2018 Healthy Americas Survey · 2018-12-17 · Zoning ordinances banning fast food restaurants and...

Healthy Americas InstituteNational Alliance for Hispanic Health at the University of Southern California (USC)

2018 Healthy Americas SurveyA national survey of the leadership of community-based

health and human services agencies serving Hispanic communities

Key Findings Report

Methodology available at www.HealthyAmericasInstitute.org/HAS2018Methodology

Key Findings

2

Community Health Status Leadership reports that community health status is fair to poor. Less than one in five (18%) Hispanic serving community agency leaders surveyed reported that the health of the communities they serve is good (13%), very good (3%) or excellent (2%) with 80% saying community health status is either fair (41%) or poor (39%); 2% didn’t know or did not respond.

Health Care AccessAccess to quality affordable health care is seen as the top priority for fostering healthy communities and the top action item for government, employers, and the business sector. When asked to name the three most important policies for a healthy community, a majority (58%) of surveyed agency leaders cited policies promoting access to quality affordable health care. Community agency leaders also cited making affordable health care available as the most important step for local government, employers and the business sector to take to support a culture of health in communities.

Food and HealthAccess to healthy food is a top priority for surveyed community leaders and a part of the services provided by three in four community agencies. Access to affordable and nutritious food was the second most frequently cited (20%) policy for healthy communities. The importance is reflected in the fact that 71% of organizations reported being involved in efforts to improve healthy food access with efforts focused on community food banks (42%) and nutrition education (41%).

http://www.healthyamericasinstitute.org/HAS2018Methodology


Key Findings

3

Beverage and Food Policy Community leadership supports policies to reduce prevalence of unhealthy foods in their communities, particularly for children. While a majority of surveyed community leaders support local taxes on sugar sweetened beverages (59%) support is even stronger for requiring healthy beverages in soda vending machines (77%), tax incentives to small retailers for healthy food options (76%) and banning unhealthy items from school and daycare food programs (75%).

Tobacco PolicyCommunity leaders support tobacco policies that limit youth access to tobacco and promote clean air at home and in the workplace. Surveyed leadership supports a broad range of policies to reduce tobacco use with strongest support (90%) for banning e-cigarette purchases for youth under 18, banning smoking near schools (80%), and raising age to buy tobacco cigarettes from 18 to 21 years (74%). There was also strong support for banning smoking in workplaces (76%) and multi-unit dwellings (73%). Surveyed community leaders also supported local ordinances banning pharmacies from selling cigarettes (69%).

Housing and JobsBeyond health system access, surveyed community leaders cite the importance of affordable housing and good jobs as part of a healthy community. In addition to traditional public health approaches (health services, individual behaviors, healthy eating), leaders pointed to affordable housing (35%) and good jobs and a healthy economy (31%) as important factors for a healthy community.



Key Findings

4

PartnershipsCommunity resident opinions guide agency health and human services programs, with services supported by a broad range of local agency partnerships. More than two-thirds (72%) of surveyed leaders reported getting advice in a formal way from members of the community to guide services. Other key partnerships cited included formal alliances (binding agreement and common goals and metrics) with other non-profit organizations (45%), managed care systems (41%), hospital systems (36%), and local human services agencies (35%). Other cited formal alliances were with K-12 school systems (29%), local health departments (28%), and higher education systems (27%).

Community Needs AssessmentFormal needs assessment guides program development at a majority of community agencies and is conducted in partnership with other community institutions. A majority (57%) of surveyed agencies report doing a community health needs assessment in the last five years. The majority (70%) included survey questions, focus groups, or other vehicles to assess community opinions on policy issues. A majority (70%) of assessments were conducted with partners with hospitals or medical centers (27%), universities or colleges (24%), and health departments (22%) being the most frequently cited.

