As we marked our 20th anniversary in 2022, the Colorado Health Institute (CHI) set a new course for advancing health in our third decade. We committed ourselves to driving change on three pressing issues. These three initiative areas are key challenges that must be addressed to make Colorado a healthier place for all.
CHI made significant strides in all three areas in 2022, and we are building on this progress in 2023. This 2023 Health Agenda serves as a progress report and action plan for CHI’s three initiative areas:
Climate and Health
- Rising temperatures, declining air quality, persistent drought, and destructive wildfires have created an urgent health challenge. While cutting global carbon emissions is critical, local and state action must help Coloradans adapt to a changing climate. We will equip every community in Colorado with essential tools, insight, and analysis to drive sound adaptation policies that support equitable health outcomes.
- Coloradans — including our youngest community members — are experiencing a behavioral health crisis. The impact of COVID-19 was acute, but many ongoing issues, such as substance use disorder and the housing crisis, are deep-rooted causes of this challenge. We will advance policies and practices that improve behavioral health outcomes where Coloradans live, work, and learn.
Integrating Systems of Care
- Colorado’s public health, social services, and health care systems historically operated in disconnected and fragmented siloes. The 21st century ushered in a new era of integration, with the recognition that whole people require whole-person care. CHI is working with partners around the state to create and scale an ecosystem of integration that can help people get the care and services they need faster and easier, and one that will address today’s challenges and be ready to solve tomorrow’s problems.
We have already seen success in these initiative areas. In 2022, CHI launched Acclimate Colorado, a collaborative effort that draws on the passion and expertise of a broad base of Colorado leaders working in climate change and health. The group began developing the state’s first broad policy agenda for climate and health and will work in 2023 to gain widespread buy-in and adoption of the agenda. We are also engaging with key partners to develop calls to action to improve mental health. Our team has built a broad coalition to create a shared governance structure to connect the myriad systems of care in the metro Denver region.
Behavioral health, climate and health, and integrating systems of care are high-priority topics where CHI is leading meaningful progress to build healthier lives for all people in Colorado and beyond. We invite you to join in our efforts by lending your experience, ideas, critiques, and resources. Read on to see the exciting work we have in store in 2023.
Climate and Health
Colorado’s warming climate is hazardous to our health. Extreme heat affects the human body and increases environmental perils such as air pollution, fires, and floods. Often, people with the least resources are at the highest risk for climate-related illness and death.
We need to protect people’s bodies and minds from the damaging impacts of rising temperatures. The stakes for health equity and environmental justice could not be higher. Many Coloradans whose health is likely to be affected the most by a changing climate — including children and Black, Indigenous, and Hispanic and Latino Coloradans — may already experience multiple barriers to their health and well-being.
Through Acclimate Colorado, CHI and its partners are working to bolster the resilience of Colorado communities to a warming climate by assessing local risks and strengths, aligning key players from a broad coalition of disciplines, and advancing concrete steps that local and state governments, businesses, health care providers, and community organizations should take to protect health.
CHI’s efforts will center on preventing dangerous health effects of a warming climate among those already marginalized or who have experienced the brunt of historical inequities.
We will build on Acclimate Colorado momentum by advancing the strategies laid out in its climate and health policy agenda. We will focus on identifying available resources and policy levers at the local, municipal, and state levels. We will explore how Acclimate Colorado can equip local and state governments, businesses, health care providers, and community organizations to implement climate change adaptation policies.
The Acclimate Colorado team will expand community engagement efforts and forge new partnerships with local, state, and national organizations. The initiative has been successful at partnering with thought leaders at The Denver Foundation, the Rose Community Foundation, the National Network of Public Health Institutes, Kaiser Permanente of Colorado, the Colorado Division of Insurance, and Healthy Air and Water Colorado to explore opportunities advancing adaptation work in the state. But more work is needed. The policy agenda casts a broad net of strategies and requires collective action to implement. In addition, particular areas — such as the implications of climate change and health within the realm of adaptation planning, transportation, and mental health — deserve deeper analysis to identify best practices and move policy discussions forward.
Our Work So Far
CHI continues to build on its past five years of providing evidence to drive health and climate change policy discussions. The year 2022 marked several significant achievements, namely our launch of Acclimate Colorado, an initiative focused on adaptation planning and policy, guided by the Center for Disease Control and Prevention’s Building Resilience Against Climate Effects (BRACE) model. We identified opportunities to address community vulnerabilities in the 2022 health and climate index, Think Globally, Adapt Locally. We methodically built a network of advisors and experts through CHI’s Climate and Health Adaptation Action Team to vet policy strategies. And we developed a comprehensive adaptation policy agenda that we anticipate will serve as a blueprint for the state’s climate change adaptation efforts.
One in four Coloradans say they are experiencing poor mental health, a rate that has significantly increased in the past few years with the disruption and isolation created by the COVID-19 pandemic.
Despite overwhelming consensus about the importance of this issue and the state’s unprecedented response through the development of the Behavioral Health Administration in 2022, Colorado is not yet equipped to respond comprehensively to the behavioral health challenges affecting its residents. The existing behavioral health system is overtaxed, but simply expanding the workforce won’t solve the problem. We must also address systemic causes behind behavioral health challenges.
