Healthy By Design & By Choice

Banding together to keep our community at its best

By Sarie Mackay

What if it was easy to make the right health choices? Find the best foods, exercise several times a week, quit smoking, get help with depression – if all these were, well, a walk in the park, the world would be far different—and so would we.

The reality is that we are often met by barriers—things as deceptively simple as convenience and habit—when we even think about changing our lives for the better. Healthy by Design is a Billings-based community coalition working to change all of that, and the results of their efforts are both interesting and encouraging.

“It’s about having choices to live a long and healthy life,” says Healthy by Design Manager Heather Fink of RiverStone Health. “Put simply, our goal is to make the healthy choice the easy choice.”

Heather and her colleagues, Billings-area health professionals and a host of businesses and agencies, are creating tangible opportunities like a Gardeners’ Market on Billings’ South Side, free Active Living classes, and boosting the grocery-buying power of needy families.

The history behind this far-sighted plan to change the culture of health and the choices we make goes back to 2001, when Billings Clinic, RiverStone Health, and St. Vincent Healthcare all agreed that improving community health was a project best done together. The partnership gave birth to the Alliance, a common ground for initiating Healthy by Design. “The initial focus of the Alliance was healthy weight goals,” explains Heather, “but because of our community research and the additional goals we’ve established, Healthy by Design now has a life of its own. Through working across sectors, we can move into the areas where people live, work, play, and worship.”

THE PROGRAM’S GOALS

The Community Health Improvement Plan is the Alliance’s strategic approach. Every so often, the group will survey the community to figure out its health needs. Through that data, the CHIP targeted three urgent goals, which probably aren’t all that surprising: Healthy Weight, Access to Health Services, and Mental Health/Substance Abuse.

Since Healthy by Design was brought to life to urge the community to live with a healthy weight in mind, it launched several programs aimed at exercise and nutrition. Because of the far reaching impact of Healthy By Design’s second goal —access to health services — other groups such as the Veterans’ Administration, Rocky Mountain Tribal Leaders Council and Indian Health Services have come to the table to form a plan of attack. Heather says, all have an eye on the mission to “better serve our community’s most vulnerable patients in order to provide the right care at the right time in the right place.” The program’s third goal — Mental Health/Substance Abuse — revolves around the widespread impacts of childhood trauma. With the help of even more players at the table, Heather says they have secured funding through grants to try to educate our community on the impact that childhood trauma can have on a person’s well-being long into adulthood.

THE HEALTHY BY DESIGN IMPACT

Often, the visible evidence of progress is seen in programs and projects, but as Heather explains, “What we are really seeking is cultural and system change. Things as subtle as installing a bike rack at work can begin to influence people to make a healthy choice.” That’s why Healthy by Design places a great deal of emphasis on creating a network of partners across the area and region. Involving organizations such as United Way, Friendship House, and the Yellowstone Boys and Girls Club connects programs with city, state, and the federal government to knit ideas together for the public good.

For example in June 2011, Yellowstone County was chosen as one of 10 sites in the nation to implement the Healthy Weight Collaborative—a project aimed at achieving a healthy weight on a community level. The driving forces behind this initiative were Billings Clinic, RiverStone Health, and St. Vincent Healthcare. One of the first steps these organizations took was to incorporate body mass index (BMI) measurements and conversations about weight into patient visits. Not long afterward, a series of classes entitled Active Living Every Day was added to the roster. Those in the class teamed up and used group problem solving to find ways to fit physical activity into their day-to-day life.

Healthy by Design was also one of the most vocal groups in support of adopting the Complete Streets policy in Billings. Complete Streets are roadways built with all users in mind: drivers, cyclists, transit riders, runners or walkers. By making our streets user-friendly for all, the group feels those who live here will be more active. The community will be more vibrant and other good things like economic revitalization and better property values will follow.

One of the most colorful and exciting health opportunities created is the Gardeners’ Market. Seeing a need on Billings’ south side — especially following the closing of the Southside IGA — Healthy by Design stepped up. “We’ve made it easy for our vendors,” says Heather Fink. “There are no fees and it’s a come-when-you can approach.” A simple booklet provides vendors with basic guidelines on selling home-grown produce, eggs, and handcrafted items every Thursday from 4:30-6:30 p.m. at South Park near the corner of S. 28^th and 6^th Ave. S. “There has been a steady increase in sales over a three year period,” Heather reports. “It’s very encouraging. What the market also does is create a sense of social interaction and community partnership.” As a plus, special cost-saving features are available to needy families through the SNAP Booth (Supplemental Nutrition Assistance Program) at the Market.

THE PERSONAL CONNECTION

Krista Alden of Billings, a new mom and homemaker, learned about Active Living Every Day classes through a Montana State University-Billings cooking project. As most new moms know, it can be hard to get out of the house and fit in exercise when you have a newborn or toddler. “I wanted to find a way to get out and do some healthy activities, and also to set healthy example for my new son,” says Krista.

The Active Living Every Day Classes are not exercise classes. Instead, they teach participants how to make manageable, low-cost (or free) lifestyle changes. “Active Living Every Day simply made me think differently about my day,” says Krista. “Even in the first class, we talked about taking what’s called the Two-Minute Walk. It’s easy and it has become something I do every day, usually with my son in the stroller.” As most of us know, a short walk often gets extended because we enjoy ourselves once we get out in the fresh air or see friends in the neighborhood.

Krista also visits the Gardeners’ Market regularly, which she discovered by participating in the WIC (the Women, Infants and Children nutrition program offered through RiverStone Health’s Public Health Department) Community Garden. “We love going to the Gardeners’ Market on Thursdays,” she says. “We can get out in the community and meet people, as well as learn where our produce comes from. I also love the fact that a lot of agencies are represented and they are always ready to provide a recipe or answer questions about unusual foods.”

A PARTNER APPROACH

Although Healthy by Design has its offices at RiverStone Health, both Billings Clinic and St. Vincent Healthcare are active partners. Luke Kobold, Director of Public Affairs for Billings Clinic, says not only does the Billings Clinic financially and physically support Healthy by Design by serving on the leadership team, it shares in the work to conduct the Community Health Assessment every three years. He says, “Improving community health is a continuous effort — an ongoing process of identifying needs, designing improvements and evaluating progress. We see it resulting in a better community to live in, making Yellowstone County even more attractive to those families and businesses looking to move into our community.”

Tracy Neary, Director of Mission Outreach and Community Benefit at St. Vincent Healthcare, says helping to improve the health of our community is ingrained in the hospital’s mission, so being a part of solving some of what ails our community is just a given. She says, “Our commitment to Healthy by Design helps give life to that missional calling of improving health for all, especially those most vulnerable.” What started with just a few at the table, Neary says has grown to an investment of hundreds of hours by dozens of St. Vincent Healthcare associates, financial resources to help support paid staff, and grant writing hours resulting in millions of dollars back to our community. Neary adds, “That fact is that our community’s healthcare institutions, who provide a backbone to this work, are working together with shared vision and action to make us all healthier is something to appreciate.”

Heather Fink couldn’t agree more. “As we look at community health programs across the country, we’re pleased to note that Billings is very much ahead of the curve in its push for community collaboration.” Over the nearly 15 years that this program has been alive, it’s become clear this outreach is changing the rules when it comes to battling the most common and pressing health issues facing our community. Heather underscores that by saying, “Health isn’t necessarily something that happens in a doctor’s office. It starts long before illness or medical care comes into our lives. That’s where Healthy by Design makes a difference, providing choices for everyone to improve and sustain their health.”