Civic EngagementCommunity organizations are engaged in policy change and deliver a broad range of programs to support civic engagement of community residents. Four out of five (79%) surveyed leaders report that they have a working relationship with local elected or appointed officials in carrying out the mission of their organization. Agencies carry out a range of civic engagement activities including voter registration and information (44%), advocacy training for community members (42%), citizenship classes and information (28%), and hosting candidate forums (17%). A majority of agencies (54%) report that they are providing immigration legal services and information.



Detailed Findings• Community Health Status• Policy Opinions• Partnerships• Culture of Health


Community Health Status


2%

3%

13%

41%

39%

1%

1%

Excellent

Very good

Good

Fair

Poor

Don't know

NA

7

Health of CommunitiesFour in five non-profit leaders surveyed state the health of the communities served by their organizations is generally not good (41% fair and 39% poor). Only 13% indicate the community health is good, with very few stating excellent or very good (2% and 3%, respectively).

Q1. In general, would you say the health of the communities your agency serves is excellent, very good, good, fair, or poor? Base: Total respondents n=110



22%

29%

45%

4%

Better

Worse

Stayed about the same

Don't know

Change in Community Health Past Five Years

8

Change in Health of Communities Past Five YearsCommunity health leaders surveyed, report overall community health over the past five years has generally stayed the same (45%), or it has gotten worse (29%). Fewer than one-quarter (22%) state it has improved.

Q2. Over the past five years, what do you think has happened to the overall health of the communities your agency serves? Has it has gotten better, gotten worse, or stayed about the same?Base: Total respondents n=110



Policy Opinions


Top Three Most Important Policies for Healthy Community

Top Three

Access to health care/Quality/Affordable health care 58%

Access to food/Affordable food/Healthy/Nutritious food 20%

Health education/Information 14%

Access to/Affordable Behavioral and mental health care 12%

Access to housing/Affordable housing 11%

Access to/Affordable preventative care/Services 10%Access to venues/Opportunity for physical

activity/Exercise 10%

Education (unspecified) 10%

Access to/Affordable health insurance 9%

Jobs/Living wage jobs/Job security 9%Accommodating language/Culture when providing

medical services 8%

10

Surveyed community leaders report that the top three most important policies to have in place for a healthy community primarily focused on access to quality/affordable health care (58%), followed at a distance by access to healthy/affordable food (20%) and health education/information (14%).

Q3. What do you think are the three most important policies to have in place for a healthy community? Base: Total respondents n=110

Top Three

Access to/Affordable medications 7%

Safety/Public safety/Security 7%

Integrated care/Care coordination/Collaborative care 6%

Transportation 5%

Free health care 5%

Reduce pollution/Environmental initiatives 5%

Considering social determinants of health/Health care 4%

Walkable neighborhoods/Communities 3%

Drug and Alcohol Prevention/Policies 3%

Other 45%

Don't know 3%

NA 10%



90%

84%

80%

76%

74%

73%

69%

65%

57%

Youth under 18 should not be allowed to buy e-cigarettes

Vaping or using e-cigarettes should not be allowed in the same

public places where smoking cigarettes is not allowed

Smoking tobacco cigarettes should be banned near schools

Smoking should be banned in workplaces, including casinos,

bars, or private clubs

The legal age to buy tobacco cigarettes should be increased

from 18 to 21

Smoking should be banned in multi-unit dwellings such as

apartment complexes

City and local ordinances should ban pharmacies from selling

cigarettes

Smoking tobacco cigarettes should be banned in outdoor public

places

The price of tobacco cigarettes should be increased because it

will reduce smoking

Percent of Respondents Who Agree…

11

Smoking and Tobacco ConcernsSurveyed community organization leadership supports a broad range of policies to reduce tobacco use with strongest support focused on efforts

addressing youth focused tobacco control policies including banning e-cigarette purchases for youth under 18 (90%), banning smoking near schools

(80%), and raising age to buy tobacco cigarettes from 18 to 21 years (74%). There was also strong support for banning smoking in workplaces (76%) and

multi-unit dwellings (73%). Surveyed community leaders also supported local ordinances banning pharmacies from selling cigarettes (69%).

