Cara McNulty, MSManagerOffice of Statewide Health Improvement Initiatives

Julie RingDirectorLocal Public Health Association

Statewide Health Improvement Program (SHIP)

SHIP Overview

SHIP is a key public health component of historic health reform bill signed into law May 2008

SHIP aims to reduce obesity and tobacco use and exposure through evidence-based systems change strategies

$47 million appropriated for SHIP for fiscal years 2010 and 2011

Competitive grants to Community Health Boards and tribal governments began July 1, 2009

Impact on Local Public Health

Grants awarded to all 53 CHBs (87 of 87 counties) and 9 of 11 tribal governments

Unprecedented collaboration

38 of 53 CHBs are working collaboratively

Seven tribal governments are working collaboratively on a unified SHIP project

Shift in public health focus from programs to systems-change approach

Importance of a Systems-Change Approach Major health problems will not be solved solely

by addressing individual health behaviors

Health problems are influenced by societal policies and environments that in some way either sustain behaviors or fail to foster healthier choices

By moving “upstream” to address fundamental causes or poor health, and by improving environments where we live, work, learn, play, and receive health care, we can prevent many people from becoming chronically ill

SHIP InterventionsA comprehensive Menu of Interventions was created with input from local, state, national and tribal government experts

Grantees were required to select a minimum of four interventions that included:

At least one in each of the four settings (schools, communities, worksites and health care)

At least that addresses tobacco

At least one that addresses obesity

Statewide Evaluation Grantees are required to:

work with MDH to finalize an Evaluation Plan submit interim and annual reports detailing overall

progress towards SHIP goals and objectives

Should grantees fail to meet expectations, MDH will work with grantee to modify activities to meet goals of each intervention

In addition, MDH synthesizes evaluation across state conducts surveillance of health care costs, health

behaviors, risk factors, and systems changes related to SHIP goals

Statewide Technical AssistanceDesigned to facilitate successful implementation of a comprehensive, integrated health improvement program

Assist and develop capacity of community health boards and tribal governments to implement systems change at local level

A team of experts from MDH and partner organizations provide assistance, drawing on internal and external resources

Technical assistance involves: Planned trainings Responsive technical assistance Guidance documents Peer-to-peer assistance

Statewide conference

Early Successes in SHIP CommunitiesIn first six months of grant period, SHIP grantees:

Built community capacity to leverage experience in chronic disease prevention and policy change

Coalesced community support and commitment through official teams, partnerships and coalitions

Completed community assessment of needs, supports and assets

Selected interventions based on community assessments

Developed action plans to implement strategies in schools, communities, worksites and health care settings

Submitted evaluation plans that: Identified outcome measures Designated key benchmarks to measure progress

Early Successes in Tobacco

In first year of grant period: At least 37 post-secondary campuses have begun

work to become tobacco free. Six campuses, affecting over 38,000 people, have adopted policies since SHIP began

Over half of SHIP grantees are working on implementing comprehensive worksite wellness interventions, many of which address tobacco use and exposure among employees. SHIP has been an integral part of a number of early successes in this arena.

For example, Coborn’s Grocery Stores have implemented a tobacco-free grounds policy and links employees to cessation for their 26 Minnesota locations affecting 6,500 employees.

Early Successes in Health Care

In first year of grant period: About two-thirds of SHIP grantees are

working with providers to improve the active referral process for patients in need of weight management or cessation services to resources offered by health plans or in the community. In Hennepin County alone, the 3 grantees

have partnered with 33 clinics and Park Nicollet system involving 18 additional clinics

Early Successes in Healthy Eating and Active Living

Majority of SHIP grantees have elected to work on strategies that:

Increase affordability and access to healthy foods in communities and schools. Well over 40 communities and more than 110 schools are engaged

Increase opportunities for walking and biking for transportation and rec reation in communities and schools. Well over 50 schools and more than 130 cities are engaged

Implement comprehensive worksite wellness initiatives that support reduced tobacco use, increased physical activity and improved nutrition. Well over 160 worksites across state, including large corporations and manufacturing businesses such as Polaris, Swift Manufacturing, Cargill, General Mills, HealthPartners, Target, Best Buy, Medtronic, and many others are engaged

Lessons Learned Integrate with other Health Reform Initiative components

to support overall health reform transformation

Build on existing prevention efforts to expand and not duplicate work that is already being done

Make efforts to help grantees succeed, even before funds are awarded including developing list of evidence-based strategies

Enhance capacity of local public health and tribal governments to implement policy, systems, and environmental changes

Develop a statewide system to demonstrate that reductions in risk factors decreases in chronic disease substantial health care savings!

Achieving SHIP Goals“We are building something here, that will last our lifetime and beyond.” – Mitch Jasper, Mayor, City of Jackson

In many ways, SHIP grantees have only just started their work, yet results they have already accomplished show tremendous promise for future success

It will take time and sustained effort throughout our communities to achieve reductions in tobacco use and exposure and obesity that can lessen burden of chronic disease in Minnesota

SHIP is on path to reaching those goals by making healthy choice the easier choice for all Minnesotans

Questions?SHIP Website:http://www.health.state.mn.us/healthreform/ship.html

Cara McNulty, Manager, Office of Statewide Health Improvement Initiatives Email: Cara.McNulty@state.mn.us

Phone: 651-201-5438

Julie RingDirector, Local Public Health AssociationEmail: Ring@mncounties.org

Phone: 651-789-4354