Judul : United Health Services Credit Union
link : United Health Services Credit Union
United Health Services Credit Union
hello everyone, and welcome to today's webinar. today we are going to be discussing the nationaladvisory committee on rural health and human services policy brief on social determinantsof health, which is a very hot topic right now and i'm really excited to hear what ourspeakers have to say. i'm kristine sande, and i'm the program directorof the rural health information hub, and i'm
United Health Services Credit Union, going to quickly run through a couple of housekeepingitems before we begin the webinar. we hope to have some time for your questionsat the end of today's webinar. if you do have questions for our presenters,i ask that you submit them at the end of the webinar using the q&a section, and that'sgoing to appear in the lower right-hand corner
of the screen following the presentations. we have provided a pdf copy of the presentationon the rhihub website, and that's accessible through the url that's on your screen rightnow or by going to our rhihub webinar page, which is www.ruralhealthinfo.org/webinarsand then clicking into today's presentation. if you do decide to go download those slidesduring the webinar, i do ask that you don't close the webinar window, or you'd have tolog back into the event. if you experience any technical difficultiesduring today's webinar, please call webex support, and the number for that is 866-229-3239. our first speaker today will be ronnie musgrove,who has served as the chair of the national
advisory committee since 2010. he previously served as the governor of mississippifrom 2000 to 2004, serving as the lieutenant governor prior to that. for more than two decades, he's taken a leadingrole in the state of mississippi to improve education and expand economic development. governor musgrove will give us an introductionto the work of the national advisory committee, and then introduce the other committee memberswho will be speaking today. governor musgrove? the advisory committee board, it's a boardthat advises the secretary of health and human
services on issues related to how the departmentand its programs serve rural communities. we have no animosity whatsoever against metropolitanareas, we just feel it's important when you talk about major issues to consider the ruralareas in our state. our presenters today, which some as a resultof the work that we just did on our last meeting on determinants, i think will be very interestingwith these three great presenters. first will be christina campos, who is theadministrator of the guadalupe county hospital in santa rosa, new mexico. following her will be kathleen belanger, who'sprofessor emeritus at the school of social work, the stephen f. austin state universityin nacogdoches, texas, and then ona porter
who's president and ceo of prosperity worksin albuquerque will make their presentations, so i know that you will gain a lot of insight. with that christina, i'll turn it over toyou. thank you, governor musgrove. at our most recent meeting in september, thecommittee met in my hometown of albuquerque, new mexico and looked at the issue of socialdeterminants of health. we decided to focus on the social determinantsof health because during our previous meetings, while studying issues such as the opioid crisis,child poverty and mortality, and life expectancy in rural areas, we noticed a distinct pattern.
there were obvious disparities in outcomes,whereby the outcomes of rural communities were often much worse or at least significantlyworse than their urban counterparts. in order to make recommendations for policyimprovement, we needed to get a better understanding of the determinants or factors influencingwell-being and leading to poor health outcomes in rural communities. as a baseline, the committee chose to adoptthe robert wood johnson foundation's philosophy, that health starts where we live, learn, work,and play. in other words, the elements contributingto health and well-being go way beyond healthcare and include genetics, individual behavior,and social environmental factors.
even though researchers, policy makers, andpractitioners are increasingly coming to recognize the broad range of social determinants thataffect health outcomes, our budgets and investments don't yet reflect this. whereas on average nations that are membersof the organization for economic co-operation and development spend about $1.70 on socialservices for every dollar spent on health services, the us spends only 56 cents, orone third. furthermore, the united states spends considerablymore of our gdp on medical services than other developed nations, but our health outcomesare no better and in many cases are much worse. if we as a nation accept that the premisethat health begins where we live, learn, work
and play, the question then becomes how canwe realign our health and human service systems to reflect this understanding and target someof the upstream determinants of health that you see listed on the previous page? at the national advisory committee on ruralhealth and human services, we focused on the question of what is the rural dimension ofthe social determinants of health? in other words, are the social determinantsthat are particularly challenging to rural communities, and how do they contribute tothe poor health outcomes that we explored in our past policy briefs? are there certain social determinants thatwe can target directly, or are there larger
systemic changes that need to be made to improvehow health and human services tackle these issues at large? this brings us to the site visit in new mexico,the land of enchantment. we first heard from a variety of expert speakersthat had been doing excellent work and research related to the social determinants of healthin rural areas. later we split into three groups to visitthree distinct rural communities in new mexico. while there, we learned some frontline communityleaders, who while facing challenges are coming up with innovative solutions on a daily basis. you can read more about some of the amazingwork we saw at each of these visits in the
appendix to our brief, but i'll give you abrief outline of where we went and with whom we spoke. one group went to cuba, new mexico, wherethey met with healthcare and economic development leaders at the cuba health center, and learnedabout ... excuse me, i'm just boarding here. there we go. that group went up to cuba, new mexico innorthern mexico where they met with healthcare and economic development workers at the cubahealth center, and learned about the health center's role in developing a series of walkingtrails throughout the community. the second group came to santa rosa, new mexicoand visited my hospital.
