The Health Section

Healthiest Cities and Counties challenge could change community health

Garth Graham, MD, MPH

With the launch of the Healthiest Cities and Counties Challenge in April, the president of the Aetna Foundation hopes to inspire communities across the U.S. to create local solutions to a very local problem – the health of their own residents and community.

Garth Graham, MD, MPH, president of the Aetna Foundation, said the idea of the challenge came from research that showed a connection between a person’s zip code and health disparities in their community.

“We have long seen in public health data that your zip code is a much stronger contributing factor than your genetic code in terms of health outcomes, particularly in poor and under-served communities,” Graham said.

The Healthiest Cities and Counties Challenge is open to small and mid-size cities and counties, which will compete over a two-year period to create healthier communities. Depending on the size of the community, finalists can win up to $500,000 for their progress.

For example, a number of factors that aren’t health related, such as education, housing and transportation, can contribute to someone’s health after they visit a hospital or clinic, Graham said.

The Healthiest Cities and Counties Challenge is a competition created by the American Public Health Association, National Association of Counties, as well as the Aetna Foundation.

“The Healthiest Cities and Counties Challenge is designed to generate local solutions to local problems. The challenge requires community leaders at different levels to help solve a problem that affects all of the members of their community,” he said. “The problems are hyper local, so the solutions have to be hyper local too.”

An early look at emerging healthiest cities

Over a dozen communities across the country contributed ideas to Healthiest Cities and Counties Challenge, providing an early glimpse of what some solutions may look like. These communities tended to focus on “higher utilizers of the health care system,” or people who face a number of social challenges, Graham said.

“It’s encouraging to see some of the cities put together local coalitions and groups so they can bridge the communication gaps that sometimes exist between the police department, health department and housing department,” Graham said. “They’re treating the individual not as a sick individual, but as an individual living in the community who may use services from any number of community programs.”

When finalists are announced in September, Graham said he expects to see plans featuring collaboration among many organizations in a community. “The best solutions will be the ones that are cross-sectional,” he noted.

The future of healthiest cities

Graham is optimistic the Healthiest Cities and Counties Challenge will have a lasting impact on health care at a community level. By addressing social challenges, it could lead to better treatment of the community, better patient care and lower health costs, he said.

“For us, it’s about building the community that keeps people healthier on the front end,” Graham said. “By investing in that, hopefully it will keep the cost down on the back end.”

He added that he believes the Healthiest Cities and Counties Challenge will evolve health care conversations and create more opportunities.

“We want to see the conversation about health not be just about blood pressure and whether someone had a stroke, but include the kinds of things in a community that can help address these kinds of issues,” Graham said. “Twenty years from now, we hope to see more linkage between social determinants of health and healthier communities.”