Healthier Communities Initiatives

YMCAs are known for their ability to bring people together every day to generate solutions for challenges facing communities across the nation. The community development efforts of YMCAs over the years have initiated important community programming and activities, such as the YMCA’s commitment to parent-child programs, youth in government programs, day and summer camps, and child care and afterschool care. Through its health and well-being programs, the YMCA is a major player in the health promotion and chronic disease prevention revolution that is saving lives, improving health and reducing health care costs. Every day, YMCAs lead community efforts to build understanding and respect for others by bringing together people of diverse ages, races, religion, abilities and incomes.

The urgent challenge facing children, their caregivers and adults to find healthier lifestyles demands a fundamentally new and aggressive social response. This response requires: 1) mobilizing community leaders who have influence on children, adults, families and the greater community; 2) engaging representatives from all sectors to break down silos and come together for a coordinated approach, utilizing diverse assets within the community; and 3) influencing and activating policy and environmental changes at community and state levels with the greatest potential to impact health and create sustainable and healthy living environments.

To effectively stem the tide of overweight and obesity among young people and adults, we need to ensure leaders from diverse sectors are engaged to leverage their clout and decision-making authority to activate change at local and state levels. YMCA of the USA’s (Y-USA) Activate America® Healthier Communities Initiatives are helping more than 100 YMCAs and their communities take the action needed to increase opportunities for physical activity and healthy eating.

• Y-USA’s Healthier Communities Initiatives
• Pioneering Healthier Communities
• Lessons Learned
• National Experts Help Shape PHC
• Statewide Pioneering Healthier Communities
• ACHIEVE: Action Communities for Health, Innovation and EnVironmental ChangE

Y-USA’s Healthier Communities Initiatives

Y-USA’s Healthier Communities Initiatives focus on collaborative engagement with community leaders, how environments influence health and well-being, and the role policy plays in sustaining change. In addition, these initiatives empower local communities with proven strategies and models to create and sustain positive, lasting change for healthy living. 

Y-USA’s three Healthier Communities Initiatives are:

• Pioneering Healthier Communities (PHC, launched in 2004)
• Statewide Pioneering Healthier Communities (Statewide PHC, launched in 2009) 
• Action Communities for Health, Innovation and EnVironmental ChangE (ACHIEVE, launched in 2008)

Key principles are common to all three initiatives:

• High-level community leaders are involved at every step, utilizing their positions, influence and ability to make changes within their organization and within the greater community.
• Multiple sectors and diverse organizations are involved to maximize experience, assets, resources and skills.
• The ultimate goal is to influence policy and environmental changes to improve community environments.
• Local initiatives are organically grown with strategies specific to the needs of each community.
• YMCAs serve as conveners in the community and co-leads with partners.

Through these initiatives, community leaders—such as public health officials, mayors and city council members, city managers, state legislators, transportation and education officials, voluntary health/disease group partners, hospital executives, philanthropic foundation leaders, presidents of local businesses, leaders from faith-based community organizations, professors and chairs of academic institutions and executives of chambers of commerce—have an opportunity to collectively influence opportunities for residents in their community to be healthier through the planning and implementation of evidence-based strategies that influence policies and environmental changes that support healthy living.

Currently, 101 YMCAs and their communities are participating in these initiatives. In 2009, Y-USA plans to expand these initiatives to an additional 31 YMCAs and their communities. Participating communities represent a variety of sizes (urban, rural, suburban), hard-to-reach populations (low-income, underserved, and racial and ethnic populations), geographic diversity and committed leadership at the community level, including strong YMCA leadership and presence.  

Participation in Healthier Communities Initiatives builds healthy spirit, mind and body for all by:

• Enhancing the importance of a healthy lifestyle.
• Building relationships within communities by focusing on the leading health issues facing this country.
• Strengthening the capacity for coalition-building communities.
• Attracting a new set of volunteers to the effort to build a healthy community.
• Increasing the community’s ability to promote policy and environmental changes that encourage and support healthy living, such as:

• Increasing access to and use of attractive and safe locations for physical activity.
• Developing supportive environments to complement and support individual and family efforts to make healthy decisions.
• Providing all students adequate opportunities for physical activity before, during and after school through recess, intramural activities and other offerings.
• Influencing worksite policies and implementing worksite wellness programs.
• Increasing healthy food choices in restaurants, grocery stores, worksites, schools and other community settings.
• Increasing the locations and hours of farmers’ markets and making fresh fruits, vegetables and community gardens more accessible for community members.
• Influencing policies such as those that impact the availability of sidewalks and countdown cross signals in neighborhoods and of fruits, vegetables and whole grain foods in school lunches.
• Reducing the disparities in health and access to opportunities for physical activity and healthy eating in low-income communities.