here, i and the group met with healthcare,education, economic development leaders in the community who spoke about how our hospitalhas been able to partner with the schools and other organizations to make communityinvestments that target issues related to the social determinants of health. they heard how my hospital's non-profit governingboard had invested over a million dollars in the santa rosa community over the past10 years, helping to fund community initiatives such as youth employment, higher educationscholarships, senior walking programs, and exercise equipment in local parks. finally, the third group visited the lagunapueblo, where they met with the native community
finance organizations and learned about effortsto consolidate funding streams in order to create more holistic solutions to improvehealth and well-being. the partners for success program consolidatesand leverages funds from five different federal and tribal programs, thus increasing the effectivenessand efficiency of these programs, providing education and job training services to thecommunity. in a bit, you'll hear from my colleague kathleenbelanger, who will tell you about some of the lessons the committee learned during ournew mexico visit. however, i want to leave you with two reallyimportant takeaways learned from our partners in new mexico.
these are lessons that can be used going forwardwhen seeking about addressing health disparities for historically marginalized communities. first, historical trauma and land loss matterwhen examining the root causes of health. in laguna pueblo, stakeholders shared storiesof disruption and displacement, and also spoke about the legacies of enslavement and forcedassimilation that produced social trauma, with which these communities are still grapplingtoday, so when we think about social determinants of health, outcomes, and potential solutions,we absolutely must take into account culture and history. second, families or clans can be strong sourcesof knowledge, influence, and expertise in
efforts to improve health and well-being. in all three communities, we learned aboutmultiple generations living under the same roof or nearby, and we learned how these multi-generationalfamilies and networks of families work together to overcome legacies of historical trauma,survive adverse economic conditions, and improve overall well-being, also empowering individualcommunity members. as such, we must remember to engage familiesand networks of families as essential partners in our quest for viable and sustainable solutionsto the social determinants of health. now i'll turn it over to kathleen. thanks, christina.
let's go back to our first guiding questions. which social determinants of health seem topose significant challenges to rural communities? the short answer is all of them, but we wantedto look in more depth at them, so we visited those three communities, and the challengeswe heard about in those communities were similar, and yet they were unique, but there were somecommon themes we heard from our speakers and on our site visits that policy makers shouldconsider when we think about how social determinants of health manifest in rural communities. first is to think about geography. as we talked about in many of our previousbriefs, outcomes related to chronic disease,
mortality rates, and live expectancy all tendto be worse in rural geographies than in urban ones. as you can see on the slide, life expectancyis shorter in rural areas. as a rural woman, it seems that every timei read a new report, my life expectancy shortens. we've also talked a bit about how geographicisolation in rural communities has made it incredibly difficult to sustain and supporteven basic health and human services, but we need to point out that in talking aboutsocial determinants of health in rural communities, place matters. the communities in which we live determinethe quality of available housing, the opportunities
to accrue wealth, and the extent to whichthe built environment may offer opportunities to make healthy choices. hhs programs and policies should keep in mindthat the policies and programs intended to address the social determinants of healthin rural areas can't take a one size fits all approach. during our site visits, we heard a lot aboutthe ways poverty in rural communities adversely affect people's ability to lead healthy lives,so this map highlights persistent poverty counties, and those are counties in which20% or more of the population was living in poverty over the last 30 years.
