Delivering Community Benefit:
Healthy food playbook

Inspiring a community-wide culture of health

The Abraham Lincoln Memorial Hospital Smoothie Bike features a pedal-powered blender that students pedal to make healthy snacks as part of the Coordinated Approach to Child Health (CATCH) program activities. [Abraham Lincoln Memorial Hospital]

Inspiring a community-wide culture of health

Abraham Lincoln Memorial Hospital - Illinois
From banners and radio ads to 5Ks and smoothie bikes, residents in this rural town are inspired by messages of healthy eating and active living.

Takeaways

  • Community health needs indicators showed extremely high rates of obesity in Logan County, Ill.— 30.4 percent of adults are obese, a 19.5 percent increase since 2001.
  • Abraham Lincoln Memorial Hospital facilitated three innovative projects focused on improving healthy food access and physical education
    • Coordinated Approach to Child Health program
    • 5210 marketing and activities campaign
    • Abraham Lincoln Memorial Hospital Farmers Market
  • In the 2016 county-wide survey of youth, Logan County reported a decrease in body mass index (BMI) across 8th, 10th, and 12th graders compared to 2014. Among the same population, fruit consumption increased by 10 percent from 2014 to 2016.
     
Hospital
  • Hospital Type: Nonprofit, critical access facility
  • Hospital Size: Small (25 beds)
  • Geographic area: Rural    
  • System/Network: Memorial Health System of Springfield--includes four hospitals, mental health centers, physician services, and home services.
  • Network coverage: Central Illinois
Demographics
  • White: 89.7%
  • African American: 7.9%
  • Asian: 0.7%
  • Hispanic: 3.3%
Community
  • CHNA community: Logan County and eastern Mason County
  • Population: 30,305
Health indicators
  • Adult obesity: 30.4%
  • Adults with diabetes: 9.9%
  • Persons living below poverty line: 13.8%
  • Hyperlipidemia in Medicare population: 51.5% 

Abraham Lincoln Memorial Hospital (ALMH) lies just off historic Route 66 in the northwest corner of Lincoln, a small town in central Illinois. Beyond the hospital, much of the town is planted with endless fields of soy and corn. Together with mining, agriculture and its related industries account for most of the employment in Logan County, for which Lincoln is the county seat. 

With its picturesque main street appeal and a population of 14,000, Lincoln embodies a typical rural, midwestern town. In this small town, the banners advertising healthy eating that cover the courthouse square are hard to miss. In fact, ALMH is responsible for the many advertisements, banners, and posters that encourage residents to eat healthily and engage in physical activity. Playing jingles on the local radio and placing commercials before summer box-office hit movies in the local theater are some of the ways that ALMH has tried to “inspire a culture of health,” among local residents. These marketing strategies are part of a larger strategy to reduce high obesity rates in the county.  

Community health needs assessment: Priorities and process

  • Food and diet-related disease priorities: 
    • 2012 CHNA - Cardiovascular disease, diabetes, and obesity
    • 2016 CHNA - Obesity 
  • Participation from food-based organizations in CHNA process: Women, Infants, and Children (WIC) and Community Action Partnership of Central Illinois (an anti-poverty organization that manages the local food pantry)
  • How/why did food issues emerge as a priority? 
    • There was compelling, alarming data gathered during the CHNA process that propelled obesity to the top of community needs priorities. Among this was data from the Healthy People 2020 Report and local and state data.  
  • Key community indicators:
    • 30.4% of Logan County adults are obese. 
    • From 2005 to 2008, 33.9% Logan County residents over age 20 were obese.
    • The percentage of obese, low-income preschool children increased from 13.4% in 2008 to 15.4% in 2011.

Full assessment: 2015-2018 Abraham Lincoln Memorial Hospital Community Health Needs Assessment. 

