Pueblo health department: Why the big focus isn’t substance abuse

Three years ago Pueblo decided teen pregnancy and obesity were the biggest health concerns facing the county. Now, the health department is preparing for a new health improvement plan.

Every few months a billboard overlooking the Main Street bridge leading drivers downtown changes messages, reminding those speeding by the Pueblo Police Station to get healthier.

“Remember me?” the billboard read last fall, featuring a golden retriever and leash. The message wasn’t about pet neglect, though it could have read that way. The Pueblo City-County Health Department was hoping the giant photo of man’s best friend would motivate Puebloans to get out walking. Most recently, the sign, before being switched out to a Carls Jr. ad, featured a young girl with a glass of water and a thumbs up, a gentle reminder that healthy choices can be simple.

The health-focused billboards are part of a five-year Community Health Improvement Plan, which was introduced in 2013 to address major health concerns facing communities throughout Colorado. State statute requires each health department to identify community health issues that are “winnable battles” and tackle them. The state doesn’t set a benchmark for the counties or the plans, but each health department must create a plan and implement it.

Pueblo’s health department determined that obesity and unintended and teen pregnancy were where they were going to focus efforts from 2013 through 2017, and now more than halfway through the plan, the department is going through the analysis process again to select another set of issues to prioritize for the next half-decade.

While the new plan is two years out, identifying the key issues heavily involves community input and comparing various sets of data to determine where and how the health department can best make a dent in health concerns.

Shylo Dennison, public health planner at the Pueblo City-County Health Department, said the plan expectedly comes with challenges.

“Unfortunately there aren’t always dedicated resources to these priorities. So often it’s things we have to go out and search grants for,” Dennison said. “I think that’s why we’ve tried to make it a community plan as well. Even if the health department had all of the resources available to us, the health department can’t do this alone. We really do require a lot of our partners to work with us on it (the plan), and dedicate their resources to the plan as well.”

For obesity, that meant working with food retailers to determine barriers to getting healthier food, city planning to figure out how to get more 10–14 year olds in the city to nature and partnering with Pueblo Active Community Environment to promote bike paths.

“The topics are really umbrella topics,” Dennison said.

In tackling unintended and teen pregnancies, the plan has had to focus on education and employment, which aren’t usually seen as health department specialty areas. But Dennison said they’re key to reducing unintended pregnancies. Last year, the health department held a youth resource fair with more than 30 organizations and programs that are available.

“These are not simple issues that can be solved overnight and it’s going to take everyone getting behind these to make an impact.” — Shylo Dennison, Public Health Planner at the Pueblo City-County Health Department

Other major community health concerns, such as the influx of heroin use in Pueblo, that aren’t a target area in the CHIP are still being addressed by the health department, Dennison said.

“Specifically for heroin, we do have a group that is getting together and they’ve had two meetings and have another one scheduled. They’re trying to figure out how to address it. We’re figuring out how we can work with them,” Dennison said. “There’s always going to be health issues that come up and it may involve a totally different process and totally different group. We have to be really responsive to the community, but the plan is more of a longterm plan of how do we address these really, really large issues.”

Instead of a health issue receiving a long-term plan, “we’ll just deal with the other issues as they come up” Dennison said.

Substance abuse could be a key area the health department focuses in the next plan, Dennison added. It was in the top eight priorities that came out of the community health assessment. The top five were obesity, mental health, teen pregnancy, lack of access to healthcare and poverty. Attendees of a community engagement night voted for the top two priorities.

“One of the biggest things (we learned) was how to engage community members,” Dennison said. The 2013–2017 plan was the first for the health department.

“We had a community group and in reality it ended up being a lot more community agencies. And so we really want to do that better this time around and get to the community members and see what their concerns are. So we’re going to go to them instead of asking them to come to us.”

Dennison said the health department is planning on attending several health fairs through the end of the year to talk to Puebloans about health issues that should be addressed.

“We really want this to be a community plan and not just a health department plan,” Dennison said. “These are not simple issues that can be solved overnight and it’s going to take everyone getting behind these to make an impact.”

The key areas for the next CHIP will be determined by the end of 2016 and a plan will be drafted in 2017.