WIN Measures Update:

Intro to the WIN Core Measures

Supported by Well-being and Equity (WE) in the World

May 20, 2021

Together, we acknowledge indigenous peoples, on whose ancient and sacred land we live, work, and play. As a community, we recognize the ever-present systemic inequities that stem directly from past wrongdoings, and we commit ourselves indefinitely to respecting and reconciling this long history of injustice.

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Land Acknowledgement

https://native-land.ca/

Adapted from BSS Land Acknowledgement Statement by Isabell COLEMAN 17’ and Abbie LAI 17’

Agenda

1. Welcome
2. Groundsetting
3. Applying a Racial Justice Lens to the Well-being of People and Places
4. Breakout Session: Applying a Racial Justice Lens to the WIN Core Measures
5. Well-being of People Across the Lifespan
6. Breakout Sessions: Applying an Intergenerational Well-being Lens to the WIN Core Measures
7. Reflections / Next Steps

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Well-being and Equity in the World

Working to advance intergenerational well-being and equity with a racial justice lens

weintheworld.org

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www.winnetwork.org

What is the Well-Being In the Nation (WIN) Measurement Framework?

• The Well-Being In the Nation (WIN) Measurement Framework offers a set of common measures to assess and improve population and community health and well-being across sectors that was developed with contributors from each sector and with local communities.
• The framework was developed by the National Committee on Vital and Health Statistics; measure development was facilitated by 100 Million Healthier Lives, with input from 100+ people and organizations.
• The National Quality Forum served on the Stewardship Group and NQF criteria was used in evaluating measures.
• The framework is a living library of measures that is updated as we learn.

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www.winmeasures.org

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2018: Modified Delphi Process – 100+ organizations across sectors participating along with communities

• Landscape analysis of 500+ measures
• Cycle 1: What’s missing?
• Process: Participants were invited to suggest additions to the list of candidate metrics being considered.
• Output: Complete metrics list compiled
• Cycle 2: Prioritization
• Process: In each domain participants were asked to prioritize 10 metrics for each the National and Community measures based on the measure’s importance, value/usefulness, and usability to stakeholders
• Output: Candidate metrics lists for each domain at each National and Community levels were reduce to ~20 most selected measures
• Cycle 3: Evaluation
• Process: In each domain participants were asked to prioritize 5 metrics for each the National and Community measures, then evaluate their importance, feasibility, usability and value on a scale of 1 (least) to 3 (most) using NQF decision criteria
• Cycle 4: Multisector expert validation and community testing
• Cycle 5: Alignment with related measurement initiatives, such as Healthy People 2030

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Well-being In the Nation (WIN) Measurement Framework (NCVHS Framework)

• Core measures
• Well-being of people
• Well-being of places
• Equity
• Leading indicators
• 12 domains and associated

subdomains related to determinants of

health (upstream, midstream, downstream)

• Full flexible set (developmental measures)
• 12 domains and associated subdomains

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LEADING INDICATORS

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www.winmeasures.org

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Applying a Racial Justice Lens to the Well-being of

People and Places

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Arpita Sharma, MPP, MUP

Data Analyst

USC Dornsife Equity Research Institute ��

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Developing Indicators for Racial Equity

1. Economic Inclusion and Climate Equity

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• Immigrant Integration and Racial Justice

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• Social Movements and Governing Power

Our areas of focus

National Equity Atlas

Bay Area Equity Atlas

California Immigrant Data Portal

nationalequityatlas.org

bayareaequityatlas.org

immigrantdataca.org

Developing Indicators

Identify the geographic level indicators are for - and which specific communities are being served/what data may be helpful to them

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Conduct informational interviews with community organizations advocating for particular groups to identify the data they need

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Find the balance between finding appropriate data and meeting community requests

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Developing Indicators

Include both charts/data points and insights/analysis, strategies for action, examples, and resources when possible

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If there is potential to do so - create downloadable and exportable versions of the data so that your audience can easily access them

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Conduct training sessions on how to use the indicators developed because what may be intuitive to those working on the project may not be to those trying to use the tools

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Darryl Answer

Pastor, New Community Church

Founder, Verge Solutions, LLC��

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From Clients to Creators

Access & Agency

Access & Agency

How many “listening sessions” or community meetings were led/facilitated by community members?

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How many community members (give number of people) were present in multiple meetings (how many meetings) to plan/shape the program/service/listening session?

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Was your initial plan adapted or changed as a result of hearing input from the community? How many adaptations were made?

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Access & Agency

How many people no longer need the service? I.e. how many consistent clients who got emergency services no longer need them due to stability? This gets at measuring if people are better off.

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Racial - does the language/space reflect the audience? Are BIPOC centered?

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How many intergenerational relationships are fostered or connected?

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Access & Agency

Are the gifts/passions of each age group/generation being identified and activated/mobilized?

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Is there representation of each generation on your board/leadership/committee/team etc?

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How was community positively and personally impacted by resources distributed? How much money got into the hands of people?

