MISSOURI
STATE HEALTH
IMPROVEMENT
PLAN

2024

OUR VISION IS
OPTIMAL HEALTH AND SAFETY
FOR A L L MI SSO URI A N S , I N A L L
CO MMUN I T I ES , FO R L I FE .
Our mission is to promote health and safety throughprevention, collaboration, education, innovation and response.

MISSOURI STATE HEALTH IMPROVEMENT PLAN

Table of Contents
Executive Summary................................................................................................................... 4
Director’s Letter.......................................................................................................................... 7
Introduction................................................................................................................................. 8
State Health Partner Group.......................................................................................................9State Health Improvement Plan Review Team................................................................10
SHIP Priority Health Issues..................................................................................................... 12
1. Public Health System Building............................................................................................12
2. Infant & Maternal Health........................................................................................................19
3. Health Behaviors........................................................................................................................28
4. Emerging Public Health Threat Preparedness............................................................40
5. Social Drivers of Health...........................................................................................................48
6. Whole Person Health Access...............................................................................................52
Closing............................................................................................................................................ 60
Glossary.......................................................................................................................................... 61

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MISSOURI STATE HEALTH IMPROVEMENT PLAN

Executive
Summary
The Missouri Department of Health and Senior
Services (DHSS) is devoted to achieving its vision of
optimal health and safety for all Missourians, in allcommunities, for life. DHSS will achieve that visionby carrying out its mission of promoting health andsafety through prevention, collaboration, education,
innovation and response.
DHSS developed this State Healthyear systematic plan to address issues

Improvement Plan (SHIP) document,

identified in the SHA. Based on the SHA,

assembled as part of the Department

the SHIP describes how the state healthreaccreditation process through thedepartment, stakeholders and the

Public Health Accreditation Board

communities served can work together(PHAB), in tandem with the Missouri

to improve the health of the population,

State Health Assessment (SHA).

signaling opportunities for partnershipwithin state public health systems.

The SHA combines a variety of analyzed
health indicators with qualitative

As part of the process, and to ensure

feedback gathered during listeningthat a diverse set of stakeholder voices

sessions conducted in communities

were heard, a group of local public

across the State of Missouri to identify

health agencies, academic institutions,leading health issues facing Missourians.

non-profits and other state agencies

The listening sessions provide an

was assembled. This State Healthopportunity for DHSS to incorporate

Partner Group (SHPG) offered their

qualitative information such as the lived

time and expertise through a number

experience of specific communities

of assessments, surveys, conversations

and unique challenges experienced

and digital meetings to develop theat the local level, working in concert

SHIP. Another group of stakeholders

with the quantitative data utilized by

was assembled in 2023 to review and

DHSS to understand state health needs.

revise the SHIP to better align the plan

The SHA also pinpoints resources andwith shifting public health needs andinforms the development of priorities

priorities.

included in the SHIP. The SHIP is a five-2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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EXECUTIVE SUMMARY

Summary of Outcomes
In the wake of the COVID-19 pandemic, an unprecedented
level of investment in the transformation of the publichealth system is taking place nationwide. The public healthsystem in the State of Missouri is no exception. Many areasof Missouri’s health system have seen improvements at thestate and local levels since the last SHA completed in 2016.
However, despite the work of the system as a whole, some
Missouri residents still do not have the same opportunities
for health. Disparities and inequity continue to be a concern
reflected in health indicators and across jurisdictions in theState of Missouri. The Southeast Region of the state continues
to experience the poorest health outcomes with the highest
mortality rate and lowest life expectancy of any other region.

For the purposes of thisSHIP document, thefollowing terms are usedwithin each SHIP priority
issue (SPI) with thefollowing definition:▶

SHIP Priority Issue: broad themesthat influence the health ofMissourians▶

▶

partnerships and transparency, access to services and diversity reflect theimportance of building the public health system at every level. This investment intransformational work begins with the vital planning around improving the health of
the state included in the SHA and SHIP.