Q4. Thinking about not only your community, but communities throughout the country, for each of the following statements please indicate on a scale of 1 to 5 how much you agree

or disagree with it. 1 is disagree strongly and 5 is agree strongly.

Base: Total respondents n=110



59%

37%

22%

15%

18%

14%

4%

8%

Support (Net)

Strongly Support

Somewhat Support

Neutral

Oppose (Net)

Somewhat Oppose

Strongly Oppose

NA

Percent Support or Oppose Sugar Sweetened Beverage Tax

12

Support of Sugar Sweetened Beverage TaxThe majority of community leaders surveyed support local taxes on sugar sweetened beverages (59%).

Q5. Some cities have imposed a sugar sweetened beverage tax, or a soda tax, in addition to existing state taxes included in the purchase price of beverages. Thinking about not only your community, but communities throughout the country, how much do you support or oppose this type of city tax as a strategy for improving community health? Base: Total respondents n=110



77%

76%

75%

57%

50%

49%

14%

Local ordinances requiring healthy beverage options to be included invending machines that offer sugar sweetened beverages

Tax incentives to small food retailers to increase healthy food options

Policies banning unhealthy food items from school and daycare foodprograms

Local ordinances banning or limiting density of junk food advertising

Zoning ordinances that limit number of retailers in communities that donot meet a community established standard for healthy food options

Zoning ordinances banning fast food restaurants and unhealthy mobilefood vendors in a specified zone around schools

Reducing Supplemental Nutrition Assistance Program (SNAP) benefits andreplacing with direct distribution of food boxes

Percent of Respondents Who Support…

13

Strategies to Improve Access to Affordable, Healthy FoodThree-quarters or more of surveyed community leaders support the implementation of local ordinances requiring healthy beverages in soda vending machines (77%), tax incentives to small retailers for healthy food options (76%), and banning unhealthy items from school and daycare food programs (75%).

Q6. Thinking about not only your community, but communities throughout the country, how much do you support or oppose implementation of the following strategies on a scale of 1 to 5 with 1 being strongly oppose and 5 being strongly support? Base: Total respondents n=110



Yes

71%

No

19%

Don't know, 2%

NA

8%

Improving Healthy Food Access

Engaged in Improving Access to Affordable Healthy Food

14

More than two-thirds of leadership surveyed report that their organizations have engaged in efforts to improve access to affordable

healthy food in their communities. Key efforts focused on community food banks (42%) and nutrition education (41%).

Q7. Has your organization engaged in efforts to improve access to affordable, healthy food in your community?


*Multiple responses accepted, may add to more than 100%.

*

Key Efforts Currently Engaged In n=78*

Food bank initiatives/partnerships 42%

Health/Healthy food/Lifestyle education 41%

Grocery store/Farmer's market partnerships 18%

SNAP/WIC assistance 13%

Provide/Serve meals 9%

Vouchers/Financial assistance to purchase food 8%

Shopping/Cooking/Eating on a budget 6%

Community/school garden 6%

Healthy foods in vending machines 5%

Support/Partner with farms/Urban farms 4%

Provide health care/Health-related services 4%

Breastfeeding support 3%

Provide maps/Directions/Information to help locate food

sources3%

Make referrals to other organizations/programs 3%

Other 27%



Community Health Needs Assessment Participation

Yes57%

No27%

Don't know

7%NA9%

Participated in Health Needs Assessment

15

Yes70%

No21%

Don't know, 6%NA, 3%

Inclusion of Survey, Focus Groups, etc.

More than half of leadership surveyed report that their organizations have undertaken a community health needs assessment in the past five years (57%), with the majority of these (70%) including survey questions, focus groups or other vehicles to assess community opinions on policy issues.

Q8/8a. In the past 5 years has your organization undertaken a community health needs assessment? Did the assessment include survey questions, focus groups, or other vehicles to assess community opinions on policy issues?. Base: Total respondents n=110/Total respondents who conducted a community health needs assessment in the past five years n=63.

