C8 How Do We Move Collaboration Upstream?_Vanessa Parlette

How Do We Move Collaboration Upstream?

Building Strategies Together June 5, 2014 Prevent More to Treat Less

CFPC Conflict of Interest

Disclosure of Commercial Support Presenter Disclosure Presenter:

Vanessa Parlette, Phd Project Manager, City of Hamilton PHS Jennifer Vickers-Manzin, RN MEd Program Manager, City of Hamilton PHS Keyna Bracken, MD Assistant Professor, McMaster University Physician Director, Maternity Centre of Hamilton

Relationships with commercial interests: • • • •

Grants/Research Support: Speakers Bureau/Honoraria: Consulting Fees: Other:

None None None None

Outline Low Birth Weight in Hamilton Taking Action as a Community Collaborating Upstream

Motivation: Low Birth Weight in Hamilton “Of the 20 neighbourhoods in Ontario with the worst rates of low birth weight babies, three of them are in the former City of Hamilton” • • • •

Hamilton’s citywide LBW rate: 6.5% Canada LBW rate: 6.2% Ontario LBW rate: 6.6% Code Red: Inner city neighbourhoods see rates above 7.1%, seven above 10% • Complex SDoH, lower SES, high inequity

Determinants of Health and Low Birth Weight

Social Disadvantage

LBW Risk Factors • Low Income • Smoking • Stress • Mom Age <20 or >35 • Poor Nutrition • Drugs; Alcohol • Low Education • Fetal Growth Restriction LBW Impacts • Higher costs and risk at birth • Risk of long-term chronic health problems • Impaired brain and physical development

Taking Action as a Community: The Healthy Birth Weights Coalition

Strengthening Our Community by Supporting Healthy Lives and Healthy Relationships for Moms, Babies, and Neighbourhoods

Public Health and Primary Care  PHS and Maternity Centre of Hamilton, moving in

together  One-stop hub of care and services  Integration of perinatal supports  Collaboration with PHS, Family Health Teams, Hospitals, Community Organizations, and School Boards

Local Data FSA

LBW

Low Income

Smoking during preg.

<20 Smoking during preg.

Age <20

No Prenatal in 1st Tri (1st time moms)

No prenatal classes (1st time moms)

L8M

8.6

24.5

27.3

32.4

12.3

9.5

74.7

L8L

7.9

28.6

35.5

33.3

12.1

12.1

71.7

L8K

7.6

14.7

20.4

48.2

6.7

6.5

70.9

L8H

7.6

21.3

29.5

37

8.1

9.6

63.2

L8N

7.2

33.7

29.2

44.4

8.7

9.9

74.7

City

6.5

14.0

16.7

40.1

4.8

6.3

63.2

LOR

5.6

4.0

7.4

28.6

…

3.7

49.2

L8T

5.1

10.3

17.3

16.5

…

6.2

59.7

L8S

4.9

19.2

15.5

14.1

…

6.2

59.7

Target Priorities

3 Priority Strategies 1. Care Pathway for Young Parents

2. Professional Education

3. Smoking Cessation Supports

Care Pathway

Prof Ed Smoking Cessation

Improve Collaboration Strengthen System

Best Possible Care

Teen Pregnancy Prevention

Target Risk: Smoking, Teen Pregnancy, Education and Supports

LBW

Reduce LBW Risk

Structure of Coalition and Work Groups

Current State of Collaborative Impact  Broad base of local multi-sector partners  Supportive local context  Strategic City Initiative  Media attention on SDOH  LHIN Priorities; Health Links

 Collaborative strategic priorities  Shared goals  High potential to impact local system and experience of

care

Barriers to Moving Upstream  Leadership changes  Complexity  Code Red Stigma  “Too many tables” –competing priorities  Funding models  Upstream initiatives less measurable  Federal and provincial austerity

Think Tank What actions and strategies can we take to break past those barriers and move collaboration upstream?

• Leveraging Partnerships • Overcoming system and institutional barriers • Models of collaboration

Letâ&#x20AC;&#x2122;s Talk

Vanessa.parlette@hamilton.ca Jennifer.vickers-manzin@hamilton.ca bracken@mcmaster.ca