Key Issues
The Missouri SHA documents in detail both the qualitative and quantitative analysisof the issues facing Missourians in terms of their health. Throughout 2023, the SHA
team traveled the State of Missouri and conducted nineteen listening sessions to

may be long-term and require

capture candid feedback about the lived experience of Missourians. These listening

collaborative work from all levels of

sessions were designed to hear from geographically, socioeconomically andthe public health systemdemographically diverse audiences. Asking open-ended questions, the SHA teamObjective: narrowly defined targets,carefully recorded notes and led discussion around the factors that influence thehealth of Missourians. Combined with the analysis of primary and secondary healthbegin taking action

data, the SHA provides a comprehensive picture of the state of health in Missouri.

Activity: the specific work required to

As the SHA details the challenges facing citizens, the SHIP focuses on the work

drive progress towards achieving theassociated objective and goal▶

DHSS strategic priorities focusing on innovation, workforce concerns, building

Goal: wide-ranging targets thattimebound and specific enough to▶

Like many other peer states, Missouri is dedicating teams,
funding and pioneering work to the transformation of the public health system.

Metric: measurable elements ofthe public health system must do to address these challenges to improve healthoutcomes in the State of Missouri. The qualitative and quantitative analysis in the
SHA directly informs the development of the six SPIs that form the core of the SHIP.

either an objective or activity,
tracked and reported by the DHSS
performance management system
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EXECUTIVE SUMMARY

Priority Issues
The State Health Partner Group (SHPG) organized issues

large-scale concerns that affect the State of Missouri as a whole.

identified in the SHA into six SHIP priority issues and assembled

These SHIP priority issues force the public health system toteams around each theme. The strategic priority issues

innovate and integrate collaborative action steps from partners

identified represent areas that require concerted focus andat the state and local levels.

energy from every level of the public health system. These are

PUBLIC HEALTHSYSTEM BUILDING

1
WHOLE PERSONHEALTH ACCESS

62

INFANT &MATERNAL HEALTHMISSOURI STATE HEALTH
IMPROVEMENT PLAN

SOCIAL DRIVERS
OF HEALTH

53HEALTHBEHAVIORS4EMERGING PUBLIC HEALTHTHREAT PREPAREDNESS

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DIRECTOR’S LETTER OF SUPPORT

Dear Missourians,
It is my distinct pleasure to present to you Missouri’s State Health Improvement Plan (SHIP), a document that
represents the collective vision of people dedicated to transforming how we keep our families, neighbors andcommunities healthy and safe. In 2023, the Missouri Department of Health and Senior Services assembled
a group of partners across the public health and healthcare systems to revise the existing SHIP. This revised
document reflects the robust activities this partnership will prioritize to address the extraordinary challenges
and opportunities the public health system faces in the wake of COVID-19.
Amid the pandemic, it was a privilege to witness firsthand the commitment and selflessness of the people
who compose the public health, healthcare and behavioral health workforces as they served their communities
and saved lives. We also must recognize the underlying causes of poor health that drove disparate outcomesof disease during the pandemic. With our strengths revealed and our shortcomings laid bare, it is the
responsibility of the public health system to use this information and seize this opportunity to build a systemthat better serves Missourians.
The revised SHIP draws from those lessons learned and the State Health Assessment’s (SHA) key healthindicators to focus the entire public health system’s efforts over the next five years. The SHIP first identifies six
SHIP Priority Issues (SPIs) that need to be met by the public health system, with goals and specific objectives
designed to address them. The six SPIs from the existing SHIP are maintained in this edition, with the goals
and objectives modified to align with new opportunities and innovative efforts. The SHIP will continue as aliving document, subject to future changes as the public health landscape continues to shift and demand new
strategies and ideas.
Implementation of the SHIP will demand focused coordination throughout Missouri and across the publichealth and health sectors. The Department expresses our deep appreciation for the partners who contributed
to this plan and who will continue to work towards a healthier Missouri. We look forward to the work ahead!

