Public-Private Partnerships: An Example of Building Healthier Communities

14 March 2012 | William O’Leary, Executive Director, Policy, Health and Human Services at Microsoft

​We are witnessing the emergence of a new and exciting era of public-private partnerships at the intersection of business and health, where a significant focus is being placed on building healthier communities. Reducing costs, extending access, and improving care are key to achieving healthy communities, and these new public-private collaborations are leveraging technology advancements in order to tackle such challenges and achieve mutually beneficial outcomes.


Last month, I introduced a series of forums, held in communities across the country, that focus on this very topic. Each forum serves as an opportunity for leaders from government, business and the industry to come together and discuss models for building healthy communities.
In December, Microsoft, Building Healthier Chicago, and the Chicagoland Chamber of Commerce kicked off the first forum, titled, “Innovation in Public and Private Collaboration.” During the forum, we heard from keynote speaker, U.S. Surgeon General Regina Benjamin, and reviewed community care and prevention models from organizations such as Walgreens, Health Care Services Corporation, Scotts Miracle-Gro and more.
This week, Microsoft, the County of San Diego, the San Diego Regional Chamber of Commerce, and the San Diego Regional Economic Development Corporation will co-host “Live Well San Diego: Innovations in Public-Private Collaboration.” The forum will explore how the nation’s fifth largest county – San Diego – has mastered an effective public-private partnership between the health and business communities.
In advance of the forum, and as part of our ongoing conversations with health leaders across the country, I sat down with our event co-host, Nick Macchione, Director of the Health and Human Services Agency in San Diego County.
Bill: Nick, you are as about prevention and wellness as anyone in the country. Give us your perspective.
Nick: Without a focus on prevention and wellness, we cannot hope to ever truly address the profoundly destructive trends— a looming health “tsunami,” if you will—that are being seen with respect to chronic disease. Just take a look at the numbers. Fifteen years ago there was not a single state with an obesity rate that exceeded 20 percent of its adult population. Today, there is not a single state with an obesity rate of LESS than 20 percent. If that’s not bad enough, consider the fact that we now have twelve states where more than 30 percent of the adult population is obese. And they are not alone! Dozens of other states are rapidly following this pattern, with nearly one-third of their entire adult population poised to be classified as obese.
So, it’s no surprise that in San Diego we place a big focus on bending the chronic disease curve as it relates to obesity and other lifestyle-related conditions. It’s our own personal “Battle of the Bulge,” and the only way it’s going to be won is through the active involvement of government, community agencies, businesses, the military, schools—really, ALL San Diegans-- using prevention and wellness as our combat tactics. And unfortunately, the reality is that this illness “tsunami” has just gotten started. It is seriously diminishing the number of quality years of life Americans are enjoying, as well as presenting a serious threat to our nation’s financial security.
Take, for instance, the costs associated with a phenomenon we in San Diego call “the 3-4-50”: three behaviors (poor diet, lack of physical activity, and smoking) contributing to four chronic diseases (heart disease/stroke, cancer, Type II diabetes, and lung disease) that are causing over 50 percent of all deaths in the San Diego region. The statistics are sobering: over 4 billion dollars are spent each year in San Diego County to treat these four chronic diseases alone. Overweight and obesity are particularly costly conditions: a 2009 study published by the California Center for Health Advocacy found the estimated annual direct and indirect costs of being overweight or obese and physical inactivity in California was $41.2 billion, while in San Diego it was over $3 billion.
Bill: How is public and private collaboration important to achieving measurable breakthroughs? How can technology help enable improved outcomes?
Nick: Public and private collaboration is crucial for a number of reasons. First of all, we have to go beyond just private industry, or just the public sector, to achieve truly sustainable, population-level health improvements. Government really can’t do it alone. Our partners are absolutely essential in making any real progress in the fight against costly chronic diseases. We need to be a community of one—or an “Accountable Care Community,” as I like to refer to it—where community-wide health goals are established together and performance against those shared goals is measured.
Technology is a strategic enabler for all of this, as it helps us exchange data and information between entities and eliminate silos. Also, you really can’t change what you can’t measure. In order to figure out how best to craft an intervention--as well as how to figure out if you’re actually making any progress with an intervention--you really need a robust evaluation framework, which is only possible through innovative technology solutions.
Bill: As we looked across the country to co-host the forums on Public and Private Innovation, San Diego came to the forefront. A number of factors contributed to that including San Diego’s diversity, size, wide array of small and large businesses, share of major national health players, and the national credibility the County has earned with respect to health modernization, accountable care, wellness and prevention. How do you account for the progress you have made?
Nick: With our 10-year regional wellness initiative, Live Well, San Diego!, we are trying something that is new, innovative and frankly, huge in scope. Thankfully, we have a lot of extremely dedicated, hard-working folks in the private, public, and non-profit sectors locally that recognized the dire need to address the health of San Diegans in a transformative way. To put it simply, we have great partnerships because we have great partners.
And while true system transformation will take time, we’re seeing encouraging trends emerge. We are one of the few regions in the nation to reduce heart disease and stroke from the first leading cause of death from chronic disease to the second leading cause. As the 5th largest county in the nation, representing about 1 percent of the nation’s population, this trend holds a great deal of significance for us. Furthermore, the University of California at Los Angeles recently completed an independent evaluation of childhood obesity, finding that San Diego County saw a reduction in obese/overweight children by 3.7 percent – the largest reduction in Southern California.
Bill: What might we expect from the forum?
Nick: We are going to have a wide representation from multiple sectors, including business and government. Folks from a diverse collection of industries, from tech, to agriculture, to healthcare, will be there to share their perspectives.
We’re also fortunate that the legendary author, writer and speaker, Ken Blanchard will be our keynote. I believe Ken’s talk captures the essence of the entire forum; it is entitled, “Wellness is NOT an Option…For You, Your Employer and Your Community.”
This forum is going to give attendees a chance to learn about Live Well, San Diego!, the exciting wellness movement that’s transforming San Diego. Perhaps even more importantly, we’re going to give attendees ideas on how they can pluck components of Live Well, San Diego! and plug them into their own business or jurisdiction.
Bill: I agree Nick, and as I participate in other regional and national forums, I am sure we will all be equipped to frame the successes that the broad San Diego community is achieving. I look forward to seeing you on Friday.
William O’Leary
Executive Director, Policy, Health and Human Services at Microsoft