The Duke Endowment has been a longtime supporter of statewide health improvement efforts.
In 2008, for example, the Endowment helped support a task force to research and study ways to improve public health by focusing on prevention. Led by the North Carolina Institute of Medicine, the task force examined underlying causes of death and morbidity, looked at systemic health disparities in the state and recommended dozens of prevention strategies to address root causes of poor health.
Based on the findings, the North Carolina Division of Public Health produced Healthy North Carolina 2020, a list of 13 key prevention focus areas for the state. They include promoting healthy eating, physical activity, prevention of obesity and education about chronic diseases. This effort continues today with the funding of Healthy North Carolina 2030, which reinforces the importance of healthy behaviors.
In South Carolina, the Endowment has supported Alliance for a Healthier South Carolina, a coalition of more than 50 executive leaders from diverse organizations working together to ensure that all people in the state have the opportunity to have healthier bodies, minds and communities. Live Healthy South Carolina, the current State Health Improvement Plan, highlights the importance of addressing chronic disease.
The Duke Endowment launched its Healthy People, Healthy Carolinas (HPHC) Initiative in 2015 to help communities in North Carolina and South Carolina address chronic health issues such as obesity, diabetes, and heart disease.
The Endowment recognizes that health and well-being are created and sustained not through individual and clinical efforts alone but through the cooperation and support of the extended local community. Shaped by the Division of Public Health’s 2020 objectives to reduce obesity and chronic disease, the initiative brings together diverse leaders to implement programs and policies that promote healthy behaviors through a collective impact model. Through this mutual work, opportunities to engage in physical activity and healthy nutrition become more prevalent in the places where people spend time, such as child care, school, work, church and recreation.
Healthy People, Healthy Carolinas began with coalitions in five North Carolina regions that have currently received seven years of funding. There are 24 coalitions in North Carolina and South Carolina. As the first cohort of coalitions becomes self-sustaining, the Endowment plans to add additional coalitions across the Carolinas. The Endowment has, to date, invested $18.6 million in the coalitions. The local coalitions engage leaders from a wide spectrum of area organizations in aligning existing programs and developing ways to help residents get involved in improving their health.
Healthy People, Healthy Carolinas builds on those successful efforts by targeting resources to communities with considerable health needs and the proven ability to take on local challenges. The model will help those communities tackle complex social problems to stimulate sustained improvement in population health.
The program is designed to support coalitions through collective impact and to enhance community capacity to implement evidence-based and informed interventions. Performance metrics will be monitored throughout to help the coalitions improve and learn.
Program goals include:
- Increase the number of highly effective community coalitions
- Increase the number of health-promoting programs adopted in communities
- Increase the adoption of policies by government and non-government agencies that promote health
- Increase the community infrastructure necessary to engage in healthy behaviors
- Increase the number of organizational changes that make the healthy choice the easy choice
- Increase the number of community residents engaged in health-promoting activities
- Document the impact of health improvement efforts
Data about the HPHC coalitions, their interventions and outcomes are publicly available and can be found at the Duke Endowment HPHC online dashboard.