader regional and state trends, there has been a consistent reported decline over the past ten years in many of the risky and negative behaviors tracked among students. There are a few notable exceptions: • Recent data show a possible upward trend in alcohol/tobacco use among 9th grade girls. It also confirms the uptick of e-cigarette consumption. Rates are still below state averages for the same time period. • There has been a reported increase in online bullying, counter to a trend of declining physical bullying. • There has been a substantial increase in the number of students reporting that they have been treated for a mental health, emotional, or behavioral problem, particularly among girls. Adult Health Another source of information that can help to triangulate current health conditions in Edina is the Adult Survey of the Health of All Populations and the Environment (SHAPE). In Hennepin County SHAPE has been administered every four years since 1998, surveying randomly chosen adults about their health. In this survey, Edina is grouped with Richfield and Fort Snelling in the category of South Suburbs – Inner Ring. While it captures some overall health perceptions and specific conditions such as overweight, asthma, diabetes and hypertension, it is very difficult to evaluate where Edina sits relative to other communities in this area. Overall, the survey suggests that the majority of people in the area think their health is excellent or very good (over 65%), and that the highest reported health concerns are being overweight (33%) or having high cholesterol (32%). However, it’s likely the actual Edina numbers are somewhat different given the difference in demographics between the communities. The City of Edina 2017 Quality of Life Survey asked a few questions of residents related to health, summarized below: • 92% thought health and wellness opportunities in Edina are “excellent” or “good.” • 86% thought the City’s public health services were “excellent” or “good.” • 4% had been in contact with the health department during the course of the year. • 75% thought fitness opportunities (including exercise classes and paths or trails, etc.) are “excellent” or “good.” In terms of understanding baseline health status and trends over time, it would be highly beneficial if Edina were able to build on these sort of satisfaction-driven questions as well as collect baseline city-specific data relevant to disease prevalence, mental health needs, environmental exposures, or other metrics. Health Care Resources Edina Comprehensive Plan Health Chapter 070818 Draft Page 6 In addition to the community health services provided through the Health Department, there are private health services and facilities serving Edina. Fairview Southdale Hospital has served the Edina community since 1965, as well as the communities of Bloomington, Richfield, Southwest Minneapolis, Minnetonka, Eden Prairie, and others. It is a full-service, 390-bed acute care center, specializing in maternal and newborn care, oncology, mental health treatment, eye care, vascular, spine, neurology, neurosurgery, urology, and orthopedic surgery and joint replacement. It also provides complete outpatient care with a comprehensive 24-hour emergency department, urgent care for evenings and weekends, diagnostic radiology and imaging, and a same day surgery center. It also offers a wide selection of health education and wellness programs. In addition to the hospital, there are numerous smaller specialty clinics and medical offices serving Edina. Most are located in and around the Greater Southdale area. At the regional level, other major medical centers provide access to specialty care as needed. Generally speaking, the Edina area has excellent access to health care facilities. Trends, Challenges and Opportunities Many factors combine together to affect the health of individuals and communities. At the time this plan was developed, the following factors were considered to be emerging or priority issues over the next ten years: Health, Economic, and Racial Disparities Disparities exist across many factors in the city including health, economics, and race. Structural inequities occur when structures or systems of society—such as finance, housing, transportation, education, social opportunities, etc.—are designed in such a way that they benefit one population unfairly (whether intended or not). One example of a disparity in Edina is that from 2012-2016 there were lower than average rates of health insurance coverage among certain groups including non-US citizens (83.1%), people with less than a high school education (80.0%), and individuals of color (89.6% for Black or African American; 81.5% for Alaska Native or American Indian; 74.4% for Hispanic or Latino) despite fairly high health insurance rates in the city overall (97.4%). Premature death, defined as dying before age 65, is used to identify largely preventable causes of death impacting our community. On average from 2013-2015, 10% of white individuals died before 65 compared to 31% of individuals of color living in Edina. Blacks in Edina are especially disparate with 42% of premature deaths. Additionally, according to 9th grade responses in the 2016 Minnesota Student Survey, 64% and 44% of Hispanic and Black students respectively respond to enrollment in Free and Reduced Lunch program compared to just 3% of white students in Edina. See Appendix XX for further illustrations of racial and income disparities in Edina. Transportation & Mobility Transportation is an integral component of an individual’s health, from utilizing transportation to access healthy foods and healthcare, to walking and biking for exercise as well as travel. The City will consider the health benefits of an active transportation system when development and road construction projects are designed and constructed. While Edina has an array of healthy food resources, it has fewer community food service programs than both Bloomington and Richfield, according to a 2013 Community Food Assessment. See Appendix XX for a map of Edina Community Food Asset Locations Edina Comprehensive Plan Health Chapter 070818 Draft Page 7 and additional information from the assessment. As well, while a ‘circulator’ for seniors debuted in 2018, it will be important to build upon and track success with that investment. Aging Population The average age of an Edina resident is increasing, with growth in the 18-64 age group and a decrease in those under age 18. Edina is close to reaching the point of having more residents over 65 than under 18. The aging population will require adjustments in many areas, from expansion of care facilities to adding senior-focused recreational opportunities. Not surprisingly, according to the 2012-2016 American Community Survey, disability rates are higher for seniors in Edina. 