Located just north of the city of Seattle, Snohomish County is the third most populous county in Washington, technically part of the Seattle Metropolitan Area. The county is one of the fastest growing in the nation and boasts a strong economy. While the majority of residents are white, there is a fair amount of diversity, and almost 20% of the population speak a language other than English.
A strong economy doesn’t equate a lack of health challenges. While Snohomish County is home to one of the largest aerospace and advanced manufacturing sectors in the nation, it is also home to some of the most marginalized and underserved communities. Population is rising rapidly – the northeast region of the county including the cities of Arlington and environs are expected to be among the fastest growing areas of the state. Snohomish County traditionally has been relatively “young” but will be at parity with the rest of Washington State by mid-2020s – the age wave is being felt with particular impact. Suicide rates are above norms; the ratio of mental and behavioral health providers to population is very low.
In 2013, leaders from a variety of community sectors wanted to improve the health of the community and launched the Snohomish County Health Leadership Coalition, which leverages its leadership accountability and combined expertise to address the challenge of delivering sustainable healthcare. In 2015, the Providence Institute for a Healthier Community (PIHC) was formed, and became the backbone support organization to the SnoCo Health Leadership Coalition. The SCHLC and PIHC are working on a range of innovative partnerships to improve overall health and well-being of the community.
The coalition built a foundation for LiveHealthy2020, which engages a broad cross-section of partners around a common focus to improve the health and economic vitality of Snohomish County. The work centered around increasing physical activity, improved nutrition, mental/emotional wellbeing and civic health. The result: a shared community vision to improve health, quality of life and competitiveness in a globalized economy. Initiatives included decreasing food insecurity, developing more walkable cities, and implementing mental health first aid. PIHC is using a strong Community-Based Participatory Research component and allowing community members to report health issues that are important to them and build a plan around that. Anchored within the healthcare system, PIHC’s focus is to improve self-reported measurable health and wellbeing by 5% over a 5-year period.
THE BRIGHT SPOT
PIHC created an annual countywide Health & Well-being Monitor survey, and is working with community partners from across sectors to administer them in English, Spanish and a growing range of languages, which has created common ways the community defines health and wellbeing, as well as a common measurement system around which to collaborate and address health needs. The local medical system has made a commitment to improve health in the community and is engaging the community to do so in a meaningful, multigenerational way. This includes systematically screening people for seven non-medical needs in the course of normal care at Providence health centers, local federally qualified health centers such as Community Health Centers of Snohomish County, and a growing number of other community partners. They’re looking to expand this model into the home-health setting, and to non medical settings. They’ve established seven outlined issue-specific leadership groups — “hubs” — who review data and determine where gaps exists and work together to fill those gaps. This model enhances cross-sector collaboration; for example, the Human Services Commission in county government is in the housing hub because they have a number of contracts with local housing groups.
Importantly, Snohomish County recognized that while you can survey adults to determine their needs, this isn’t necessarily a reliable way to assess youth needs. They’ve developed a youth council in partnership with local Boys and Girls clubs, made up of 18,000 youth; Big Brothers/Big Sisters, and a range of other organizations supporting youth including organizations connected to the City of Arlington, whose experience with a massive landslide in recent years has redefined how civic leaders approach governing. The young people were guided through a process in which they identified three priority issues affecting them: addictions (including screen addictions), bullying and violence, and relationships. The group is bringing together a score of local organizations to pledge commitment to the youth-identified needs and the youth will select one priority area in which to partner and put together resources to make change in their community.
According to the community, establishment and implementation of a community-driven, common assessment, intervention, and reassessment process has created the plumbing to be able to have a common view going forward, that hasn’t existed before. The integration of the local healthcare systems, community development organizations, local government, and more, implementing this common measurement system, is invaluable. Moving forward, the community can understand what the health needs are throughout the county and how needs differ based on geographic locations throughout the county, which in turn allows for better delivery of medical care, transportation, housing and food assistance. They’re building visibility around existing options for accessing care, tailoring options and resources based on neighborhood, and expecting improved health outcomes in the future.