*



§ “Ours is done annually with local hospitals, outpatient providers of medial and behavioral health providers andlocal public schools and health foundations.”

§ “We conducted a survey about 6 months ago that asked participants of our Center what they believed wasneeded in terms of creating a healthy future for themselves. Many requested a diabetes class to either helpavoid becoming diabetic or how to handle being a diabetic. A popular request was how to cook healthy foodwith recipes that would include fruits and vegetables.”

§ “The needs assessment was made up of patient surveys, County, State and National data on the areas weserve. The need for education and advocacy based on cultural norms was identified. For instance, screeningsfor breast cancer for women were low. The answer for not taking advantage of free screening mammogramsgiven by some of the Hispanic women was I am afraid they might find something. When pressed for a rationalethey responded with: ‘If they find something and my breast is removed I will no longer be a complete woman.Will my husband see me different?’ “

§ “We are constantly involved in surveys which keep us abreast of conditions in our rural areas.”

§ “We conducted client surveys related to mental health needs in 2018, mental health needs related to theimpact from Hurricane Harvey in 2018, and annual surveys of refugee asylum care needs.”

16

Needs Assessment UndertakenA majority (70%) of assessments were conducted with partners with hospitals or medical centers (27%), universities or colleges (24%), and health departments (22%) being the most frequently cited. Specific comments were:

Q8b. Could you please describe in 2-4 sentences, the needs assessment undertaken, approximate date, and key partners if any (e.g. local health department, hospital system, local university, etc.)? Base: Total respondents who conducted a community health needs assessment in the past five years n=63.

*



Needs Assessment Dates & Key Partners*

Key Partners/Participants (Net) 70%

Hospitals/Medical Center 27%

University/College 24%

Health Department/Public Health Department 22%

Clinics/Community Clinics/Health Care Centers 13%

Hospital/Clinic/Health care organization/foundation 11%

Schools 10%

Local/Community organizations/Agencies 10%

Government/Local/City/County/State government 8%

Patients 6%

Stakeholders (unspecified) 5%

Non-profit organizations (unspecified) 5%

Focus groups (unspecified) 5%

Partners/community partners (unspecified) 5%

Funding agencies 3%

Other key partners responses 10%

17

Q8b. Could you please describe in 2-4 sentences, the needs assessment undertaken, approximate date, and key partners if any (e.g. local health department, hospital system, local university, etc.)? Base: Total respondents who conducted a community health needs assessment in the past five years n=63.

*

Approximate Date (Net) 49%

This year 14%

Last year 13%

Annually 10%

Two years ago 8%

Every three years 6%

Three years ago 5%

Other approximate date responses 8%




Reasons Not Undertaken Assessment*

Lack of staff/time/resources 33%

Others do health needs assessments 30%

Lack of funding/too expensive 23%

We do not provide health related services 10%

Other 20%

Don't know 7%

NA 3%

18

Why Needs Assessment Not UndertakenReasons for not undertaking a community health needs assessment in the past five years are due to the lack of staff, time, resources (33%), others do health needs assessments (30%), and lack of funding/too expensive (23%).

Q8c. Could you please describe in 1-3 sentences the primary reason that your organization has not undertaken a community health needs assessment in the past 5 years? Base: Total respondents who have not conducted a community needs assessment in the past five years. n=30 *Multiple responses accepted, may add to more than 100%.

*

Caution: Small base size.



Yes72%

No14%

Don't know4% NA

10%

Receive Advice

19

Receive Formal Advice From Members of the CommunityMore than two-thirds of leadership surveyed report that their organizations (72%) get advice in a formal way from community members to guide the organization’s programs and services.

Q9. Does your organization get advice in a formal way from members of the communities that you serve to guide your organization’s programs and services? Base: Total respondents n=110

*



§ “Patient Satisfaction Surveys are conducted every other week. We are also part of two collective impact groupsin which other organizations provide us with advice based on their client's needs. Our Board of Directors is alsovery active and provides input, direction, and guidance on provision and delivery of services based oncommunity needs.”