Pioneering Healthier Communities™

Y-USA launched Pioneering Healthier Communities (PHC), the signature initiative of Activate America that focuses on policy and environmental change in communities to promote healthy lifestyles, in July 2004. With support from the Centers for Disease Control and Prevention (CDC) and corporate and foundation donors, 81 communities are participating, and an additional 15 YMCAs and their communities will be selected in 2009. 

Building on National Efforts That Promote Healthy Communities

PHC was modeled after three major national initiatives: 1) Steps Communities, funded by CDC; 2) Racial and Ethnic Approaches to Community Health, funded by CDC; and 3) Active Living by Design, funded by the Robert Wood Johnson Foundation. These national initiatives have provided resources to communities to enable them to encourage and support healthier living through innovative and effective community-based health promotion and disease prevention efforts. Y-USA served as the national partner for the 40 Steps communities, helping build strong partnerships between YMCAs and the communities in order to promote better health and prevent disease. For additional information on Y-USA’s Steps national partnership, please go to: http://www.ymca.net/activateamerica/activate_america_partnerships.html.

The traditional PHC model has been the basis for the development of the state/local model of Pioneering Healthier Communities, funded by the Robert Wood Johnson Foundation. ACHIEVE was inspired, in part, by the traditional PHC model.

Goals of PHC

• Develop community-level policy and environmental change strategies that increase opportunities for physi­cal activity and healthy eating.
• Raise awareness and strengthen the framework for com­munity-wide and national movements among all sectors of society to reverse the trends in physical inactivity, poor nutrition, obesity and other chronic conditions.
• Strengthen community capacity to initiate and sustain promising practices for healthy communities.
• Utilize mechanisms and strategies to transform healthy community principles into practice.
• Identify cost-effective, practical and sustainable solu­tions and tools that teams can replicate to educate and mobilize communities to make sustainable changes that support healthy living.
• Build complementary community, state and national efforts by implementing policy and environmental change strategies for all sectors to increase support for healthy living.

PHC teams are:

• Making available to community members high-quality fresh fruits and vegetables for purchase at 40 percent of the market price.
• Working with corner stores in low-income areas where grocery stores don’t exist to provide fresh fruits and veggies.
• Improving walkability infrastructure by building new or enhancing existing walking/biking trails and sidewalks or influencing master plans for cities.
• Influencing schools and worksites to change their food contracts and vending and meeting policies.

Pioneering Healthier Communities is funded mostly through an annual appropriation of $2.5 million from the Centers for Disease Control and Prevention (CDC).

Lessons Learned

Great lessons and strides have been made in the communities participating in PHC. The initiatives described in the report below illustrate advances in creating awareness, providing opportunities and removing barriers to healthier lifestyles. They may serve as models, and as inspiration, for future PHC teams and others committed to healthier communities.

• PHC Lessons Learned Report (PDF)

National Experts Help Shape PHC

Y-USA wants to replicate models and help communities implement policies that work and, therefore, is partnering with successful national experts to better understand the best evidence and strategies for improving opportunities for healthy lifestyles. In 2008, Y-USA formed the Healthy Communities Roundtable, designed to enhance national-level partnerships by bringing leading organizations together to actively participate as an advisory board and technical assistance providers to community teams around the country. The roundtable promotes community team efforts to activate policy and environmental change strategies by providing expertise in relevant areas to effectively guide teams towards their goals. The roundtable is headed by Y-USA, and members include the following federal agencies, foundations and national organizations:

Action for Healthy Kids	National Governors’ Association
Active Living by Design	National League of Cities
Alliance for a Healthier Generation	National Park Service
American Hospital Association	National Recreation and Park Association
American Planning Association	Partnership for Prevention
Centers for Disease Control and Prevention	Robert Wood Johnson Foundation
Directors of Health Promotion and Education	Save the Children
Food Research Action Center	Society for Public Health Education
National Association of Chronic Disease Directors	Stanford Prevention Research Center
National Association of County and City Health Officials	Trust for America’s Health

Statewide Pioneering Healthier Communities

Y-USA received funding from the Robert Wood Johnson Foundation to launch a PHC policy change initiative in six states and 32 communities over a period of five years. The aim of this initiative is to address the childhood obesity epidemic through policy and environmental changes that will have implications for communities, states and the nation.

