Identifying Community Solutions in Clare and Sonoma Counties

How counties determine priority areas and develop strategies to improve health was the topic of a panel discussion at the 2013 NACO Roadmaps to Health Forum. Peter Rumble, Deputy County Administrator of Sonoma County, California, and Mary Kushion, Former Health Officer for the Central Michigan District Health Department in Clare County, Michigan, offered insights on how stakeholders were brought together to identify needs, make plans and lay the groundwork for sustainable change.

 Even though the makeup of these communities is different—Sonoma is a diverse county of nearly 500,000 residents, while the six counties (including Clare) that make up the Central Michigan District Health Department have a population under 200,000—both communities are determined to improve the health of their residents.

After Clare County ranked 82^nd out of 82 counties in the 2010 Rankings, they were catapulted to action. “The Rankings really did empower the community to come together,” Kushion said. The community created the “Together We Can” initiative, which focused on increasing access to health services, increasing healthy eating and active living, maternal and child health, and improving environmental health. Kushion emphasized a lot of the policies and programs they implemented didn’t require a significant amount of funding. She credited tools such as What Works for Health as extremely helpful to her community.

Sonoma County has focused a lot of its efforts on addressing the social determinants of health—income, education, and health equity. “Eighty percent of health is affected outside of the doctor’s office,” Rumble said. “That has led to us focusing on long-term strategies to improve community health,” he added. According to Rumble, health is about more than clinical care. He explained Sonoma has aligned its efforts with programs that go beyond traditional public health activities and instead address the root causes of poor health, including education and poverty. Sonoma’s Cradle to Career and Economic Security initiatives are solid examples of that philosophy coming to fruition and laying the groundwork for a culture of health.

• View Peter Rumble’s slide presentation
• View Mary Kushion’s slide presentation