§ “Our Board of Directors are from each County we serve. They talk to people in the community and bring back theinformation to the whole Board who sets policy for the Center. Management implements the policy.”

§ “Our Board of Directors is involved in strategic planning and program evaluation to determine programmingneeds. Clients are surveyed to determine delivery of services. Interactions with the health community assistwith programming ideas and implementation.”

§ “We engage with community members directly and, additionally, community members and clients/patientsmake up at least 50% of our Board of Directors.”

§ “Our agency has a client advisory board that provides input. We also participate in other advisory boards andplanning bodies.”

§ “Our agency meets monthly with different community agencies to share information. The community is able toknow all the services that [our organization] provides and referrals are shared with other providers.”

20

Process Receive Advice From Members of CommunityThe process in which advice is received varies across surveyed organizations, but focuses on their own Advisory Boards, Board of Directors, as well as program member participation via surveys or focus groups. Specific comments were:

Q9a. Could you please describe in 2-4 sentences, the process in which this advice is received from community members and the impact it has on your organization’s decisions on what services to provide and how to deliver those services? Base: Total respondents who formally seek advice to guide programs and services n=79

*



21

Process Receive Advice From Members of Community

Q9a. Could you please describe in 2-4 sentences, the process in which this advice is received from community members and the impact it has on your organization’s decisions on what

services to provide and how to deliver those services?

Base: Total respondents who formally seek advice to guide programs and services n=79


*

Process in Which Advice is Received*

Other community agencies/organizations/providers 23%

Advisory Council/Committee/Board 19%

Patient/Client/Program participant/Other surveys 19%

Patients/Clients/Program participants serve on Board of Directors 17%

Focus groups 14%

Meetings/Community meetings/Town hall meetings or Community Events 14%

Community members serve on Board of Directors/committees 13%

Engage with community members directly 9%

Government agencies/organizations 8%

Board of Directors 6%

Patients/Clients/Program participants 6%

Universities/colleges 6%

Needs assessments 6%

Other non-profits 5%

Quality Committee/Quality Assurance Committee 3%

Organizations that provide us with funding/grants 3%



Reasons No Formal Process to Receive Advice Exists

Yes

72%No

14%

Don't know, 5%

NA

10%

Receive Advice

22

Why No Formal Process for Receiving Advice*(Number of mentions)

Receive advice/input from other organizations 4

Little/no interest from community in participating 3

Lack of time 2

Lack of resources 2

Other 3

Don't know 3

NA 2

Those organizations that do not have a formal process to receive advice from community members primarily state the

reasons as receive advice/input from other organizations, little/no interest from community in participating, and lack

of time or lack of resources.

Q9b. Could you please describe in 1-3 sentences the primary reason that your organization does not have a formal process to receive advice from members of the communities that you

serve?

Base: Total respondents who do not formally seek advice to guide programs and services n=15


*




Community Partnerships


Involvement with Partners

45%41%

36% 35%29%

36%

17%

34% 35% 33%

5%

15% 12% 11%19%

1%10%

4% 5% 5%

Other non-profit

organizations

Managed care systems Hospital systems Local human services

agencies

School systems (K-12)

Formal Alliance Collaboration Networking Not Involved

24

28% 27%

9% 8% 7%

41% 38% 40% 40%

26%

14% 16%

30% 29%39%

4% 5% 7% 8% 12%

Local health departments Higher education systems Local elected or appointed

officials

Employers/Business in

your community

Local media

Q10. How do you currently work with each of the following partners in carrying out the work and mission of your organization? Please select the category which best represents your

working relationship, if any, with each.


More than two-thirds (72%) of surveyed leaders reported getting advice in a formal way from members of the community to guide

services. Other key partnerships cited included formal alliances (binding agreement and common goals and metrics) with other non-profit organizations (45%), managed care systems (41%), hospital systems (36%), and local human services agencies (35%). Other cited formal alliances were with K-12 school systems (29%), local health departments (28%), and higher education systems (27%).



