Addictions and Dependency
The mission of the Addictions and Dependency subcommittee is to evaluate and mobilize community resources for various addictions including multiple drug use and alcohol. To help reduce addictions and dependencies in Hamilton County, this subcommittee provided the following recommendations:

• Promote greater awareness of substance abuse issues among residents of Hamilton County through use of a strategic prevention framework methodology and other proven means.

• Use “National Recovery Month” to partner with prevention and treatment providers and other stakeholders to sponsor events or activities that help de-stigmatize illness of addiction, and make known treatment resources.

• Partner and collaborate with the Hamilton County (Drug) Coalition regarding selected prevention initiatives.

• Advocate for training for vendors who are granted licenses for the sale of alcoholic beverages and promote the inclusion in this training of local Beer Board officials, enforcement officers and other appropriate personnel.

• Advocate for better venues for the public to report concerns to the local Beer Board and other appropriate agencies regarding establishments that sell alcoholic beverages.

• Support more formal partnerships among agencies that license vendors and those that regulate, monitor and enforce policies, ordinances and laws relating to the sale and consumption of alcoholic beverages.

Health Care Reform
The mission of the Health Care Reform subcommittee is to identify community partners and resources to advocate for health care reform, including affordability, accessibility, and coverage for uninsured Americans. To improve our health care delivery system, this subcommittee provided the following recommendations:

• Advocate for the inclusion of prevention and wellness strategies in health reform legislation to prevent premature death and significant health care costs attributable to chronic disease.

• Promote affordable, quality health care coverage for all Americans.

• Advocate for insurance coverage of pre-existing conditions.

• Advocate for adequate provider payment from insurance companies.

• Support health information technology initiatives that improve quality of patient care.

• Advocate for federal fiscal reimbursement of costs associated with TennCare expansion.

• Promote consumer choice of medical providers and health plans.

• Encourage the youth of Hamilton County to pursue public health and health care careers.

Infant Mortality
The mission of the Hamilton County Core Leadership Group is to educate and mobilize the community around factors that lead to poor birth outcomes, establish priorities within the community, and create community partnerships that will coordinate, collaborate, implement and evaluate evidence-based practices that will improve birth outcomes for Hamilton County. To improve birth outcomes in Hamilton County, the Core Leadership Group provided the following recommendations:

• Promote and increase preconception health knowledge to both the community and to medical providers.

• Increase awareness and education within the community about crucial mental and physical development that occurs in the final weeks of pregnancy, about potential health risks of late pre-term deliveries, and communicating with your physician the importance of not delivering prior to 39 weeks.

• Educate the medical community about infant mortality, preconception health, and the problem of late preterm births. Increase adherence to American College of Obstetricians and Gynecologists (ACOG) guidelines to deliver babies no earlier than 39 weeks of gestation unless medically indicated.

• Mobilize a network to connect social service providers working to improve birth outcomes.

• Investigate transportation barriers and potential solutions for women seeking prenatal care.

Obesity, Diet and Lack of Exercise
The mission of Step ONE is to create a culture in Hamilton County where residents choose to practice good nutrition and exercise regularly. From 2010 through 2013, there are three strategies that Step ONE will be focusing on to meet its goal of cultural change: increasing the health knowledge of our citizen and leaders, providing an environment suitable to sustaining healthy lifestyles, and implementing policies capable of supporting healthy environments in the workplace, home, schools, neighborhoods, and faith-based institutions. From evidence in research and best practices, the Step ONE Operations committee provided the following recommendations to approach cultural change. We will be a healthier community if:

• All county residents have equal access to affordable healthy foods and equal opportunities for regular physical activity.

• All employers create healthy work environments by implementing policies that support healthy food options while discouraging unhealthy foods and by creating office policies that support employees taking actions to improve health habits regarding diet, physical activity/exercise, and smoking cessation.

