In early 2003, the RHC established a Community Health Workgroup to determine how better prevention and education might improve the health of our region. The initial charge of the Community Health Workgroup was to examine the infrastructure of services in place to improve behavior choices, educate the community about diseases and prevent the onset of diseases and conditions.

In 2005, the RHC and the Community Health Workgroup embarked on a yearlong, comprehensive Community Health assessment that involved broad stakeholder participation, the development of more than a dozen survey instruments and contact with more than 800 organizations that provide primary and secondary prevention services in the region.

What is Primary and Secondary Prevention?

Primary prevention promotes optimal health and includes increasing awareness of health issues, health education, immunizations and behavioral interventions to reduce disease risk.

Secondary prevention detects symptoms or early stages of disease and includes screening and early diagnosis.

Why was the Assessment Conducted?

The specific aim of the assessment was to document organizations that provide community-based preventive services, funding for prevention services, and prevention service barriers and gaps. Emphasis was placed on the following 10 health issues that contribute to substantial morbidity and mortality, and are central to health disparities in the St. Louis region:

  1. Asthma
  2. Tobacco use
  3. Breast cancer
  4. Prostate cancer
  6. Lead poisoning
  7. Maternal and child health
  8. Obesity
  9. Cardiovascular disease
  10. Type-2 diabetes

Health disparities were addressed by placing an emphasis on populations that reside in high need zip codes.

How was the Survey Conducted?

Using surveys, phone interviews and focus groups, the research team collected information from:

  • community health organizations
  • schools
  • places of worship
  • community health centers
  • hospitals
  • Medicaid managed care plans
  • departments of health
  • area funding organizations

Key Findings

Among other findings, the report exposed holes in the community health infrastructure, particularly for promoting physical activity and good nutrition, leading risk factors for many diseases that burden the health care system and disproportionately affect underserved populations. It also revealed that few stable funding streams are specifically designated for health promotion and disease prevention in St. Louis.

Developing Recommendations Based on the Findings

The Community Health Workgroup’s next charge was to develop recommendations based on the assessment. Using completed health literacy and community health recommendations, the RHC hosted Building a Healthier St. Louis, a health summit in April 2006 with more than 500 stakeholders across the community to discuss implementation of some key areas. More than 500 people attended the Health Summit hosted on April 25, 2006.

Community Health and Health Literacy Implementation Areas

Below are the key recommendations developed for strengthening community health and health literacy in the St. Louis region. Based on these recommendations, eight implementation areas are described below. For a full description of proposed activities, download the Detailed Discussion of Community and Health Literacy Recommendations.

Center for Health Literacy

Build a sustainable infrastructure for health literacy efforts, including a region-wide health literacy campaign, sustainable funding sources, training programs for medical students, health professionals and providers and a central repository (In collaboration with Missouri Foundation for Health’s  Health Literacy Council).

Business Partnerships in Community Health

Build alliances between businesses and community health organizations to increase and strengthen community health service delivery.

Youth Health and Wellness

Identify opportunities to further integrate health education and promotion for youth in the region (Recommendation being implemented by the Healthy Youth Partnership).

Evidence into Practice

Develop strategies for use of evidence-based programming by community organizations, researchers and funders.

Regional Health Department Collaboration

Identify and implement opportunities for increased regional coordination between health departments (Recommendation being implemented by area Health Directors).

Diabetes Education Network

Build regional alliances to focus on prevention, early detection and enhanced management of diabetes (In collaboration with the Diabetes Coalition and the Missouri Primary Care Association).

Primary Care Home Initiative

Strengthen/develop referral process between outreach and primary care (In collaboration with the Integrated Health Network).

Community Health Coaches Program

Identify opportunities to expand health coaching programs and models (In collaboration with the Integrated Health Network).

Progress Made

As a result of the Commission’s leadership from 2006-2007, substantial progress in the key areas was made. This included launching the regional Primary Care Home Initiative, expanding the health coaches model under the leadership of the St. Louis Integrated Health Network, establishing new collaborations between the health departments in the region, and obtaining a commitment for substantial funding for a statewide Center for Health Literacy by the Missouri Foundation for Health.

Key Documents

Community Health Infrastructure Assessment for St. Louis City and County, full report

Community Health Infrastructure Assessment for St. Louis City and County, executive summary

Community Health Detailed Discussion of Community Health Recommendations 

Sharing Responsibility, Improving Community Health event flyer