Desired Partnerships*

6%

6%

5%

5%

5%

4%

3%

3%

Hospitals/ hospital organizations

Governments/ Governmentagencies/ Government officials

Health care clinics/ Organizations/Agencies/ Professionals

Funding organizations/ foundations/businesses

Employers/ Businesses/ Businessorganizations

Schools/ school districts

Health centers

Health department/ Public healthdepartment

25

2%

2%

15%

2%

5%

25%

13%

4%

13%

Local media

Universities/ Colleges

Other

Want partnerships/ collaborations

Do not need additional partnershipsat this time

Not Applicable

Don't know

None/Refused

No Response

When surveyed community leaders were asked to describe a partnership that does not currently exist but would advance the mission of their organization, most frequently cited partnerships are with hospitals and government organizations, as well as Health Care clinics, foundations and business organizations.

Q11. Could you please describe, in 2-4 sentences, a partnership that does not currently exist but that would help advance the mission of your organization? If none, please click not applicable? Base: Total respondents n=110 *Multiple responses accepted, may add to more than 100%.



16%

14%

8%

8%

6%

6%

4%

4%

4%

22%

4%

6%

Lack of time/Scheduling conflicts

Cost/Funding

Potential partner not interested/Has other priorities

Currently working to establish partnerships

Lack of staff/Qualified staff

Identifying the correct contact person of potential partner

Hospitals/Medical providers not interested in assisting uninsured

Geographical separation from potential partner

Have not worked on it/Not pursued it

Other

Don't know

NA

26

Barriers to Desired Partnerships*

Barriers to these desired partnerships focus on the lack of time/scheduling conflicts and lack of funding.

Q11a. What is the primary barrier to this partnership happening? Base: Total respondents who mention partnerships that don’t exist that could advance their mission n=51 *Multiple responses accepted, may add to more than 100%.



Positive and Negative Partnerships

72% Reported Positive/Helpful Partnerships*

Hospitals/Hospital organizations 12%Clinics/Health care organizations 11%University/College 11%Government 8%Department of Health 7%Schools/School districts/Teachers 6%Community organizations 6%Mental health organizations 5%Group/Consortium/Collaborative of orgs 5%Other non-profit organizations (unspecified) 3%Media organizations 2%Law Enforcement 2%Foundations 2%Other 24%Not Applicable 8%Don't know 1%None/Refused 5%No Response 14%

27

19% Reported Negative/Disappointing Partnerships*

University/College 5%Government 4%Health care organizations/Clinics 2%Hospitals 2%Other organizations similar to ours 2%Other 5%Not Applicable 48%Don't know 15%None/Refused 5%No Response 14%

More than two-thirds (72%) of surveyed community leaders reported their organizations have experienced positive partnerships that advanced their mission, while only about one in five (19%) reported having experienced a negative or disappointing partnership that did not advance their mission.

Q12/13. Could you please describe, in 2-4 sentences, a partnership that has significantly helped advance the mission of your organization? If none, please click not applicable. / Could you please describe, in 2-4 sentences, a partnership that was disappointing and did not advance the mission of your organization? If none, please click not applicable. Base: Total respondents n=110 *Multiple responses accepted, may add to more than 100%.

*



54%

44% 42%

28%

17%

Immigration legal servicesand/or information

Voter registration and/orinformation

Advocacy training forcommunity members

Citizenship classes and/orinformation

Candidate forums orinformation on key

positions from candidates inlocal, state or national

elections

28

Services OfferedSurveyed community leaders report that their organizations carry out a range of civic engagement activities including voter registration and information (44%), advocacy training for community members (42%), citizenship classes and information (28%), and hosting candidate forums (17%). A majority of agencies (54%) report that they are providing immigration legal services and information.

Q14. Could you please indicate if your organization in the past 24 months has or is providing any of the following services in your community? Base: Total respondents n=110



20%15%

5%17%

13%5%

8%8%8%

7%5%

3%3%

37%3%

15%2%

5%

Legal (Net) Legal aid/Legal services/Legal advocacy orgs.