• City and County leaders choose to design communities for active living including walking paths, bike lanes, parks and recreation centers, ensures all residents have equal access and opportunities for active living, and implements a health impact assessment policy for all new community plans or revised community plans.

• Restaurants provide healthy menu options and public policies are created to support restaurants that choose to do so.

• Vending machine policies are implemented requiring that healthy snack selections are provided in all public vending machines.

• The Hamilton County Department of Education implements policies designed to involve students of all grades in 30 minutes of physical activity every day, and work with the communities to increase access to playgrounds outside of school hours for children.

• Physicians and other providers candidly confront overweight/obesity in children and adults, nutrition, physical activity/exercise issues with their patients as a routine part of their practice, and follow-up with their patients.

• The Health Department will work with planning agencies, health care providers, businesses, faith-based institutions, and community organizations to connect resources, build partnerships, and advocate for policy and environmental changes designed to create a culture in Hamilton County where residents choose to eat healthy, are physically active, and will ensure all residents have equal access to healthy affordable food and opportunities to be physically active regardless of race, socioeconomic status, education, or sex.

Preventive Health Services
The mission of the Preventive Health Services subcommittee is to mobilize community resources for health promotion and wellness. To promote prevention, this subcommittee provided the following recommendations:

• Identify existing preventive health resources available to address the top four chronic disease risk factors of Hamilton County residents and determine if services need to be expanded or if new services are needed.

• Identify where gaps in preventive health service exist.

• Work with appropriate organizations and agencies to identify potential partnerships to ensure that adequate preventive health services and activities are available.

• Provide education and awareness activities regarding preventive health services and screenings for Hamilton County residents and develop a calendar of health fairs, screenings, and continuing education activities provided for lay residents and professionals.

School Health
The mission of the School Health subcommittee is to evaluate health issues affecting children’s school performance and promote partnerships and resources available to address those issues. To improve our children’s health, the School Health subcommittee provided the following recommendations:

• Explore the creation of a pilot school-based health clinic within a public high school within the Hamilton County Public School System and report findings to the Regional Health Council at that time.

• Advocate for improved health policies and practices within the Hamilton County Public School System and within private schools, and recognize schools that support good health practices, including regular exposure to good nutritional and physical education activities for students and their families.

• Work to inform, educate and empower the families of Hamilton County school children about the risks associated with overweight and obesity, as well as well as about the increase in prevalence of diabetes and asthma.

• Assist in working to link families to the nutritional services provided by the Department of Education, the Health Department, and other service providers.

• Support the work of existing collaborations and activities through the Partnership for Healthy Living (Step ONE) as they advocate for increased participation in physical activity and good nutritional practices among children and families of Hamilton County.

• Advocate for the continued monitoring and tracking of BMI, cardiovascular fitness, and chronic health conditions of youth in Hamilton County schools as initiated by the Coordinated School Health Program of the Hamilton County Department of Education.

Tobacco
The mission of the Tobacco subcommittee is to evaluate and mobilize community resources for tobacco cessation. To help reduce tobacco use in Hamilton County, the Tobacco subcommittee provided the following recommendations:

• Promote efforts through June 2010 and annually thereafter to eliminate secondhand smoke by supporting the “Chattanooga Clean Air for All” initiative that seeks to educate partners (daycares, all area car seat providers, hospitals and others) with the goal of ultimately eliminating parental smoking in autos and their homes.

• Support efforts to reduce the initiation of tobacco use by youth by supporting Campaign for a Healthy and Responsible Tennessee (CHART) efforts for bringing about legislative action on the tobacco excise tax and opportunities for youth education.

• Work to reduce tobacco related disparities by working with project “Chattanooga Clean Air for All” and other initiatives in underserved areas, and by working with other organizations and services (Head Start, WIC, car seat classes, etc.) that target underserved populations.

• Continue efforts to reduce the incidence of the distribution of tobacco products to youth at public venues and events that are not adult only activities or places.