BUILDING HEALTHY MILITARY COMMUNITIES TOOLKIT
A RESOURCE FOR THE DEPARTMENT OF DEFENSE HEALTH PROVIDERS AND COMMUNITIES
When addressing the health of the force—especially Service members who do not live on installations—it is beneficial to coordinate and collaborate with state and local public health agencies. Collaboration efforts with them can include both tactical and strategic activities.
CDC’s Health Impact Pyramid, shown below, is a five-tier pyramid that describes the impact of different types of public health activities (also called interventions) to improve health. It provides a visualization of how different efforts provide different returns. The interventions listed at the base of the pyramid have the greatest potential impact. These efforts address social and economic factors that influence health. As you move up the pyramid, you find interventions that change the context to make individuals’ default decisions healthy, clinical interventions that require limited contact but provide long-term protection, ongoing direct clinical care, and health education and counseling.¹
State and local health agencies are ideal first contacts when addressing community health. However, it is important to understand that other entities are critical to collaboration. Together, they comprise a public health system. The public health system is commonly defined as “all public, private, and voluntary entities that contribute to the delivery of essential public health services within a jurisdiction.”1 In addition to health agencies, these groups are also considered as part of the system:
The work of the public health system can be summarized into 10 types of activities or services:
Many state health departments have a state health improvement plan (SHIP). SHIPs are multi-year and identify priorities and strategies for improving health in the state. Most states have a SHIP planning committee that meets to determine progress on the plan and new priorities for the next version of the plan. While most states publish their SHIPs online, some may not. To learn more about a state’s health improvement process and plan, find the state or territory in the Directory of State and Territorial Health Departments and request a copy of the current SHIP. Keep in mind that some states may not have a plan.
SHIPs are data-driven documents and often focus on the Policy, Systems, and Environmental (PSE) work that will have the greatest impact on health. State Health Departments (SHDs) use State Health Assessments (SHA) and other reliable data sources to determine goals and priorities and track progress. As you make the case for prioritizing geographically disbursed Service members in a state’s SHIP, providing data from the Community Readiness Open Data Dashboard (password: mh-dashboard) can help support your case to the planning committee. Contacts for engaging in the SHIP and Community Health Improvement Plans (CHIP) process are discussed below.
Like State Health Improvement Plans, many local jurisdictions publish Community Health Improvement Plans. [Note: Local jurisdictions can be called counties, parishes, or boroughs.] The goals of these plans are made are often based on data from Community or County Health Assessments (CHAs). As with SHIPs, not all local jurisdictions will have a CHIP.