as you can see on the map, almost two thirdsof rural counties are persistent poverty counties, compared to just 14% of urban counties. persistent poverty can negatively impact people'sperceptions of mobility, and that can ultimately lead to toxic stress and a variety of otherpoor health and human behavior health outcomes. at the end of this presentation, you'll hearfrom one of our expert speakers who will tell you about how asset building strategy canhelp to reverse the trends in rural areas. looking at this slide, you can see that eventhough educational levels have increased since the year 2000 overall, over a third of therural counties have more than 20% of their population without even a high school diploma,and that's compared to under a fifth of the
urban counties. there are often few job training and employmentoptions for high school graduates wanting to stay in their rural communities, and thecommittee heard about the need to foster apprenticeship programs, entrepreneurial and technical education,and co-operative development options. we believe that hhs's workforce and healthprofessional training programs may have a role to play in this. transportation: in rural areas, only 32% ofthe counties have full access to public transportation services, with another 28% having just partialaccess. a lack of reliable transportation makes itextremely difficult to travel to work, doctor's
offices, and grocery stores, unless you havea private vehicle or access to one. while the committee understands that hhs'sability to support transportation activities is limited, there are several programs includinghead start, the community health center program, and medicaid's program of all-inclusive carefor the elderly that include transportation components. going forward, hhs programs attempting toaddress social determinants of health should consider transportation barriers in ruralareas and think about ways more transportation options can be included or ways that servicescan be co-located in order to reduce these transportation barriers.
given some of those challenges that we heardabout during our meeting, i want to return to our second question, which is how can hhsprograms and policies be created, altered, or enhanced to improve outcomes related tothe social determinants of health in rural communities? that's always the tricky question: what canwe do about it? we want to reiterate that across our threesite visits, we saw three incredibly resilient, creative, and hardworking communities thatwere working to overcome very difficult issues contributing to poor outcomes in their areas. given the innovative work we saw occurringon the ground, the committee had two main
concerns regarding federal barriers that wereeither hindering the extent to which rural communities are able to focus on the upstreamcauses of poor health, or hindering the extent to which their work to address these upstreamcauses was actually leading to improved outcome. the first concern we have is that even thoughthere have been several new financing and community integrated care models that aimto improve population health by targeting the social determinants, for example accountablecare organizations and care coordination, we believe that federal funding mechanismsfor social and community services have limited the extent to which rural communities canparticipate in these efforts, so in order to do this work well health systems rely heavilyon human service agencies as essential partners
to address the upstream determinants on health. however, based on what the committee saw andheard, there seems to be a real lack of human services in rural areas. we might even call them human service deserts. we think there are a few factors related tofunding mechanisms that might be causing this, and those factors include reduction in blockgrant funding, an uneven playing field in applying for competitive grants, and possiblyless advantageous indirect rates to administer the grants. first, rural areas rely heavily on block grantsto fund human services, and as you can see
on this slide, block grant funding has declinedsignificantly, roughly 26% since it began in 2000. with small populations, which may alreadymean less block grant funding and more reliance on that funding, it's possible that ruralareas are feeling the decrease in funding the hardest. second, urban communities may have greatercapacity to hire professional grant writers and collect larger amounts of community leveldata than smaller, rural governments and community-based organizations. rural communities may be competing on an unevenplaying field when it comes to competitive
federal grant program. finally, let's think about indirect rates. that's the administrative overhead and applicationthat includes funds for part- or full-time staff to administer the grant program. a lack of knowledge about indirect rates mayreduce the impact of the federal grants that rural communities do receive. while large, urban organizations may be applyingfor and receiving more federal grants and negotiating adequate indirect rates, ruralorganizations may have less experience or ability to negotiate indirect rates that theyactually need to administer their programs.
the committee's second concern, as you seeon this slide, is that many federal programs that seek to improve health outcomes may actuallyimpose solutions on rural communities without having a full understanding of the true problemsfacing that community. they may not fully appreciate how servicedelivery operates in those communities. the committee believes that rural communityleaders and service providers are the experts when it comes to understanding the factorsaffecting health outcomes in their area and that they need to be brought to the tableto work alongside funders when devising solutions to those issues. christina, back to you.
