Magazine article Policy & Practice

The Rise of the Healthy Individual

Magazine article Policy & Practice

The Rise of the Healthy Individual

Article excerpt

Tracking Grassroots Commitment to Health and Human Service Convergence


Local jurisdictions such as counties and cities are in an excellent position to drive health and human service convergence. For example, consider counties' unique ability as policymakers to incorporate social determinants of health into their approaches to achieve better health outcomes:

* Local safety nets. Counties deliver individual and populationbased services such as indigent care; behavioral health; nutrition counseling; disease surveillance, screening and treatment; violence prevention; employment services and residential services.

I Significant investment. Counties invest $69.7 billion in health2 and $53.8 billion in public welfare3 (e.g., housing, public assistance, nutrition assistance, etc.) to provide these services via health and human service departments and health care facilities.

I Multiple touchpoints. Counties often serve the same individuals and families through various agencies.

I Services coordination. Coordinating comprehensive services delivery in a data-driven manner is critical to counties, as it allows them to address multiple needs in a more efficient, effective, and holistic manner to better serve people.


Data indicate that social determinants of health account for as much as 40 percent of poor health outcomes.4 These determinants also influence health behaviors (e.g., tobacco use, substance use, physical activity), which also affect health outcomes.5

By addressing the socioeconomic factors and the context in which individuals make default decisions, interventions are likely to have the greatest impact on a population.6 For example, Plumas County, CA, a rural county with a population of approximately 20,000, has engaged the community at all levels with its 20,000 Lives Initiative across its mountainous terrain.

For the past several years, Plumas County has partnered with tribal organizations, the health care system, community organizations, and local businesses to obtain data to better address the community's needs. The Plumas County Public Health Agency also collaborated with the school district to ensure that families of children receiving free school lunches are enrolled in Medicaid and social service programs, if they are eligible. By using socioeconomic data and coordinating efforts with the education system, the county has been able to address access to care for both children and adults.


Health and human service convergence is a complex undertaking fueled by the need for coordination, innovation, leadership, and inspiration. Add a healthy dose of strong governance, and counties can drive progress through incremental success.

The National Association of Counties' (NACo) Healthy Counties Initiative helps counties share best practices, whether they are urban or rural, regardless of their available capital and human resources. Counties are linked by their growing understanding that the data reveal a compelling story about the need to break through traditional silos that commonly isolate health and human service delivery from one another. The Healthy Counties Initiative was launched in 2011 to enhance publicprivate partnerships in local health delivery, improve individual and community health, and assist counties to implement federal health reform.

As counties independently demonstrate the benefits of addressing the social determinants of health while coordinating services, broad trends have emerged that characterize the dynamics of health and human services convergence today:

1. Addressing the social determinants of health at the local level is a movement spreading across the nation.

As noted earlier, convergence is taking root locally in diverse areas, driven by cost pressures and the hyper-transformation triggered by the Affordable Care Act. …

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