60% of those aged 65 and older are disabled (two-third of those are over age 75). This includes hearing, vision, cognitive, ambulatory and self-care difficulties. Providing a full spectrum of community services to support aging in place will be critical. Table XX: Edina Age Distribution % Under 5 % Under 18 %18-64 %65 and Over 2010 Census 5.4 24.2 55.2 20.7 2016 ACS Estimates 5.7 23.8 55.4 20.7 Mental Health and Social Connectedness There is an increasing need for mental health services for all ages in the city, from elementary and middle school children to seniors. Social connectedness contributes to improved mental and physical health in people of all ages. In older adults, social conditions like loneliness and isolation have a significant negative impact on long-term health and wellbeing. As Edina continues to age and the number of adults living alone continues to increase, strategies to address social isolation will become important to improve community health. According to the 2014 SHAPE survey, nearly 25% of the population in Hennepin County had been diagnosed with depression and another more than 20% with anxiety. The numbers were slightly higher in the south suburbs (which would include Edina) than the county at large. While it is not possible to tease out Edina specifically given the survey design, these are staggering numbers that indicate the need for mental health support in our community and surrounding areas. As noted in the previous section, the Minnesota Student Survey indicates that mental health concerns are surfacing among the younger generation as well. Addiction and opioid abuse/overdose are growing issues across the state, as well, including in Hennepin County. Municipal activities such as first responder training with naloxone (an opioid antagonist used to reverse overdose) are important, as are sufficient community resources to address mental health needs and crises. Housing Safe and affordable housing is one of the most basic and powerful social determinants of health. Quality housing improves the health of vulnerable populations and is a cornerstone of a strong and healthy community. The City will continuously evaluate housing policies and regulations to provide safe and affordable housing for residents of all ages, cultural backgrounds, and social demographics. This might include enhanced efforts to address the large proportion of homes that register elevated radon levels. Edina Comprehensive Plan Health Chapter 070818 Draft Page 8 The City will also look at ways to support sustainable housing. Homelessness disparities were pronounced among black 9th graders in Edina (14% compared to 5% among white students) as measured in the 2016 Minnesota Student Survey. Recommendations To effectively address the trends and challenges identified above, it is recommended that Edina commit to the following actions: Enhance Data Collection Collection of quality health-related data, especially at the city level, is becoming increasingly difficult and expensive. Traditional survey methods like mail or landline telephone use are typically answered by only certain demographics which results in poor quality data that does not represent the community as a whole. The City will research and invest in collection methods for quality, city-specific health data to better inform local decisions. The City will study best practices, including around privacy protections, and work to design a comprehensive public health survey that can be used consistently from year to year with flexibility to ask detailed questions about emerging trends. Address Social Determinants of Health Health is a critical aspect of planning. In fact, a community’s plan for housing, transportation, land use, parks, and economic development encompasses the largest factors that determine one’s health. “Social determinants of health” are structural factors and conditions in which people are born, grow, live, work and age. Most premature deaths are connected to these determinants, like air and water quality or access to physical activity and healthy food. Since the practice of community planning plays a significant role in shaping the built environment, local planning can have real and significant impacts on community health. The comprehensive plan is a tool to strategically increase health and reduce health disparities for all. Edina Comprehensive Plan Health Chapter 070818 Draft Page 9 Use a Health in All Policies Approach “Health in All Policies” is a collaborative approach to improve health by incorporating health considerations into decision-making across all policy areas. A Health in All Policies approach will be embedded in decision-making across all policy areas within the city. Questions to be addressed while pursuing this strategy include: a. Does it empower those that live and work in Edina to support their physical, mental and social well-being? b. How does this decision affect social determinants of health? c. How will this decision reduce health disparities and improve health equity? i. Health Disparity – When a health outcome is seen to a greater or lesser extent between populations, there is a health disparity. Populations may be defined by race, ethnicity, gender, sexual orientation, age, disability, socioeconomic status, or location. ii. Health Equity – Achieving the conditions in which all people have the opportunity to realize their health potential – the highest level of health possible for that person- without limits imposed by structural inequities. Goals and Policies Data Collection Goal: Improve the quality and availability of city-specific public health data in Edina to inform policy development and monitor impacts. 