all right, sorry about that. now i'm going to walk us through the committee'srecommendations. first, hhs should develop a federal healthcommunities designation that recognizes place-based, community-driven plans to address the socialdeterminants of health. this designation could be modeled after ruralor other rural place-based efforts, such as the rural impact in promise zones, which willallow rural communities to have the local autonomy to develop their own plans to improveoutcomes related to the social determinants of health. second, hhs should facilitate coordinationand collaboration among hospitals, health
systems, and human service providers on communityneeds assessments and community benefit agreements in order to support the development of localstrategies to address the social determinants third, hhs should structure grant review panelsto allow rural applicants to be reviewed as a separate cohort, in order to compete againstsimilarly resourced communities. this will help to solve the issue discussedearlier, where rural communities are often competing against larger organizations withmany more resources. fourth, hhs should encourage the use of prioritypoints for rural applications that face unique structural challenges related to the socialdeterminants of health, such as but not limited to geographic isolation, low population density,higher poverty, and lower life expectancy.
finally, hhs should offer technical assistanceand funding opportunity announcements, which highlight the ways rural organizations canfactor in administrative costs of effectively managing grants into their budgets and plans. now i'm going to turn it over to ona porter. ona is the president and ceo of the organization in new mexico called prosperity works, which has taken a really, really innovative approach to improveoutcomes related to the social determinants of health for families across new mexico. thank you for this opportunity to speak withyou. prosperity works is a state-wide organizationin new mexico that works to alleviate poverty.
we work really to develop assets among low-incomepeople with the understanding that income gets you by, but assets get you ahead. one of the things that i think is really importantto understand is the concept of wealth versus income, and the disparities in wealth aremuch greater than those in income. wealth actually reflects our ability to investin the future and the future of our children. assets deliver families financial stability,providing secure economic foundations from which families can address day to day challengesand major economic shocks. this is the work of prosperity works. so...
what we do is actually enable people to planfor their future by helping them build assets. we have a couple of strategies that i'm goingto tell you about. unlike income, which can be very unpredictable,assets can be drawn on in times of need, and provide security and support upward mobility. with assets, households move from making endsmeet to achieving their aspirations. this is hope in concrete form. one of the products that we have is calledindividual development accounts. and individual development accounts are matchedsavings accounts. people complete 10 weeks of financial capabilitytraining, and then they're eligible to save.
when they reach their goal, we match themfour to one for the purchase of a first home, to capitalize a small business, or for post-secondaryeducation. the impact in new mexico in the past 10 yearshas been dramatic with these. first of all, we've assisted 319 familiesin securing safe and affordable housing. now, it's apparent from this that this isa household strategy, but it's also a community economic development strategy. you can see there that $57 million in newmortgage money holdings are in new mexico. we also helped 512 residents achieve somelevel of college or post-secondary education, we took almost $2 million of tuition moneyinto new mexico institutions of higher education,
but in addition to that, the 512 people thatwe're talking about actually now have now have an aggregate increased income in ourstate of almost $4 million annually. that money is spent in their communities,another community economic development driver. the other thing that has happened is thatwe opened and grew 660 locally owned businesses and created 1,155 jobs, again a local communityeconomic development driver. we started this work 10 years ago in ruraland deeply rural new mexico. we started there, because we know that ruralcommunities have high needs, are always underserved, and are also difficult to serve. our idea was that if we could address theneeds of rural people, not only could we stabilize
and help grow those communities, but we alsolearned about how to serve the larger community all over our state. a new product that we have is called prosperitykids. it actually is a true collective impact strategy. now, i know for many of you on the call collectiveimpact has become a buzzword, but this actually incorporates all of the organizations on theleft, each of those bringing their own missions and resources to the work of serving a particularpopulation. prosperity works is the backbone organizationin this, and our grants have actually been distributed to the other organizations whowere involved also.
with prosperity kids, what we're actuallydoing is a child savings account, but it's unlike any other child savings program inthe nation. it's different because we start first withparents. parents receive 10 weeks of child developmentand community leadership training, and additional economic development training...personal economic training. then, their children from birth to 11 areeligible for a savings account, which we open at a local credit union with $100. then we match family money up to $200 a yearfor 10 years. in addition to that, families get an emergencysavings account.