Private attorney/Law firmReligious Organizations (Net)

Catholic churches/Catholic Charities Other churches/Religious organizations

Local/Community agencies/Orgs./ResourcesMexican Consulate/Embassy

National organizationsGovernment Offices (Net)

Government immigration offices Government/Government officials

Immigration organizationsOther

Many/Too many to listNot Applicable

Don't knowNone/No Response

29

Immigration Legal Services and/or Information*Most frequently mentioned partners regarding immigration legal services and information are legal organizations (20%), followed by religious organizations (17%).

Q14a1-14e1. Which key partner(s), if any, did you work with to provide this service? If none, please click not applicable. Base: Total respondents who provide immigration legal services/information n=60 *Multiple responses accepted, may add to more than 100%.



31%

15%

15%

4%

2%

13%

4%

2%

2%

29%

2%

17%

6%

6%

Government Offices (Net)

Government/Government officials

Government voter registration office/Officials

Department of Health and Human Services

Government immigration offices

National organizations

Local/Community agencies/Orgs./Resources

Other churches/Religious organizations

Legal aid/Legal services/Legal advocacy orgs.

Other

Many/Too many to list

Not Applicable

Don't know

None/No Response

30

Voter Registration and/or Information*Most frequently mentioned partners regarding voter registration and/or information are primarily government offices (31%), followed at a distance by national organizations (13%).

Q14a1-14e1. Which key partner(s), if any, did you work with to provide this service? If none, please click not applicable. Base: Total respondents who provide voter registration/information n=48 *Multiple responses accepted, may add to more than 100%.




15%

11%

9%

4%

4%

4%

28%

17%

7%

15%






HIV/AIDS organizations

Other

Not Applicable

Don't know

None/No Response

31

Advocacy Training for Community Members*Most frequently mentioned partners regarding advocacy training for community members are other local community agencies (15%) and national organizations (11%), as well as government officials (9%).

Q14a1-14e1. Which key partner(s), if any, did you work with to provide this service? If none, please click not applicable. Base: Total respondents who provide advocacy training n=46 *Multiple responses accepted, may add to more than 100%. Caution: Small base size.



16%

16%

10%

6%

6%

26%

10%

19%





Universities/Colleges

Other

Not Applicable

None/No Response

32

Citizenship Classes and/or Information*Most frequently mentioned partners regarding citizenship classes and information are government officials (16%) and local agencies (16%), followed by national organizations (10%).

Q14a1-14e1. Which key partner(s), if any, did you work with to provide this service? If none, please click not applicable. Base: Total respondents who provide citizenship classes/information n=31 *Multiple responses accepted, may add to more than 100%. Caution: Small base size.



37%

32%

5%

11%

5%

42%

5%

16%

5%

Government Offices (Net)


Government voter registration office/Officials



Other

Many/Too many to list

Not Applicable

Don't know

33

Candidate Forums/Candidate Info/Election Services*Most frequently mentioned partners regarding candidate forums, information and election services are government offices (37%), followed at quite a distance by national organizations (11%).

Q14a1-14e1.Which key partner(s), if any, did you work with to provide this service? If none, please click not applicable. Base: Total respondents who provide candidate forums/information/election services n=19 *Multiple responses accepted, may add to more than 100%.




Culture of Health


65%35%

32%31%

30%15%

11%10%

9%6%6%

5%4%

1%1%

13%

Access to health care servicesAffordable housing

Access to healthy foodsGood jobs and healthy economy

Healthy individual behaviors and lifestylesLow crime/safe neighborhoods

Strong family lifeGood schools

Civic engagement (voting, com. org., group activism)Parks and opportunities for physical activity

Transportation (affordable public trans., bike lanes, sidewalks)Clean environment

Good relationships between different culturesReligious or spiritual values

OtherNA

35

Important Needs for Any Healthy Community NationwideThe primary factor of importance for a healthy community stated by surveyed community organization leaders is access to health care services (65%). Secondary factors stated by these agency leaders for a healthy community are affordable housing (35%), access to healthy foods (32%), good jobs and healthy economy (31%) and healthy individual behaviors and lifestyles (30%).