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Myra Parker, JD, MPH, PhD

Executive Director

�Seven Directions: A Center for Indigenous Public Health

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Indigenous Social Determinants of Health

Indigenous social determinants of health include social circumstances (e.g., social status, cohesion) and context (e.g., governance, policies, culture/societal values) specific to Indigenous communities.

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We seek to include measures that are strengths-based, culturally-grounded, and actionable.�

These determinants are also informed by the legacy of colonization, including policies and systems that have sought to eliminate Indigenous people, our ways of life, and deplete our cultural and natural resources.

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What are Indigenous Social Determinants of Health?

What are Indigenous Social Determinants of Health?

Example: Swinomish Indigenous Health Indicators

Donatuto, Jamie, Grossman, Eric E, Konovsky, John, Grossman, Sarah, & Campbell, Larry W. (2014). Indigenous Community Health and Climate Change: Integrating Biophysical and Social Science Indicators. Coastal Management, 42(4), 355-373.

Example: Swinomish Indigenous Health Indicators

Donatuto, Jamie, Campbell, Larry, & Gregory, Robin. (2016). Developing Responsive Indicators of Indigenous Community Health. International Journal of Environmental Research and Public Health, 13(9), 899.

Example: Swinomish Indigenous Health Indicators

Donatuto, Jamie, Campbell, Larry, & Trousdale, William. (2020). The “value” of values-driven data in identifying Indigenous health and climate change priorities. Climatic Change, 158(2), 161-180.

Summary

• Nothing about us, without us.

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• Culture matters, including connections to place, being able to meaningfully address contextual considerations, and identity.

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• Climate related effects are critical to incorporate, as our communities often are first to be impacted, with longstanding, widespread implications.

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Dr. Carley Riley�Assistant Professor, Pediatrics

Co-Faculty Lead, Population & Community Health

Cincinnati Children’s Hospital Medical Center�

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Dr. Brita Roy�Assistant Professor, Yale Schools of Medicine and Public Health

Director of Population Health, Yale Medicine

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Measuring to Racial Equity in Well-being

Measuring to Racial Equity

• Complexity in measuring wellbeing, its multiple dimensions, many drivers, and inequities across different groups
• Outcomes disaggregated by sociodemographic characteristic
• Policies/practices/conditions (historical and current) that create and sustain racial inequities

https://www.winmeasures.org/statistics/winmeasures

Racial Equity in Wellbeing of People

CORE MEASURES*

• Subjective wellbeing (e.g., percent thriving, struggling, suffering)
• Life expectancy

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ADDITIONAL MEASURES*

• Perceived discrimination

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DEVELOPMENTAL MEASURES*

• Hopefulness
• Meaning & purpose
• Sense of belonging
• Wellbeing adjusted life years (WALY)

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*Disaggregated by sociodemographic characteristics (e.g., race, ethnicity, SES), including intersections of sociodemographic characteristics (e.g., race and gender, race and SES)

https://www.winmeasures.org/statistics/winmeasures

Racial Equity in Wellbeing of Places

CORE MEASURES*

• Child poverty rates
• Years of potential life gained
• Income inequality
• High school/college graduation rates

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ADDITIONAL MEASURES*

• Civic engagement (e.g., voting participation)
• Incarceration/youth incarceration rates
• Social connectedness (e.g., social capital, social cohesion)

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DEVELOPMENTAL MEASURES*

• Wealth inequality
• Existence of racist policies/practices (e.g., housing, employment, voting)

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*Disaggregated by neighborhood sociodemographic characteristics (e.g., race, ethnicity, SES)

https://www.winmeasures.org/statistics/winmeasures

Racial Equity in How We Work

http://www.ihi.org/Engage/Initiatives/100MillionHealthierLives/Pages/Advancing-Equity.aspx

Breakout Session:

Applying a Racial Justice Lens to the WIN Core Measures

By applying a racial justice frame to the WIN Measures, we aim to prioritize, develop and restore Black, Indigenous, People of Color (BIPOC) communities using data that tells a complete and transparent story. In order to be effective and explicitly anti-racist, we must go beyond the identification of disparate outcomes across racial groups. We seek to include measures that:�

• Address equitable input in decision-making
• Promote equitable access and opportunity
• Highlight community-based assets and values
• Lift-up promising interventions, remedies, and solutions
• Expose systemic racism

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Further, we seek to disaggregate data, where possible, and apply an intersectional lens in order to highlight the unique needs and characteristics of each racial and ethnic group.

What do we mean by racial justice?

• In your breakout group, open up the Google doc.
• Review the list of WIN Core Measures with a racial justice lens.
• Reflect on the following questions with a racial justice lens in mind:
• What measures resonate?
• What measures are missing?
• What additional measures should be included?
• Is there anything that should be considered for removal?

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Link to Google Doc

Breakout Discussion

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Well-being of People

and Places Across

the Lifespan

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Martha Tecca, MBA

President�CommunityCare of Lyme��

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“Aging” Well –

Thriving across the Lifespan

• There is no “aging population” – we are ALL aging.
• Aging is a progression through life.
• Aging is the accumulation of experience and knowledge.�

AND there are challenges that increase with age. �There is opportunity to improve the experience �for everyone.