A broader view of behavioral health recognizes the role of unjust and inequitable systems in this crisis. Addressing chronic housing instability, supporting victims of the opioid emergency, and identifying ways to support young Coloradans can help us build a foundation to truly support mental health — not just treat mental health problems.
Moving the needle on mental health requires thinking beyond the existing behavioral health system. Reducing barriers to care and improving the affordability of services are key for Coloradans to have adequate treatment when needed. But without addressing broader systems issues, Colorado’s efforts will continue to trail behind a growing need.
CHI will bring a public health perspective to Colorado’s behavioral health challenges. We must invest upstream. We know that behavioral health providers play a key role. We also recognize that helping people build protective factors and lead less stressful lives are the most significant ways in which we can face our behavioral health crises.
We will build a framework for screening every young person in Colorado for poor mental health. We will promote policies that expand affordable, safe housing to all Coloradans. And we will identify ways to keep those struggling with substance use disorder safer as they walk the road to recovery.
We will remember that at the heart of all of this is our Colorado community: our families and neighbors, our friends, and our colleagues.
Our Work So Far
CHI identified the significant impact of job loss during COVID-19 on the mental health of Coloradans. We developed a blueprint for how Colorado could distribute funds from settlements with opioid manufacturers to address the state’s substance misuse challenges. We described the unique challenges the state’s LGBTQ communities continue to face in mental health disparities and competent care. And we continued to help hospitals implement standard maternal mental health screenings for perinatal and postpartum patients.
Integrating Systems of Care
Public health, social service, and health care systems must redefine how they work — and how they work together.
Socioeconomic factors are deeply interconnected with health. These aspects of a person’s life cannot be separated; likewise, systems of care cannot provide effective services by addressing isolated needs. Colorado is working hard to integrate systems of care, but the
COVID-19 pandemic underscored deep fault lines and exposed the maze of competing systems meant to help Coloradans but can also cause confusion and missed opportunities. Whole-person care will require stronger multisector relationships, smarter information technology, and more meaningful measurement strategies.
Systems integration can be highly technical work, but at its heart it is a human endeavor that will succeed or fail based on the relationships and trust among its participants. CHI serves as a trusted convener to uncover bold ideas, clarify new solutions, and build consensus between partners on the long road ahead.
CHI will advance regional, statewide, and national efforts to integrate systems of care.
We are bringing our skills in convening, shared governance, and community engagement to strengthen multisector partnerships in Colorado and beyond.
This includes regional initiatives like the Metro Denver Partnership for Health, a partnership between public health, health systems, Regional Accountable Entities, human services, and regional health alliances to improve population health regionally with collective action. It includes statewide programs like the Early Childhood Leadership Commission, Colorado’s federally authorized advisory council for early childhood. And it includes national movements like the National Community Information Exchange National Advisory Board, which aims to align community information exchange stakeholders on common goals.
CHI plays many roles within these partnerships, but two things remain constant: our commitment to community and our dedication to integrating systems of care to improve health for all.
Our Work So Far
CHI has convened and facilitated conversations with hundreds of stakeholders across Colorado to build consensus on the path forward. In 2022, we hosted an intensive workgroup process to develop and deliver policy recommendations to implement a cohesive statewide care coordination infrastructure to Colorado’s Behavioral Health Administration. We worked closely with partners in the metro Denver area to develop plans to implement an interoperable social health information exchange in the region. We have explored the details of topics as specific as health information governance with the Office of eHealth Innovation and its stakeholders. And we strive to make these topics accessible for every Coloradan through intentional community engagement efforts like the Metro Denver Partnership for Health Social-Health Information Exchange Community Board, which launched this year to empower community members and community-based advocates to guide and drive systems change efforts.
Our Equity Lens
CHI’s three initiatives each target an area where addressing inequities is vitally important, and where opportunities exist to think and work differently to improve health for all Coloradans. Our expertise in health data, evidence-based research, and analysis gives us useful tools to advance this work and build on our commitment to reduce the barriers that disproportionally impact the health of some Coloradans. We identify challenges and quantify disparities to collectively address them.
Policies have played — and still play — a key part in driving health inequities in Colorado. Systemic racism and the impact of discriminatory policies affect where people live, work, and play. Policies can also address injustices and oppressive dynamics that limit people’s ability to thrive. Achieving health equity requires the involvement of all of us. CHI is committed to making sure that health equity is at the center of our work together.
Four guiding principles inform our approach:
Humility and Listening
We enlist and recognize the insights and strengths that our partners bring to the work through their lived experiences.
We develop community-centered processes that meet people where they are, highlight the voices of those most affected, and value the time community members provide.
We are explicit in what we are trying to accomplish and transparent in monitoring and communicating progress.
Those with lived experience are experts in the systems in which they live. Those working in these systems to affect change are experts in their work. At the same time, we recognize and apply our unique expertise when the work calls for it.
Support Our Work
This is an ambitious agenda — and we need supporters and collaborators to work alongside us if we are to make significant progress on these critical issues. We invite you to join us as we integrate systems of care, address behavioral health, and tackle the health threats brought about by climate change.