All in for Health Merced County

Preventing and improving outcomes for cardiovascular disease, diabetes, and associated depression.

Merced County Accountable Communities for Health is developing a comprehensive effort to reduce cardiovascular disease, diabetes, and associated depression through a new model, Accountable Communities for Health (ACH).

Despite being in a region that produces the largest amount of fruits and vegetables in the country, many families have difficulty gaining access to healthy food and live under harmful conditions that are at the root cause of these health problems.

As a result, 1 in 4 Merced County residents are diagnosed with heart disease, and the rate for pre-diabetes is more than double the national rate. Merced County ranks 51 out of 58 California counties for deaths due to coronary heart disease and 48th for deaths due to stroke.

Within a three-year period (2012 to 2015), rates of depression doubled for people between the ages of 18 to 39 and the cost of this epidemic is estimated to be nearly $50 million per year in medical expenses and loss of work productivity.

Uniting Merced County to Improve Health

For years, Merced County leaders have engaged in multiple collaborative activities to address these health problems. However, many of these efforts have operated independently from one another and collaboration has been project-based and transactional. The ACH model is catalyzing these disparate partnership efforts to be transformational — i.e., aligned and coordinated to allow for deeper and sustainable relationships that can improve the health of larger populations of people. Further, the Merced County Department of Public Health is bringing new and varied sectors to the table, including nonprofits agencies, schools, and local businesses in a collective and unified campaign to make Merced County a healthier place to live.

Reducing cardiovascular disease, diabetes, and associated depression is just the first step. These multi-sector partnerships will make it possible to successfully work together on other emerging health issues in the years to come.


  • Building Healthy Communities Merced
  • Central California Alliance for Health
  • Cultiva La Salud
  • Dignity Health, Mercy Medical Centers
  • Golden Valley Health Centers
  • Intrepid Ascent
  • Lifeline CDC
  • Livingston Community Health
  • Merced County Behavioral Health and Recovery Services
  • Merced County Department of Public Health
  • Merced County Human Services Agency
  • University of California, Merced
  • United Way of Merced County

Transforming Merced Through Partnerships

The Merced County Department of Public Health is leading this collaboration to develop a coordinated system of interventions and strategies that address fundamental conditions that lead to cardiovascular disease, diabetes, and associated depression. A series of surveys and meetings were held to engage residents to inform the development of solutions that best serve their needs. In response, local leaders are moving forward with a multi-pronged approach that is based on medical and clinic services; improving living environments by making it easier for people to engage in exercise; more effective referral programs; and incorporating community health workers to more successfully educate and share information with residents on how to access resources. Recognizing that low-income communities of color do not often seek out and utilize mental health services, local leaders are recruiting community ambassadors who can engage residents as peers to reduce fears and stigma related to behavioral health.

This type of comprehensive, multi-sector initiative requires on-going and sustainable resources. Consequently, Merced County leaders are establishing a local Wellness Fund that weaves healthcare savings and resources to invest in strategies focused on prevention, equity, and more. They will be demonstrating to potential local funders the anticipated return on investment their model will yield for Merced County and how local businesses, health plans, hospitals, and other potential investors will benefit from joining this initiative.


Merced County is designing a series of interventions that link together and work to successfully combat issues leading to cardiovascular disease, diabetes, and associated depression. Specific interventions include:

  • Bringing together chronic disease and mental health resources to break the stigmas behind depression and seeking help
  • Advocating for infrastructure improvements to make it easier for community members to walk or bike
  • Creating a database and referral system that will help residents find healthier resources (e.g., Zumba classes or Weight Watchers)
  • Enhancing patient referral and tracking systems to improve coordination among service providers

To learn more and get involved with Merced County Accountable Communities for Health, contact Stephanie Nathan, Public Health Program Manager at

To learn more about CACHI and the ACH model across California, please contact Barbara Masters at or visit

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