For more in depth information on Public Health in the area, view "The Mapp2Health Report".

Problem Statement:

Health inequities, behavioral health challenges, food insecurity, and gun violence are deeply interconnected issues affecting community well-being. Persistent disparities in health outcomes disproportionately impact marginalized populations, driven by systemic barriers such as inadequate access to resources, lack of culturally competent care, and insufficient preventive measures. Despite existing efforts, these challenges remain exacerbated by limited data collection and reporting mechanisms, fragmented healthcare coordination, and insufficient community-based support systems. Addressing these issues requires a comprehensive, multi-faceted approach to reduce disparities, improve health outcomes, and create sustainable community solutions.

Inputs:

1. Resource Investment:

   • Allocate funding and infrastructure to address physical health inequities, including culturally competent care.
   • Invest in food insecurity screening and advocacy for food justice campaigns.

2. Data and Accountability Tools:

   • Establish a system for collecting, reporting, and iteratively analyzing both quantitative and qualitative data on health inequities.
   • Develop a Diversity, Equity, and Inclusion (DEI) scorecard to track disparities and link findings to quality improvement initiatives.

3. Behavioral Health Support:

   • Expand behavioral health treatment options and establish training pipelines for peer-support and formal roles.
   • Create centralized resources, such as a community-based behavioral health mall.

4. Violence Prevention:

   • Support youth programs, expand threat assessment protocols in schools, and implement case management models such as the Child Adolescent Needs and Strengths (CANS) model.

5. Policy and Coordination:

   • Advocate for Medicaid enrollment and coordinate medical services in localized, place-based clinics.
   • Partner with large healthcare networks to provide culturally competent care.

Outputs:

• Health Equity Tools: Creation of actionable tools, such as the DEI scorecard and comprehensive data systems, to monitor and address disparities.
• Behavioral Health Services: Expanded access to behavioral health care, including preventive, immediate, and culturally tailored services.
• Food Security Measures: Health system-wide food insecurity screenings and UVA Health’s participation in food justice initiatives.
• Gun Violence Interventions: New and improved youth programs, school threat assessment protocols, and care coordination for affected individuals.
• Localized Healthcare: Established place-based clinics providing accessible and integrated services for community members.

Outcomes:

1. Short-Term:

   • Increased identification of food insecurity and other social determinants of health through screenings and targeted interventions.
   • Enhanced tracking and accountability in addressing health inequities using the DEI scorecard and iterative data systems.
   • Improved collaboration between healthcare networks and culturally competent community providers.

2. Medium-Term:

   • Reduction in gun violence through preventive youth programs and care coordination models.
   • Greater community access to behavioral health services through training pipelines and the establishment of a behavioral health mall.
   • Strengthened local healthcare infrastructure through place-based clinics.

3. Long-Term:

   • Sustainable reductions in health disparities and systemic inequities.
   • Improved health outcomes across physical, mental, and behavioral health dimensions.
   • A more resilient and equitable community with integrated support systems addressing root causes of health inequities.

Key Public Health Metrics to Measure

1. Rates of incidences of premature death in the community.
2. Access to/use of care healthcare services in Charlottesville City and Albemarle County. 

Years Potential Life Lost

According to the Virginia Plan for Wellbeing (Virginia Department of Health n.d.) the Years of Potential Life Lost (YPLL) before age 75 per 100,000 population for all causes of death. Figures are reported as crude rates, and as rates age-adjusted to year 2000 standard. YPLL measures premature death and is calculated by subtracting the age of death from the 75 year benchmark. Data were from the National Center for Health Statistics - Mortality Files (2019-2021) and are used for the 2024 County Health Rankings. This indicator is relevant because a measure of premature death can provide a unique and comprehensive look at overall health status. 

Within the report area, there are a total of 1,412 premature deaths from 2019 to 2021. This represents an age-adjusted rate of 5,398 years potential life lost before age 75 per every 100,000 total population. 
Note: Data are suppressed for counties with fewer than 20 deaths in the three-year time frame.