• How to we measure and address both �challenges and opportunities, so that �everyone can thrive, through the lifespan?�

Aging – We’re All Doing It!

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Aim

Primary

Drivers

As measured by well-being�from the person’s perspective

Drivers for “Aging Well”

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• 100 Million Lives Aging Hub – forming began in 2016, drafting aims and drivers with a holistic, interconnected vision, recognizing full span of “aging.”
• Drivers aligned with 100MLives leadership framework for involvement at all levels.
• National Council on Aging (NCOA) partnered as collaborative hub leader in 2018, refining driver diagram, with focus on wellbeing as the primary outcome.

*NCOA adopted measurable near and long-term aims for its organization

100MLives Aging Hub – Driver Diagram

Engaged and supported families and informal caregivers

Collaborative leadership at the community level

Aim

Primary

Drivers

Secondary

Drivers

As measured by well-being�from the person’s perspective

• Frameworks Institute research offers ways to changing thinking about older people and aging
• Helping to address negative attitudes about aging and systems that need to change – �“The Swamp” of Public Understanding of Aging

Reframing Aging – Focus on Culture

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• Areas of focus�for system improvement that leads to improved health of older people.

IHI Age Friendly Health Systems – Focus on Systems

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http://www.ihi.org/Engage/Initiatives/Age-Friendly-Health-Systems

• Formed in 2016, with Collective Impact approach
• Current Strategic Priorities
• Developing an advocacy infrastructure
• Improving the workforce availability for quality healthcare and social services
• Enhancing support for family caregivers
• Increasing transportation options
• Advancing zoning changes to promote affordable and accessible housing options.
• Addressing measurement across domains
• Identified existing and needed measures
• NH Healthy Aging Data Report (2019)

NH Alliance for Healthy Aging – Focus on Communities

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https://nhaha.info/measurement/

https://healthyagingdatareports.org/

Aging Well (Thriving in Community) – It Takes a Village

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https://cclyme.org

https://www.vtvnetwork.org/

• Participant-driven, neighbors-helping-neighbors model.
• Focus on building connections, sharing information, and coordinating services

• Adapted “Village” model, for an actual village.
• Include all ages, all means.
• Share what we learn – and what we have – as a community.

• Dying – “We’re All Doing It” (That’s uncomfortable to read, isn’t it?)
• How do we embrace the importance of dying well … across the lifespan?
• Can we begin to reframe “The Conversation” to include some about the experience of dying, and a lot about the life transitions ahead?
• What can we learn from end-of-life measurement and management?
• Authentic focus on the person’s wishes
• Care for the dying person and their loved ones
• Explicitly multi-disciplinary
• Spiritual care must be offered
• Volunteers must be involved

The Lifespan Includes the End of Life

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Abigail Robinson

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Algoma School District��

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Intergenerational Well-being as a Youth Leader

A Fundamental Principle in Driving Social Change

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Intergenerational Wellbeing in Algoma

HOW?

Intergenerational Wellbeing Requires an Intergenerational Approach

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WHY?

Reduce the social isolation of vulnerable groups by bringing them together

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The How & Why of Intergenerational Wellbeing

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Youth-led Initiatives for Intergenerational Wellbeing

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Youth + Adult Advocate = Empowered Youth

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• Purposefully Bringing People Together
• Promote Understanding and Sense of Belonging

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Conclusions

Breakout Session:

Applying a Racial Justice Lens to the WIN Core Measures

By applying an intergenerational well-being lens to the WIN measures, we intend to recognize:

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• How different age cohorts experience and would be measured across the domains
• How the well-being of different groups is connected across generations

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In doing so, we will reflect the complex intersectional nature of the domains, that addressing disparities and inequities will require strategies which will have long term impact over generations, and of the need to develop multi-generational longitudinal measuring strategies.

What do we mean by intergenerational well-being?

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• In your breakout group, open up the Google doc.
• Review the list of WIN Core Measures with an intergenerational well-being lens.
• Reflect on the following questions with an intergenerational well-being lens in mind:
• What measures resonate?
• What measures are missing?
• What additional measures should be included?
• Is there anything that should be considered for removal? �

Link to Google Doc

Breakout Discussion

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Applying a Racial Justice and Intergenerational Well-being Lens to the WIN Measures

Overview of the WIN Measure Update Process

• Visit our WIN Measures Update page for the latest information: https://winnetwork.org/win-measures-updates
• Continue to add your reflections and ideas to the Google docs that were shared during today’s session
• Participate in future domain-specific listening sessions (registration is open for all sessions)
• Questions? Email: kristen.rego@weintheworld.org

How to stay involved:

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Domain Listening Session

Topic: Demographics

June 17, 2021

1:00 pm - 3:00 pm ET

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Stay informed about the WIN Measures update process and

register for future listening sessions:

https://winnetwork.org/win-measures-updates �

Learn more about the WIN Measures: https://www.winmeasures.org/

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Upcoming Meetings

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win@weintheworld.org

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