the emergency savings account is opened withonly $10, but we do put incentive deposits in those accounts for things that the familiesdo to support healthy outcomes for their children for up to five years. in addition to that, the families also geta secured credit card attached to that so that they can build credit. one of the major barriers, not only to havingfair credit and opportunities to purchase things at a fair price, is that without acredit history it's difficult for people to get a job. credit information is being used as a primaryscreening in employment, so here we've combined
the children and their families into a systemthat really is future oriented and also has a college identity for children. now, one of the things that you may or maynot know is that child savings account has been demonstrated by dr. willie elliott atthe university of kansas to be a powerful change agent for not only the children, butalso their families. children who have an account in their ownname are four to six times more likely to go to post-secondary education and three anda half times more likely to complete. this is critical, for the future of our jobsin america are with post-secondary education. we expect that by 2025 that up to 80% of jobsin america will require post-secondary education.
you probably realize that a small amount ofmoney is not paying for college, but we are creating a future orientation and also a collegeidentity. the other thing important to know when we'retalking about health: moms whose children have a savings account have 50% less depressivesymptoms than moms whose children don't have a savings account. this is hope in concrete form, and hope changesnot only a future orientation, but also chemicals in our brain. the other thing that happens is that by preschool,children are ahead of their peers in emotional and social development, which is criticalto learning.
by third grade, they're ahead of their peersin language and math, so we think that this is a product that holds great hope in ourstate. one of the things also that's important tonote, and i'd like to direct you to the asset funders network recent paper called wealthand health that was just released. what they found was that people with morewealth have lower death rates, lower rates of chronic disease, improved mental health,better ability to function in daily life, lower rates of smoking, obesity, and excessivealcohol use. their children also do better. they have lower obesity rates, fewer markersfor asthma, and their social emotional development
is better. the reason that i talk about that is thatwealth gaps between rural and urban residents cannot be overcome by changing individualbehaviors in areas such as education, family structure, full- or part-time employment,or personal consumption habits. similar achievements do not lead to similarrewards in terms of wealth for rural and urban workers. though attending college, getting married,working full-time are all associated with more wealth for each group, the asset valueof the household's level does not compare favorably.
barriers to wealth equality in the unitedstates can't be combated by individual or household level activity. instead, public policy is needed to eliminatethese wealth disparities. thus, i appreciate the recommendations ofthe committee that lead in this direction. finally, we believe at prosperity works thatchanging systems instead of programs is really the potential of our future. rather than imposing solutions or fixes onpeople, we are proving that investing in the initiative and ingenuity of low-income familiesand communities by making asset building opportunities available to them is the most effective wayforward.
early in this webinar, i was referred to asan expert. what i believe is that community people arethe experts in their own well-being and in their future. for six years, i worked with native communities,and while we were there our philosophy was that we don't do anything to or for people,that people know what is good for them and it was our job to facilitate the resourcesthat communities needed to achieve their goals. i think that the work that the committee hasdone is certainly pointing in that direction, and i appreciate the opportunity to participate. thank you very much.
great, thanks so much for that great information. now we'll open it up for q&a. you'll see that the q&a box did just appearon the bottom right-hand side of your screen, and if you're not seeing that you might needto click on the q&a icon up on the top right. as you enter your questions, we ask that youdo please select the option to send the question to all panelists rather than to a particularpanelist, just so we don't miss your question. while we're waiting for people to submit theirquestion, i do have a question for christina. i'm just wondering about your efforts in santarosa and how that got started? how did you get started working on socialdeterminant issues?
santa rosa is very similar to the other communities. we have a very high hispanic population anda lot of poverty, and we had some needs for human resources as well in the community. our non-profit board gets a stipend of sortsto manage the hospital on behalf of the county, and rather than use it on salaries or anythinglike that they chose to establish scholarships, so it started with nursing scholarships totry to develop our own workforce. it was incredibly successful. we haven't used any agency nurses, lab techs,x-ray techs or anything in about 12 years through the development of that program, andas we started building momentum and getting
some savings going the board decided to reachout into the community to help partner with other service agencies, so we worked withsenior citizens centers to develop walking programs to get them up and moving in a safeenvironment. we hired coaches, then that developed intoa zumba class for seniors, and then expanded into zumba for all ages. we're called the city of lakes. there's lakes all around town and really prettywalking areas, so we put some park courses for exercise. many of the best ideas came from the communityitself.
