Executive Summary

Orange County’s Healthier Togetheris a community-wide initiative that aligns public and private resources within the public health system to improve health for allcommunities in Orange County. The initiative began in late 2012 when the Orange County Health Care Agency’s Public Health Services formed the Orange County Community Health Planning Advisory Group (Advisory Group) in order to assess the county’s health and create a community-driven plan for a healthier Orange County. The Advisory Group was composed of representatives from 21 partner organizations including health care providers, academic institutions, collaboratives, community-based organizations, and other government agencies. Orange County is located in Southern California, between Los Angeles and San Diego counties, and is composed of 798 square miles with 34 cities and several unincorporated areas. The county is home to over 3 million people and is the sixth most populous county in the nation. Orange County is a diverse region, with no single racial/ethnic group making up a majority of the population. In general, Orange County’s health fares well compared to other areas. The County Health Rankings ranked Orange County the 6th healthiest county in California. However, an assessment of the county’s health shows that real health disparities exist between different populations in the county. A key emphasis of the plan and the Orange County’s Healthier Togetherinitiative is that the health of all people, families, and communities is equally important. After its assessment process, the Advisory Group identified four priority health areas for action: 1) Infant and Child Health; 2) Older Adult Health; 3) Obesity and Diabetes; and 4) Behavioral Health and improvements for the Orange County public health system. The following pages describe the key findings, goals, objectives, and a highlighted strategy for each area.

 While almost 90% of Orange County women who gave birth in 2010 received early prenatal care, subgroups, including Latinas and younger women, were less likely to do so.  Despite health benefits to the mother and infant, less than one in five women who gave birth in 2011 exclusively breastfed their babies through 3 months after delivery.

Objective 1.1: By 2020, reduce disparities in early prenatal care by ensuring that at least 90% of pregnant women in all demographic or geographic subgroups in Orange County will receive early prenatal care. Highlighted Strategy: Improve timeliness and quality of referrals and linkages between portals of entry for low-income women and prenatal care providers.

Objective 2.1: By 2020, increase the proportion of mothers exclusively breastfeeding at 3 months by 10%. Highlighted Strategy: Maintain and disseminate a directory of lactation services in Orange County.

 By 2030, one in five residents of Orange County will be 65 or older and the county’s health system is challenged to understand and meet the needs of this growing population.  Complications from chronic conditions, lack of mobility, and elder abuse are important health concerns for older adults.

Objective 1.1: Increase early identification of conditions and safety risks that commonly affect older adults.

Objective 1.2: Reduce health complications of chronic diseases among older adults.

Objective 1.3: Reduce social isolation among older adults.

Objective 1.4: Reduce the risk for abuse and neglect of older adults.

Highlighted Strategy: Produce and disseminate Annual Wellness Visit toolkit to medical providers.

 Almost one in four Orange County adults is obese and only 56.7% of 5th graders have healthy body composition.  Rates of diabetes increased from 6.6% to 7.7% between 2003 and 2009. 7.4% of adults report having diabetes in 2011-12 (methodology changes prevent comparison to previous years).  Fewer adults are getting the recommended amount of exercise or fruit and vegetables.

Objective 1.1: By 2020, increase the proportion of children and adolescents who are in a healthy weight category and reduce disparities in subgroups with lower rates of healthy weight. Highlighted Strategy: Work with school districts and educators to explore opportunities to align priorities for health and education.

Objective 2.1: By 2020, stabilize the rates of diabetes among Orange County residents. Highlighted Strategy: Work with health care providers to increase identification of and interventions for pre-diabetes and gestational diabetes.

 Expansion of mental health services due to the Affordable Care Act and the Mental Health Parity and Addiction Equity Act will dramatically alter the system of care.  Improving understanding of behavioral health issues and services among the community and public health system is a key area for improvement.  14.9% of adults report binge drinking in the last month, a key contributor to poor health.  Community concerns about prescription drug use have increased due to prescription drug overdoses more than doubling in the past 13 years.

Objective 1.1: Improve understanding of mental health needs, gaps, and resources.

Objective 1.2: Improve provider capacity to integrate behavioral health into health assessments and services.

Highlighted Strategy: Conduct an assessment of current tools and capacities related to mental health services.

Objective 2.1: By 2020, reduce adult alcohol misuse.

Objective 2.1: By 2020, reduce prescription drug misuse. Highlighted Strategy: Assure medical providers have user-friendly resources for referrals and successful linkages.

 There are many quality programs and services within Orange

County’s public health system.  Planning and coordination efforts across the system are key areas for improvement.

Proposed Improvements: Establish a permanent advisory group to increase accessibility, coordination, use of best practices, and planning to address public health challenges.

Next steps: The Orange County’s Healthier Togetherinitiative will continue to engage stakeholders and the community in implementing this plan and optimizing health for all in Orange County.