Health Action Sonoma County

Improving cardiovascular health in Sonoma County


Economic Disparities Increase Risk for Heart Disease

Sonoma County is home to some of the greatest disparities in wealth and, consequently, health outcomes. Famous wineries and wealthy estates surround the enclave of Santa Rosa, where heart attacks and strokes impact a disproportionate share of the population. There, more than one-in-three residents are expected to die from cardiovascular disease and many more have high blood pressure, high cholesterol or heart disease.


Upend the Status Quo by Swimming Upstream Together

Given these concerning statistics and deepening access to care disparities, local leaders came together in partnership with the Sonoma County Department of Health Services in 2008 to launch Health Action, an ambitious multi-sector alliance that has since adopted the ACH model.

Health Action’s vision is for Sonoma County to become a healthy place where every person can live, learn, work and belong. To accomplish this, the county established a “Health Action Council,” consisting of 47 local leaders, subcommittees and area chapters, to lead communication and planning with a variety of leaders and community members who are working together to build community-clinical linkages and improve health in the county.

To accomplish their shared goals of improving lives and reducing disparities, nonprofits, government agencies, foundations, businesses, community groups and individuals all participate in developing priorities and targeted policy, systems and environmental changes that will specifically improve education, income and health throughout Sonoma County.


Bring Together Neighborhoods, Health Care and CBOs to Fight Cardiovascular Disease

Since the adoption of the ACH model, Health Action has developed a strong portfolio of interventions with a focus on cardiovascular health. Most notable is “Hearts of Sonoma County,” an effort that first ventured into bridging clinical and community needs through community-based blood pressure screenings, helping to link high-risk residents to primary care treatment and other resources to reduce high blood pressure and other risk factors such as diabetes.

These activities were coupled with an information and outreach campaign—“It’s Up to Us”—led by two ACH partners: the Northern California Center for Well-Being and United Way of the Wine Country. The outreach campaign informed the community about cardiovascular disease risk factors, while the clinical component conducted over 1,700 screenings at 99 outreach events.

At these events, community health workers acted as care navigators, referring nearly 500 residents to clinical providers for follow-up care. What’s more, they helped support participants’ health and social needs, connecting them to healthy food and nutrition education resources.

According to the CDC’s Preventing Chronic Disease, Health Action’s efforts led to a 19 percent improvement in blood pressure control among participants. These and other new efforts are addressing critical gaps in the health care system, shifting the system upstream, and making a significant—and measurable—impact.


Launching Health Action 2.0

Health Action is continuing to reinforce the ACH model by building up Health Action as an independent, community-led entity, with a focus on the growth of a strong Wellness Fund that ensures sustainable funding from a broad array of public and private sources. With increased funding and further community buy-in, Health Action will continue expanding its portfolio to include additional health priorities and leverage an even greater influence on local policy.

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The California Accountable Communities for Health Initiative (CACHI) was established to spearhead efforts to modernize our health system and build a healthier California. To realize this vision, CACHI utilizes a model known as Accountable Communities for Health (ACH), where multiple sectors align goals and collaborate to address the leading health issues facing our communities.