Goals of the Statewide PHC Initiative

• Build capacity of 32 YMCAs and communities to develop and implement policy, environmental and systems changes locally and statewide.
• Utilize data to identify and measure opportunities for physical activity and healthy eating in areas that impact the daily lives of children, including using the Community Healthy Living Index tool, which will facilitate discussion and assist teams in determining their plan of work.
• Build and enhance collaboration among other statewide organizations in the identified six states in support of developing/implementing policy, environmental and systems change strategies statewide.
• Create a learning environment within each YMCA State Alliance for local community teams to share best/promising practices and community tools.
• Maximize communication opportunities to disseminate best practices and lessons learned so other stakeholders can leverage the project’s success.
• Increase physical activity and/or physical education and/or healthy food policy, environmental and systems change strategies statewide to reduce childhood obesity.

Differences between PHC and Statewide PHC

Like the traditional PHC initiative, Statewide PHC communities form teams of leaders that collectively influence opportunities for their community members to be healthier through the planning and implementation of policy and environmental change strategies. Statewide PHC and traditional PHC teams formulate a Community Action Plan consisting of goals and associated activities designed to make their communities healthier. 

The key distinction between Statewide PHC and the traditional PHC initiative is the added component of the State Action Plan, and the organization and coordination of funded PHC teams in the chosen states to support the state plan. In addition, the Statewide PHC model focuses exclusively on childhood obesity and the associated risk factors. 

ACHIEVE: Action Communities for Health, Innovation and EnVironmental ChangE

The Action Communities for Health, Innovation and EnVironmental ChangE (ACHIEVE) initiative was launched in 2008 to support local health departments and YMCAs in advancing community leadership as part of national efforts to prevent chronic diseases and related risk factors. ACHIEVE was inspired, in part, by PHC. ACHIEVE is meant to build on the success of PHC as well as formalize the relationships among YMCAs, local and state health departments, parks and recreation departments and other community-based organizations.  ACHIEVE is supported by the Centers for Disease Control and Prevention (and is a partnership involving the National Association of Chronic Disease Directors, the National Association of County and City Health Officials, the National Recreation and Park Association and Y-USA.

The purpose of ACHIEVEis to bring together local leaders and stakeholders to develop and implement policy, systems and environmental change strategies that can help prevent or manage health risk factors for heart disease, stroke, diabetes, cancer, obesity and arthritis. Risk factors such as tobacco use and exposure, insufficient physical activity and poor nutrition contribute greatly to the development and severity of many chronic diseases.

ACHIEVE fosters collaborative partnerships among city and county health officials, city and county government, tribal programs, parks and recreation departments, YMCAs, local health-related coalitions and other representatives from the school, business, health and community sectors. State departments of health are also available to provide state-based resources and information as well as linkages to other partners to help communities meet their goals.   

The ACHIEVE model capitalizes on the experience and expertise of national organizations in strengthening community leadership, building capacity and activating change. Establishing partnerships with national organizations to implement policy, systems and environmental changes is an efficient and effective mechanism for achieving chronic disease prevention and health promotion goals in communities.

Objectives of ACHIEVE

• Develop a cross-sector Community Health Action and Response Team, consisting of approximately 12 local leaders.
• Conduct a local assessment of policy, systems and environmental change strategies.      
• Develop a Community Action Plan (CAP) focused on policy, systems and environmental change strategies.
• Implement the CAP in each ACHIEVE community.
• Increase collaboration among and between partners on the local, state and national level.
• Identify the impact of ACHIEVE in each community.

Differences between PHC and ACHIEVE

Like PHC, ACHIEVE communities form teams of leaders that collectively influence opportunities for their residents to be healthier through the planning and implementation of policy and environmental change strategies. PHC and ACHIEVE teams formulate a CAP consisting of goals and associated activities designed to make their communities healthier. 

The key distinction between PHC and ACHIEVE is that ACHIEVE not only focuses on the health risk factors of physical inactivity and poor nutrition (like PHC), but it also expands the policy focus to address tobacco use and exposure and include strategies that can help prevent or manage health-risk factors for heart disease, stroke, diabetes, cancer, obesity and arthritis. In addition, the ACHIEVE initiative is a partnership involving CDC and three other national partners. As such, this initiative can build upon the expertise and technical assistance offered by various organizations.