Part I: Collaborating to Improve Health Behaviors in Genesee County, Michigan

Kirk Smith wasn’t surprised when Genesee County’s health behaviors ranked last among Michigan’s 82 counties in the 2010 County Health Rankings.

As president and CEO of the Greater Flint Health Coalition, Smith is familiar with the problems highlighted in the rankings, including the county’s high rates of smoking, obesity and chlamydia. But after seeing all of the community’s data consolidated in a single report, Smith realized the rankings could be the perfect way to spark motivation for a county-wide health-improvement effort among community members.

And it didn’t take long for word to get out, he said.

“Within the Greater Flint Health Coalition, we have about 15 teams and task forces, and the rankings started to come up at each and every one of those tables,” he said. “We always knew we had problems like that, but when you come in last in diet, health, exercise and nutrition, it’s a good tool to wake people up. It raised a lot of awareness.

"It was key to really starting to generate a lot of action around things like health behaviors in our community,” Smith added.

Though the county’s overall ranking was slightly better — 78 out of 82 counties — the coalition chose to hone in on its last-place health behaviors. To begin, Smith and the health coalition formed a seven-person ad hoc work group and charged its members with creating an action plan to improve certain health conditions in Genesee County.

“We really looked at physical activity, diet and smoking, and tied the rankings in to other behavioral data we had,” Smith said. “Then we said, ‘You’ve got 90 days to form a business case for how we’re going to address these health rankings.’ ”

Completed in December, the plan outlines multiple strategies for improving health behaviors and outcomes both in the city of Flint and throughout Genesee County. Examples include supporting and implementing workplace wellness strategies, such as health risk assessments or office competitions designed to increase fitness among employees.

The group has only recently begun reviewing and implementing the plan, but members are optimistic about its chances for success, according to Pete Levine, executive director of the Genesee County Medical Society, a professional society representing the county’s physicians.

“This allows us the opportunity to get others energized about the same issues that my constituents are energized about,” he said. “And to show that it can be done in ways that are effective and not odious — by creating competitions and creating awareness.”

Smith added that the county’s high-ranking facets should also help motivate community leaders. Collaborative officials focused specifically on the county’s clinical care, he said, which ranked 21 out of 82.

“We looked at a lot of things we’ve done as a collaborative. We’ve created a public health plan to generate access to care, we’ve had countless quality initiatives in our hospitals with our doctors — we’ve focused so much energy on that, and look where our ranking is there,” Smith said. “We need to use that same sort of collaboration around health behaviors to get back on track.”

Both Smith and Levine said they hope the action plan will result in a higher ranking for Genesee County in the future, though measurable results could take time (the plan itself focuses on a 10-year timeframe). And although none of the strategies outlined in the business case could be considered radical, Levine said that having the County Health Rankings data to back up the document will give it more weight among community leaders.

“Some of this probably would have happened anyway, but it would have taken longer,” he said. “Nothing we’re going to do is rocket science. It’s all logical stuff, but the nice thing is that when you can use numbers like this, it can really get people to focus.”

Read Part II: Collaborating to Improve Health in Genesee County, Michigan