Live Well San DiegoBy: Nick Macchione, MS, FACHE, Agency DirectorHealth and Human Services, County of San DiegoWhen asked, what is Live Well San Diego? I say it’s all about improving lives. Live Well San Diego is a regional vision that we have adopted, which outlines what we are doing collectively to build better health, live safely and thrive. In County government, it’s our north star that helps guide the provision of housing, health and human services and resources. It’s how we do business and improve the lives of one in three or approximately 1.3 million San Diegans. It all started in 2008. I was the newly promoted director of the County’s Health and Human Services Agency. I was tasked with answering one question: “How do we help over 3 million San Diego residents lead healthier lives?” Seeking solutions was no simple or straightforward task. Complex problems require complex solutions, and in order to create sustainable improvements across a diverse and geographically vast region, we had to seek input representing a range of diverse perspectives in the brainstorming process. Suggested solutions required the integration of efforts across sectors and were long-term in scope. As we collectively shared ideas, we engaged experts in health and human services including academics, physicians, economists, researchers, human services leaders, and an array of county, city and community partners to provide their insights. We then developed the vision, core strategies, and areas of influence (e.g., health and knowledge) to be measured by a set of key indicators. In 2010, the County of San Diego Board of Supervisors adopted Live Well San Diego, a 10-year initiative to improve population health and wellness. Over the last eight years of Live Well San Diego, we’ve made ambitious investments in the wellbeing of our residents. The advances we’ve made have helped drive our economy, improved health outcomes and reduced illness and injury. For example, in the past eight years, life expectancy in San Diego increased from 81 to 82 years, compared to 78 years in the US for the same two time periods. As technology has improved, our communication strategies, and interactions with clients have too. In 2015, we established ConnectWellSD to connect technology with practices. Our goal was to better understand our customers’ motivations, needs, entry points, and service-delivery preferences to improve the customer experience. In 2017, we added housing to our agency’s service delivery system. We realize that no housing for individuals means no health. We’ve emphasized the importance of addressing each individual’s needs, including Maslow’s hierarchy of needs outlining basic needs first, and we incorporate affordable housing in the delivery and provision of health and human services. Moreover, today we have transitioned from a 10-year initiative into the long-term vision, called Live Well San Diego for our County-wide strategic plan and the framework for investing public dollars. As such, we have embedded the vision into measurable operational outcomes that contribute to the regional areas of influence. The vision has been the catalyst for shifting away from a public welfare model, to person-centered services, and finally, what we refer to as whole person wellness. As we consider the allocation of resources and services as well as delivery systems themselves, we think of the importance of finding integrative and generative solutions. We combine solutions with empirical-based findings from models grounded in the social determinants of health and equity, the life course approach, and social ecological systems. We train staff to anticipate needs, facilitate a culture of wellness – which we call “HEART” which stands for employee practices of being Helpful, Experts, Attentive, Respectful, and Timely; as well as practicing trauma informed approaches to live well and build resiliency in our customers and communities. Our actions drive the path forward to more improved health and human services for those seeking self-sufficiency. The progress we’ve made since adopting Live Well San Diego vision is possible because of the work of our community partners. As the saying goes… if you want to go fast, go alone, and if you want to go far, go together. We have what are called recognized partners, or over 400 community stakeholders who represent approximately ten sectors: governments, community serving organizations, education, faith-based organizations, health agencies, hospitality, human services, information technology, military & veteran, and service groups & foundations. Our partners represent over 3 million residents, 37 school districts, and 15 cities. Through the spirit of collaboration we can and are becoming healthier as a population.
What we’re doing is innovative and unprecedented in San Diego County. Innovative because of an ambitious investment in time and resources, which integrates health, housing and human services. It’s also unprecedented because what we are doing right here in San Diego, is reaching 3.3 million residents through a systems-wide collective approach to population health wellness. This simply hasn’t been done yet. In order to garner support – we fall back on the simple message – wellness. I have yet to meet someone who doesn’t want to be healthy and well. Choosing health as the foundation for our vision is one way to garner support for what we’re doing here in San Diego. Leadership is not a role or a title, it’s an action, and it’s an example. While progress came in fits and starts, and establishing this approach wasn’t always a straight line. We had to stride down mockery lane. We faced criticism and resistance. But leadership is seeing what everyone is seeing, and doing what no one else is doing, gained from the lessons of the past for the betterment of the future. We have kept our heads down, and chose to keep our efforts positive. We worked together, listed to our partners, shaped efforts collectively and in a united way. I have been guided by my passion and purpose to live well and do well. Today, I am energized and motivated by the fact that I am in a position to help improve the lives of San Diegans towards their true potential, starting with health and wellness. In all, I feel fortunate to be here, as a wellness warrior, helping advance Live Well San Diego - a vision which reflects potent simplicity - health and wellness for all residents. Past blogsLet's Talk ImmunizationBy: Mackenzie Melton and Izzy BrandstetterWithinReach Immunization Experts ![]() Rethinking Our Approach for Urban Indian Studies By Adrian Dominguez, MS and Rose James, PhDUrban Indian Health Institute, Seattle Indian Health Board Summer Break with or without Hunger
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