it wasn't the board sitting around thinkingwhat they should offer or do, but people asking us if we could partner with them in theseefforts to improve health at home, and it's kind of interesting because it's a hospital. in a sense we're funding keeping patientshealthy and out of the hospital, but i think that's the real goal for communities justto create a quality of life that attracts more people to town, but it's quite gratifyingto do more than just wait for people to come into a hospital sick, but to actually reachout and make their lives better overall. great, thank you. it looks like we've got a few questions here.
the first one is for ona, and it is wheredoes the funding come from for the prosperity works program? for individual development accounts, we havehad three and a half million dollars of federal funds, and that's for the assets for independenceinitiatives. i always say there's good news and bad newsabout that. today, i got a million dollar grant, that'sthe good news. the bad news is i need to match that moneyone for one, and it's money. it's not anything but money, one for one,and to operate a rural network of 21 organizations i actually need two dollars for every milliondollars, so all of that money has to be raised
locally. with the prosperity kids accounts, the proforma budget for 500 children in the two poorest zip codes in the south valley, which is arural area of albuquerque, my budget was $1.25 million, and that's for the kids, the training,the families, and following them for a long time plus the research that dr. elliott isdoing on our project, $1.25 million. $25,000 of that has come from the city ofalbuquerque. everything else has been raised privately. okay, great. ona, there's also a question about could yougive the reference to the wealth and health
report? yes, that is health and wealth, and it's theasset funders network, so afn.org. okay, great, thank you. for the committee members, in your rural visitsdid you learn of any successful transportation programs? this is christina. i don't recall any in particular, but i knowthat we're struggling with the same thing, and so we're partnering with the city hereto provide a safety officer that would be a non-certified police officer that wouldprovide transportation within town, and seeing
if we could do something similar to like theuber in the rural area. we're also working with the usda on a setgrant for economic development, and they looked at different industries, energy and housing,and transportation came up and it was really interesting. i actually wasn't at that one meeting, butthe rest of the committee came up with a goal of non-emergency medical transportation asthe priority goal, and kind of creating a network among the civil community here ineastern new mexico for a little transit system that would take patients to the differentspecialists in the different communities so that we could work together as partners init, so we are struggling with it as well but
it looks like we might be coming up with somesolutions. great. i would also put in a plug for the rhihubmodels and innovations section. if you go to the topic of transportation,there are some nice models there of things that people have done in communities acrossthe nation to address transportation issues. let's see what else we have. here's a question: from your experience orresearch, what indicators are particularly important or effective for assessing socialdeterminants of health in general and in rural areas in particular?
what indicators are particularly importantor effective for assessing social determinants? i think a lot of the data that we got fromthe bureau of economic research from the university of new mexico helped us here in our community,but poverty is really one of the most important determinants because poverty kind of toucheson everything, on lower education, on substandard housing and everything, but that was somethingthat was really important and i think that's why programs like ona's that give people ahand up are so important in improving healthcare overall and the quality of life. the community has also helped bring that informationforward. this is kathleen.
i'd also like to say i don't know that weare ... i think that these indicators all overlap. as you can tell in ona's program, which isit, economic stability? is it community and social contexts? are we looking at income, employment, is shelooking at literacy, early childhood education? their programs are looking at all of it, soteasing out individual indicators is a little more difficult than it may first appear, becausethey do all influence each other. that's my two cents on it, and just a littlewarning. this is ona, and i couldn't agree with bothof them more.
actually, 30 years ago i did the first comprehensivestudy of the status of new mexico's children and families, which was published in a bookcalled "kids in crisis: new mexico's other bomb", and the real bomb is poverty. i can commiserate or try to lead with governormusgrove, because mississippi and new mexico are always the poorest states in the nation. we have got to reverse that trend, or we can'treverse any of the other things. i just want to add, the rural policy researchinstitute has done some recent research looking at individual social determinants that havebeen impacted by education systems, and really they do overlap.