Assessing health needs — and how to meet them

Community health needs assessment process

For the 2015 community health needs assessment (CHNA), Memorial Health Systems (Abraham Lincoln Memorial Hospital is an affiliated hospital) contracted with Healthy Communities Institute, a Berkeley, California-based organization that provides data and analytic tools on population health and social indicators. The Healthy Communities Institute provided a custom dashboard to Memorial Health Systems, which included local and national data sets on indicators for each county in their service area. The data showed extremely high rates of obesity—30.4 percent of adults in Logan County were obese, a 19.5 percent increase since 2001. This data laid the foundation for the needs assessment and the determination of community priorities.
                   
Abraham Lincoln Memorial Hospital also worked closely with the Logan County Department of Public Health to develop their 2015 CHNA. While in previous years, the two supported one another’s assessment processes, 2015 was the first year the department and ALMH coordinated their processes and timelines. Although each developed a unique assessment, both used the same data sets, identified the same priorities, and aligned implementation strategies. 

For Angela Stoltzenburg, ALMH marketing and community partnerships director, this collaborative process was a way for the department of public health and the hospital to strategically leverage their investments and resources on implementation. 

“We looked at our priorities and were able to evaluate our unique strengths and say, ‘These are the kinds of resources Abraham Lincoln can bring to the table and this is where the Department of Public Health might be better suited.’”

— Angela Stoltzenburg, Abraham Lincoln Memorial Hospital marketing and community partnerships director

Obesity, along with chronic disease management, mental health, and access to health care, emerged as community priorities.

To help them review data and prioritize community needs, ALMH relied on the input and expertise from members of the ALMH Community Health Collaborative, a 20-year-old community health coalition that includes representatives from across the community including:  WIC, as well as education and local service providers. This coalition was central to the CHNA process and provided not only insight that helped the community benefit team interpret data, but also strengthened partnerships to implement the hospital’s vision of creating a culture of health. 

“You have to have the right stakeholders at the table to collaborate on community issues. It’s important to be able to leverage each other’s resources, but it’s also the best way to present a consistent message. When you are trying to create a culture of health, you need everyone to be on board with that vision and message. When our partners take that vision and apply it to their work, it creates a community-wide effort with a focused game plan,” said Stoltzenburg.

Shoppers at the Abraham Lincoln Memorial Hospital Farmers Market in Illinois, an indoor, producer-only hospital-sponsored and supported market featuring local products (Abraham Lincoln Memorial Hospital)
Shoppers at the Abraham Lincoln Memorial Hospital Farmers Market in Illinois, an indoor, producer-only hospital-sponsored and supported market featuring local products (Abraham Lincoln Memorial Hospital)

Investing in solutions

Implementation strategy

For their implementation strategy, the community benefit team led a comprehensive search for evidence-based interventions that could be expanded or replicated at Abraham Lincoln Memorial Hospital. To identify potential interventions, Angela Stoltzenburg reviewed online case studies from Robert Wood Johnson Foundation, researched the work of organizations that received awards or were recognized for their obesity prevention work, and looked into the efforts of local and state organizations such as the Illinois Alliance to Prevent Obesity. This research helped expose Stoltzenburg to what other groups were doing and helped her team identify obesity interventions that could have an impact on the residents of a small, rural Illinois town. 

Stoltzenburg understands that an implementation strategy must not only be a good fit (replicable, realistic, and economically viable) for the community; it must also garner support from hospital leadership and decision-makers. In addition to sifting through and carefully researching hundreds of potential interventions, Stoltzenburg and her team also had to get the buy-in of the Abraham Lincoln Memorial Hospital Foundation. The foundation works with community benefit to fund interventions.  

Ultimately, an implementation strategy is a delicate negotiation between stakeholders from the community and within the hospital itself that must be carefully navigated by community benefit directors to find the best fit. 

In addition to supporting physical activity interventions (a 5K girls’ run and outdoor trails) and breastfeeding encouragement programs, ALMH funds three programs under the obesity priority: Coordinated Approach to Child Health (CATCH), a farmers market, and the 5210 program.

More case studies