1. Research and invest in collection methods for quality, city-specific health data to better inform local decisions. 2. Study best practices, including around privacy protections, and work to design a comprehensive public health survey that can be used consistently from year to year with flexibility to ask detailed questions about emerging trends. 3. Work with public and private sector partners on joint data collection and data sharing initiatives, particularly when providing community-specific results. Health in All Policies Goal: Address how all city policy and activities impact the social determinants of health, and explore changes to strategically increase health and reduce disparities for all. 1. Work with city staff and leadership to identify and address elements of the social determinants of health that are impacted by city policy and activities. 2. Pursue a collaborative approach to improve health by incorporating health considerations into decision-making across all policy areas. Public Health System Goal: Ensure an effective local government public health system. 1. Monitor health status to identify and solve community health problems. 2. Diagnose and investigate health problems and health hazards in the community. 3. Inform, educate, and empower people about health issues. 4. Mobilize community partnerships and action to identify and solve health problems. Edina Comprehensive Plan Health Chapter 070818 Draft Page 10 5. Develop policies and plans that support individual and community health efforts. 6. Enforce laws and regulations that protect health and ensure safety. 7. Link people to needed personal health services and ensure the provision of health care when otherwise unavailable. 8. Ensure a competent public health and personal health care workforce. 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services. Health Education and Promotion Goal: Reduce or mitigate behavioral or social risks that influence health through health education and promotion. 1. Support health education and promotion of health lifestyles and healthy living, including those that reduce behavioral risks that contribute to morbidity and mortality. 2. Pursue health promotion programs for children, youth, and families, including healthy growth and development, role of parents and caregivers, and early identification and intervention related to risks. 3. Pursue health promotion programs for the elderly and those with a disease, disability, or chronic illness, including fostering healthful behaviors, designing a continuum of long-term care options, preventing falls, supporting active participation and meaningful integration into community life. Environmental Health Hazards Goal: Reduce exposure to environmental health hazards. 1. Support the enforcement of federal, state, and local standards by inspections and investigations. 2. Support the evaluation of potential health-threatening environmental conditions where appropriate. 3. Support efforts to minimize and control risks from exposure to environmental health hazards; 4. Provide and promote environmental health education. Emergency Preparedness Goal: Develop a public health emergency preparedness plan. 1. Develop, maintain, and exercise a public health emergency preparedness plan, including a continuity of operations plan. 2. Support emergency preparedness by stockpiling personal protective equipment and training employees on National Incident Management System (NIMS) as needed. 3. Promote family and business emergency preparedness Plan for distribution of Strategic National Stockpile (SNS). Edina Comprehensive Plan Health Chapter 070818 Draft Page 11 Appendix XX Edina Comprehensive Plan Health Chapter 070818 Draft Page 12 There are 15 grocery stores in Edina, including six supermarkets, six convenience/limited grocery stores, and three small grocery stores. Three of these stores accept WIC and 12 accept SNAP/EBT. There are no ethnic markets in the city. The City of Edina piloted a community garden in summer 2013, which offers garden plots to city residents at a nominal fee, and an Edible Playground Garden that is open to families of registered playground program participants. Edina also has two farmers markets. The City-run market has 32 vendors including those selling locally grown produce and an extensive variety of other locally produced foods product such as breads and specialty bakery goods, candies, jams and other items. The Edina Farmers Market began accepting SNAP/EBT at the beginning of its 2013 market season but does not accept WIC. In 2013, Fairview Southdale Hospital opened the Farm to Fairview Farmers Market with four vendors who sell a variety of locally grown produce. The Farm to Fairview market does not accept EBT or WIC. Edina has one privately owned farm stand open seven days a week during the summer growing season. There are four CSA farm drop sites in Edina, only one of which is located near low-income dense residential areas and a bus line. Given the substantially smaller number of low-income residents in Edina, there are fewer community food service programs within city limits. There is one community dining site located in a housing complex that serves senior residents. There are four meal and four grocery delivery services. There are two mobile food shelf drop sites located at apartment buildings within city limits, but these services are limited to residents only. There are no Fare For All drop sites in Edina. Healthy, low-cost or free food options in Edina are limited, which presents challenges for low-income and senior residents with mobility issues and fixed incomes. Edina Comprehensive Plan Health Chapter 070818 Draft Page 13