INSIGHT & INSPIRATION FROM APHA’S 2012 MIDYEAR MEETING

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Survive All In This Friends Prevention, Strategies
& Thrive Together For Health Opportunity & Equity for Health
A State’s Perspective
“Decimated” is the word session presenter Frances Phillips used to describe her state’s public
health budget during the last five years. The cuts have been terrible for local health departments
and hundreds of jobs have been lost, reported Phillips, deputy secretary for public health
at the Maryland Department of Health and Mental Hygiene. But instead of pulling back, Maryland’s
public health community is quickly adapting to the new environment and making real
progress toward improving health as well as health care — and it has “nothing to do with the
budget,” Phillips said.
“What is happening locally now is truly phenomenal,” she said. “And that’s really where people’s
lives change and where health happens.”
Phillips reported on three areas that are helping Maryland public health workers do “more
with less.” The first is building collaborative relationships and embedding public health goals
into momentum already happening at the community level. As of summer 2012, 17 local health
improvement coalitions were working within a new framework created by Maryland’s recently
launched State Health Improvement Process. The process marshals energy around 39 health
objectives and sets short-term health improvement targets to be met by 2014. Phillips said
that each goal must be backed up with locally available data, noting that it’s not good enough to
reference state-level data “unless we can break it down locally where the health improvement
action happens.”
The state health department assists local coalitions by providing localized data, hosting a
convening website and supporting the role of the local health officer in chairing the coalitions.
Phillips emphasized that the state health department had zero funding to take on the coalitionbuilding
endeavor. But the department capitalized on a “mutual understanding” with hospitals
about the role that community prevention plays in helping hospitals come into compliance with
ACA directives on quality care. It eventually led to the state hospital association providing about
half a million dollars in start-up funds for local health improvement coalitions.