Hi-5: Health Impact in 5 Years
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- Community Commons
Achieving lasting impact on health outcomes requires a focus not just on patient care, but on community wide-approaches aimed at improving population health.[1-6] Interventions that address the conditions in the places where we live, learn, work, and play have the greatest potential impact on our health.[7-11] By focusing on these “social determinants of health” (SDOH) and on “changing the context to make healthy choices easier,” we can help improve the health of everyone living in a community.
The Health Impact in 5 Years (HI-5) initiative highlights non-clinical, community-wide approaches that have evidence reporting 1) positive health impacts, 2) results within five years, and 3) cost effectiveness and/or cost savings over the lifetime of the population or earlier.
HI-5 and the Health Impact Pyramid
The public health impact pyramid visually depicts the potential impact of different types of public health interventions.At the base of the pyramid are those interventions that have the greatest potential for impact on health because they reach entire populations of people at once and require less individual effort. The HI-5 Initiative maps directly to the two lowest tiers of public health pyramid with the greatest potential for impact.
Health conditions that the HI-5 interventions address
Community-wide approaches can have broad health impact, often addressing several health conditions at once. Below is a list of the health outcomes that HI-5 interventions can prevent or reduce:
- Anxiety and Depression
- Blood Pressure
- Cardiovascular Disease
- Child Abuse and Neglect
- Cognitive Development
- Infant Mortality
- Liver Cirrhosis
- Motor Vehicle Injuries
- Dental Caries
- Sexually Transmittable Infections
- Sexual Violence
- Teenage Pregnancy
- Traumatic Brain Injury
- Type II Diabetes
- Youth Violence
Among the list of interventions addressing the social determinants of health is the strategy of introducing or expanding public transportation (see the full HI-5 list here). The purpose of introducing or expanding public transportation systems is to increase both access and use of public transit and to reduce traffic. The body of evidence demonstrates this intervention is associated with reductions in traffic crash injuries, fatalities, traffic congestion and associated air pollution as well as increasing levels of physical activity.
Counted among the success stories of implementing or expanding access to public transportation is the Columbia/Boone County Department of Public Health and Human Services public transit health impact assessment. The local health department’s leadership in determining the community health impact of a public transit expansion provided solid evidence from which policy changes were levied.
The data gathered by local public health was turned over to the transit department for further analysis. The transit experts overlaid the information presented with available GIS data focusing on income levels and demographic information in order to determine new routes. As a result, Go CoMo was created to maximize access from neighborhoods and connect people with more services throughout the city. The new system utilizes mobile applications and buses equipped with censors to be more responsive to rider needs. The sensors record the locations that riders get on and off the bus, and the locations can be uploaded to GIS to plot areas/stops with heavy ridership, or little to no ridership at all. That in turn, helps transit staff determine where to alter routes, add/remove stops, and add amenities like bus shelters. I think explaining that will lead right into being more responsive to riders. Having that data helps transit staff make informed, data driven decisions.
Senior planner for the Columbia/Boone County Department of Public Health and Human Services, Jason Wilcox explained, “It was a great opportunity to bring transit into the 21st century for a city that was growing and changing very rapidly.”
He went on further to encourage other municipalities to explore ways they can use data, “Don’t be afraid to reach out and see what data you can provide to change the conversation about addressing social determinants of health.”
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