The Baltimore City Health Department (BCHD) this week released a blueprint to improve health and wellness in Baltimore City with an overarching vision of reducing health disparities by half in 10 years.
The population health initiative, called Healthy Baltimore 2020, outlines four strategic priority areas around which the Baltimore health department will align existing and future programs—behavioral health, violence prevention, chronic disease and life course and core services.
Officials plan to track blood-lead levels, overdose deaths, child fatalities, healthy-food availability and other indicators year by year. Tentative targets include reducing disparities in obesity, smoking and heart disease deaths by 15 percent by 2020.
These strategic priority areas were selected based on public health data as well as input from local health experts and extensive community involvement through a series of town halls, BCHD officials said. The blueprint is guided by three values—applying the lens of race, equity and inclusion to each aspect of the agency’s work; focusing on well-being through the application of a trauma-informed care; and addressing critical issues across the city including education, criminal justice, and economic development through the lens of health.
With regard to addressing chronic disease, Baltimore health officials outlined a number of equity objectives, such as reducing the disparity between the percent of black and white residents who are obese and reducing the disparity in the mortality rate for cardiovascular disease between black and white residents. And, Baltimore officials plan to use health IT resources to address some of these issues. The city’s chronic disease prevention activities include implementing a telemedicine pilot in city schools to increase clinical and behavioral health services available to students.
The report notes that 30 percent of Baltimore children are obese or overweight, compared to 15 percent statewide and 19 percent of adults in Baltimore City have asthma, compared to a statewide average of 14 percent. Twenty-five percent of adults living in Baltimore are regular smokers, compared to a national average of 17 percent and more than 56,000 children in Baltimore City are at risk for lead poisoning.
The Healthy Baltimore 2020 report summarizes the population health challenges that the city faces, as Baltimore has one of the top five highest rates of overdose in the country. In 2015, there were 393 overdoses in the city, more than the number of homicides. Baltimore City experienced 344 homicides in 2015, the 3rd highest murder rate nationally and highest rate per capita in Baltimore’s history. More than 90 percent of homicide victims are black, more than half are 18-30 years old. And Baltimore public health officials point out that there is a 20-year gap in life expectancy between neighborhoods in Baltimore City.
In the Healthy Baltimore 2020 plan, Baltimore City Mayor Stephanie Rawlings-Blake wrote that the framework will be data-driven, based on a combination of evidence-based public health research and science, as well as collaborative, action-oriented and “upstream,” with a focus on the root causes of health disparities.
And the plan to address health disparities also will target specific populations, such as youth, behavioral health patients and the most vulnerable individuals.
“We aim to improve health, but we recognize that this is not enough. Through Healthy Baltimore 2020, we aim to cut health disparities in half over the next decade,” Baltimore City Health Commissioner Leana Wen. M.D., said in a prepared statement. “While our goal may seem ambitious, this aspiration is in fact grounded in the work that BCHD tackles each day, from comprehensive wellness services for our most vulnerable children to ensuring that seniors are able to age with dignity and respect.”
Wen said the plan builds on public health initiatives that have proven to be successful in the past two years, such as programs that have resulted in a 50-percent reduction in sleep-related infant deaths, a 32-percent reduction in teen birth rates and as well as a reduction in lead poisoning. In addition, in the past two years, Baltimore launched an aggressive opioid overdose prevention program.