Q15. Thinking not only of your community, but communities throughout the country, in the following list, what do you think are the three most important factors for a healthy community? Base: Total respondents n=110



Steps by Organizations Local Government Philanthropy Employers & Business Sector

Affordable/Accessible health care 14% 5% 15%

Seek input/involvement from the community 10% 3% 1%

Promote healthy lifestyles 9% 5% 8%

Partner with/Support/Fund community organizations 4% 10% 1%

Partner with non-profit groups 3% 5% 3%

Equal treatment/cultural sensitivity 3% 2% --

Invest in education 3% 2% --

Affordable housing 3% 1% 1%

Safety/Safe environment/Safe work environment 3% -- 1%

Support/Fund community health clinics/centers 2% 6% --

Provide areas for exercise 2% 3% 1%

Good transportation system/options 2% 1% --

Support/Fund health education 1% 4% 1%

Access to healthy foods 1% -- 2%

36

Steps by Organizations to Support Culture of HealthSurveyed community organization leaders cited making affordable health care available as the most important step for local government, employers and the business sector to take to support a culture of health in their community.

Q16/17/18. A Culture of Health is broadly defined as one in which good health and well-being flourish across geographic, demographic, and social sectors; fostering healthy equitable communities guides public and private decision making; and everyone has the opportunity to make choices that lead to healthy lifestyles. Given that definition what is the most important step that (local government/philanthropy/employers and business sector) could take to support a culture of health in your community?Base: Total respondents n=110

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Steps by Organizations Local Government Philanthropy Employers & Business Sector

Fund operating costs/provide sustained funding -- 5% --

Invest in the community -- 4% --

Prevention/preventive care -- 2% 2%

Pay higher/fair/living wages -- -- 5%Provide wellness programs for employees -- -- 5%

Provide work-life balance for employees -- -- 5%

Partnerships/Collaborations (unspecified) -- -- 4%

Hire local workers -- -- 3%

Other 15% 20% 20%

Don't know 9% 5% 5%

None/Refused 16% 17% 17%

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Steps by Organizations to Support Culture of Health, Cont.Surveyed community organization leaders cited making affordable health care available as the most important step for local government, employers and the business sector to take to support a culture of health in their community.

Q16/17/18. A Culture of Health is broadly defined as one in which good health and well-being flourish across geographic, demographic, and social sectors; fostering healthy equitable communities guides public and private decision making; and everyone has the opportunity to make choices that lead to healthy lifestyles. Given that definition what is the most important step that (local government/philanthropy/employers and business sector) could take to support a culture of health in your community? Base: Total respondents n=110

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Methodology Statement

§ Survey: The 2018 Healthy Americas Survey of Hispanic Serving Health and Human ServicesOrganizations is an initiative of the Healthy Americas Institute of the National Alliance for HispanicHealth at the University of Southern California (USC) Keck School of Medicine.

§ Fielding: The survey was conducted by SSRS via an online methodology. The principal executiveleaders of 470 organizations received personal requests to participate in the online survey. Thesurvey was piloted from August 14 to August 26, 2018 with full fielding (English and Spanish) August27 to September 19, 2018.

§ Participation rate: A total of 110 organizations accepted the survey invite (92 completing and 18partial completions) for a 23.4% participation rate. The 110 organization respondents represented atotal of 673 program sites delivering services to 3.8 million people annually.

§ Support: The survey received support from the Healthy Americas Foundation. Support was alsoprovided in part by the Robert Wood Johnson Foundation (RWJF). The views expressed here do notnecessarily reflect the views of RWJF.

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The Healthy Americas Survey is an initiative of theHealthy Americas Institute of the National Alliance for Hispanic Healthat the University of Southern California (USC)

Contact

Adolph P. Falcón

[email protected]

Director, Healthy Americas Institute

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