Guest Post: Dr. LaQuandra Nesbitt – “Improving health is everyone’s work!”

November 20, 2013
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The Greater Louisville Project’s report on health affirms what we’ve known and been working to address through the efforts of our Center for Health Equity and the Mayor’s Healthy Hometown Movement for some time now.    Improving health is everyone’s work!  There is more to health than health care.  When we improve social factors such as education, income, nutrition, housing, and neighborhoods we improve health overall.

Some of our ongoing efforts to build Louisville’s capacity for health include:

  • Restructuring the Mayor’s Healthy Hometown Movement to include a Leadership Team made up of Louisville Metro department directors as well as leaders from key community organizations such as JCPS, TARC, and the Housing Authority to implement a “health in all policies” approach
  • Creating a Healthy Hometown Community Coalition to provide input for a community-wide, community-led plan for improving Louisville’s health outcomes
  • Implementing voluntary smoke free playgrounds and spray grounds in three Metro Parks (Shawnee, Iroquois, Cherokee)
  • Repurposing vacant and abandoned properties, especially for use as community gardens
  • Committing funds for 28 new miles of bike lines in the city’s core, extending the network of bike lanes to encourage more biking for transportation as well as recreation
  • Continuing to expand the Louisville Loop to provide many kinds of physical activity opportunities for residents across Jefferson County
  • Improving nutrition by increasing the number of farmers markets that accept WIC, EBT or SNAP benefits
  • Growing our Farm to Table efforts to improve economic development as well as connect more people to locally grown, healthy, fresh food
  • Launching a more aggressive employee wellness program for Metro employees including a surcharge for smokers and the launch of an Employee Wellness Center to encourage wellness, improve health behaviors, and cut healthcare costs
  • Implementing Healthy Corner Stores in partnership with the YMCA  to improve access to fresh, healthy food
  • Continuing and expanding events such as the Hike, Bike and Paddle and the Mayor’s Fall Hike to correspond with the KentuckyOne Health Four De Lis Classic
  • Launching the Healing Futures Fellowship, a six-week summer program that brings together youth ages 15 to 18 from all areas of Louisville to work together and explore differing views of race, class, culture, gender and equity as lenses for understanding and identifying solutions to prevention of injury and violence as a public health issue

We’re doing some great work in our quest to become one of the healthiest cities in the country.  We know we have much more to do.  I invite you to join us.  Get involved in the Mayor’s Healthy Hometown Movement Community Coalition by contacting Leanne French at 574-6222.  Learn more at www.louisvilleky.gov/healthythometown. Follow us on Facebook at www.facebook.com/healthyhometown1 and Twitter @LouMetroHealth.

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Natural Breaks Algorithm

For each indicator, Greater Louisville Project assigns cities into one of three groups (high-performing, middle-of-the-pack, and low-performing) based on how they compare to other cities. The assignment is based on how cities naturally cluster on that indicator. Sometimes, the differences between cities are very small, and the difference between a city ranked 5th and 6th could simply be a matter of the sampling error that arises from using survey data. Thus, rather than always make a division that declares the top 5 to be the top tier, we use a natural breaks algorithm to look for a cluster of cities that is outperforming the rest, a cluster that is about average, and a cluster that is lagging. This clustering gives us a better indication of where Louisville is thriving and where Louisville has room to learn from cities that are doing better.

Z-Scores

Z-scores (or standardization) is a way to combine data with different units of measurement into a single index. The z-score is a measure of how far away a city (or census tract, etc.) is from the average city. In order to be comparable across different units of measurement, the z-score is the distance from the mean measured in standard deviations (e.g. if Louisville has a z-score of 1 it means Louisville is 1 standard deviation above the mean of its peer cities).

Data from the Robert Wood Johnson Foundation's County Health Rankings use z-scores and all z-scores are relative to the mean of Louisville's peer cities. (On the County Health Rankings site z-scores are relative to all the counties in each state - thus z-scores reported by GLP will be different, because we are using a different reference group). The Greater Louisville Project also uses z-scores in our multidimensional poverty index, which compares each census tract to the mean of all census tracts in Louisville.