education overlaps with community and socialcontext and economic stability and healthcare. all of these and healthcare impacts education. it's very, very interesting, so i just wantedto add that i know rupri hasn't taken this question lightly. it's investigated it in some depth. let's see, it looks like there's a questionabout appalachia. it says appalachia was not mentioned as aseparate area in this presentation. does the committee think that these themesand recommendations are also applicable in appalachia?
we actually had one of our visits in kentucky. my geography is not as it should be, but itwould be on the western slopes of appalachia in that area, and my group went up to hazard,kentucky. these things definitely would apply to thoseareas. when we go out to the rural communities withthe committee, the scenery may look a little bit different and the accents of course arevery different, but the issues are the same. they had this incredible health center therethat provided so much care, from primary care all the way to cancer treatment and behavioralhealth, dental health, pharmaceuticals, everything. that healthcare, that provision of highly,highly organized excellent healthcare was
not solving other issues. their issues had a lot of social determinants,like transportation issues, lack of sidewalks lining up in the mountains, no jobs, a lotof drugs and other substance abuse, grandparents raising their grandchildren. one thing that we really saw and i think onahit on it several times was kind of a hopelessness, inter multi-generational hopelessness, andthat's the nut that needs to be cracked, but the characteristics, you can go to some areasup in northern new mexico or western new mexico in the navajo nation and see a lot of thesame social issues affected as we saw up in hazard, kentucky.
okay. another question for ona: how does the communityaccess the prosperity works program and/or initiate the classes for individuals and families? this is another part of the strategy thatwe employ. we are looking for the high trust organizationsin local communities, and they become our partners, and so they are the face of thework. there are very few individuals across ourstate that would know the name prosperity works. they would know instead habitat for humanity,they would know central new mexico community
college, they would know cuatro puertas, whichis an indigenous farmers organization, they would know those things, so one of our strategiesis to build the capacity of community organizations to serve their communities, and so they areall part of our new mexico asset consortium. we provide technical assistance and trainingto those organizations. what we know is many of those are as fragileas the families that they serve, and so helping them develop capacity, whether it has to dowith having the new resource to deliver to their community or having the new skills andunderstanding that frame the work in their community, that that's a critical piece ofdeveloping what needs to be done in local communities.
we also have a belief in a process of coaching,and so we coach our partners that are in the communities that they in turn coach the participantsin the programs, and a coaching model is one that says these are whole and complete peoplewho have lacked opportunity. they know what's good for themselves. they may need some assistance in really namingthat, but they know, and once they know that and articulate that then our job is a roadmap and a pep rally to help them achieve that. it looks like there are a couple of questionsasking about how the committee will proceed or how the administration and secretary pricewill be engaged on these issues? i don't know if somebody wants to just weighin on what are the next steps with the policy
brief in terms of sending it on to the administration? thank you kristine. this is paul moore. i'm the executive secretary for the committee,and i thought that was an excellent question. the committee is non-political, non-partisan,and we work with any of the administrations. we will continue to support the secretaryand the administration in the same way that we have. at the end of each meeting that we have, wegenerate a policy brief, wherein the committee makes the recommendations just as you heardchristina share with you today.
also from time to time, as the committee becomesaware of issues that affect rural providers in rural communities, governor musgrove willalso write a letter to the secretary, so the secretary has received a letter and this mostrecent brief on social determinants from the committee. you can also access the brief itself on ourwebsite, national advisory committee for rural health and human services. thank you for the question. great, thank you paul. i don't see any other questions at this point,so i think we will move to wrap things up.
on behalf of the rural health informationhub, i'd like to really thank our speakers for the great information and insight thatyou've shared today. also, thanks to our participants for joiningus. a survey will be mailed to you following thewebinar. we would encourage you to complete that survey. that helps us to know what you're lookingfor in future webinars and how we can improve. please do note that the survey that will appearon your screen at the end of this webinar is a webex survey, and it's not the surveyfrom rhihub, which will be emailed to you. the slides used in today's webinar are currentlyavailable on our website at www.ruralhealthinfo.org/webinars.
in addition, a recording and transcript oftoday's webinar will be made available on our website and sent to you by email in thevery near future, so you can listen again and share the presentation with your colleagues. thank you again, and have a great day.
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