A 2020 vision of health for Sonoma County

After nine months of study and planning, Sonoma County is on the threshold of a bold new approach to creating a healthier community by encouraging and supporting healthy lifestyle choices and promoting effective primary care services to all residents.

It is a vision that would make Sonoma County one of the healthiest places to live in California by the year 2020. It is designed to involve individuals and families from the very youngest child to seniors, employers and workers, and the health care delivery system. And it will only be successful with the full support of the entire community.

"A 2020 Vision for Sonoma County" is the product of Health Action, a body established by the Board of Supervisors last August.

At that time, it was widely acknowledged that the local health care delivery system was in crisis. The number of uninsured in Sonoma County, estimated at more than 42,000, was growing; physicians were continuing to leave the community; specialists were in short supply; some district hospitals and community health centers were struggling financially; funding for the health care safety net was inadequate. In addition, we faced alarming health challenges. Obesity among children and adults was epidemic. Medical experts reported alarming rates of diabetes.

The level of community concern increased significantly with the announcement of the proposed closure of Sutter Medical Center of Santa Rosa. Community groups and other health care organizations urged the Board of Supervisors to create a forum to analyze health care problems and offer solutions. At a public workshop on the proposed Sutter closure, supervisors directed the Department of Health Services to convene a community health care planning process. A Health Improvement Action Council, called Health Action, was established and meetings got under way in October 2007.

Health Action brings together the skills and experience of 31 key Sonoma County leaders. Our members are educators, employers and union leaders, workers and consumers, and representatives of the health professions, insurers, hospitals, city and county government, the media and social service agencies.

Months of discussions produced "A 2020 Vision for Sonoma County," and this month we began taking our proposed action plan to the community for your reaction.

In addition to the health and health care issues cited above, areas of concern we studied this past year included mental health services, drug and alcohol addiction, an aging population, inadequate dental services for uninsured residents, the county's low compensation rate for services covered by Medicare, and the failure by state and federal officials to deal with millions of uninsured Americans.

Health Action concluded that we couldn't tackle all of the issues at once, and that some, such as Medicare reimbursement rates and the national health insurance debate, were beyond our immediate ability to effect change. Accordingly, we focused on issues Health Action believes Sonoma County can address and which could make a profound and positive change on the health of the county.

The 2020 Vision action plan is three-fold:

First, we need to increase access to affordable, healthy food for all residents and get people eating nutritious meals.

Second, we need to get everyone in the county exercising and engaged in walking, bicycling and other kinds of healthy physical activity.

Third, and finally, we need everyone to have a "medical home," a trusted source of primary care and patient-centered preventive medical support.

Too simple? We don't think so. The three concepts, taken together and in a concerted communitywide effort, could launch Sonoma County into action and kick off a period of change impacting many of the health challenges listed above. But it will take the commitment of everyone.

The 2020 Vision will need the partnership and creative minds of young and old, local government, schools, employers and community groups to create a culture of active, healthy living where walking, biking and engaging in other forms of daily exercise are encouraged and supported for all people. This may require more and better sidewalks and safer streets to get kids walking to school and families walking to the store. It may require employers to make fitness programs part of the work day.

We must examine public policies and make changes when necessary to ensure that all residents have access to affordable, healthy food.

And we need to ensure that all residents have a regular "medical home" and that there are enough physicians and health care workers to serve our population.

If effectively implemented, the 2020 Vision could decrease the burden of chronic disease on our community, reduce demands on health care providers and enable all people to live happier and more productive lives.

We embrace Health Action's recommendation and the 2020 Vision. To make it work we will need to develop and execute specific action plans for all areas of the county.

But first, we need to hear from you. During the remainder of the summer, we will be sharing our vision and priorities for action at some 25 meetings in neighborhoods throughout the county. You'll also be hearing about Health Action on the radio and local TV, and you can check out the 2020 Vision and comment on our Web site, www.sonomahealthaction.org.

We need your input.

Tim Smith represents the 3rd District on the Sonoma County Board of Supervisors. Rita Scardaci is director of the Department of Health Services. They are co-chairs of Health Action of Sonoma County.