Paula F. Nickelson
Director
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MISSOURI STATE HEALTH IMPROVEMENT PLAN

Introduction

excellence recognized nationwide.
DHSS attained initial accreditation in2016 and has provided annual reports
each year to PHAB. The reaccreditation

The COVID-19 pandemic changed the face andthe function of public health worldwide. Throughyears of unparalleled challenges, the public healthworkforce found new ways to continue to serve thecitizens of the State of Missouri. As COVID-19 became
an endemic condition, DHSS took the opportunity
to bring teams together to re-brand, re-focus andre-center around what is most important in our
charge as Missouri’s public health authority. Thesetransformative efforts included a new brand identity,
a new mission, vision, values and strategic plan, as
well as a renewed focus on addressing universal
challenges facing the public health system.

process occurs every five years andrequires the department to show how
it has continued to utilize the capacity
indicated in the initial accreditation,
as well as focusing on continuous
quality improvement. While there aremany components to reaccreditation,
two that are vital to ensuring DHSS
receives accreditation are the SHA andSHIP. The first document describes thecurrent view of Missouri’s health system,
its capacity and the overall health ofMissourians. Additionally, it names the
Key Health Issues affecting the state.
This companion document, the SHIP,
groups the identified Key Health Issues

DHSS brought this transformative

into SHIP Priority Issues. The aim ofattitude to each activity as we worked

the SHIP is to provide actionable work

towards reaccreditation. Focusing on thedesigned to address the key issues overfuture of public health and Missouri’s

the next five years, with measurable

role as a leader on the national stage

targets and accountability measures

framed the collaborative and innovative

built in to ensure progress towards theapproach used to develop both the SHA

goals and objectives.

and SHIP. The work of public healthnever stops, and the goal of this rigorous
planning process, is to be prepared forthe next challenge the public healthsystem faces.

State Health PartnerGroup
To ensure that the plans laid out in
the SHIP are truly reflective of the

Public HealthAccreditation

work necessary to meet our goals and

The Public Health Accreditation Board

from across the Missouri health system(PHAB) is a non-profit entity thathave gathered to revisit, revise andprovides oversight for a voluntary

design new goals and objectives.

accreditation process for state, local

Through an in-person kickoff meeting,and tribal public health agencies. With

multiple virtual working sessions, andtheir mission to advance and transform

asynchronous information gathering,

public health practice by championing

this diverse group of stakeholders

performance improvement, strong

ensured that each dimension of theinfrastructure and innovation, PHAB

State of Missouri is represented in thisaccreditation represents a standard of

overarching health improvement plan.

meaningful to those working towards
those goals, external stakeholders

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INTRODUCTION

The Missouri State Health Partner
Group includes representationfrom the following associations,academic institutions, local publichealth agencies and community
action organizations:
Adair County Health Department
Atchison County Health Center
Audrain County Health Department
Barton County Health Department
Bollinger County Health Center
Brown School At Washington University | St. Louis
Butler County Health Center
Caldwell County Health Department
Camden County Health Department
Cape Girardeau County Public Health Center
Carter County Health Center
Cedar County Health Department
Center For Environmental Analysis | Southeast Missouri State University
City Of Kansas City Health Department
Clark County Health Department
Clay County Public Health Center
Clinton County Health Department
Cole County Health Department
Columbia/Boone County Public Health & Human Services
Cooper County Public HealthDunklin County Health CenterFranklin County Health Department
Grundy County Health Department
Health Literacy Media
HealthierMO
Henry County Health Center
Jackson County Health Department
Jasper County Health Department
Jefferson County Health Department
Joplin Health Department
Lafayette County Health Department
Lawrence County Health Department
Lincoln County Health Department
Livingston County Health Center
Macon County Health Department
Madison County Health Department
Marion County Health Department
Mercer County Health Department
Miller County Health Center
Mission Missouri
Missouri Alliance - Home Care
Missouri Assisted Living Association

Missouri Association of Area Agencies on Aging
Missouri Association of Local Public Health Agencies
Missouri Association of Nursing Home Administrators
Missouri Center For Public Health Excellence
Missouri Coalition Against Domestic and Sexual Violence
Missouri Coalition for Oral HealthMissouri Council for Activity and Nutrition
Missouri Council for In-Home Services
Missouri Dental Association
Missouri Department of Corrections
Missouri Department of Elementary & Secondary Education
Missouri Department of Health And Senior Services
Missouri Department of Higher Education & Workforce Development
Missouri Department of Mental HealthMissouri Department of Social Services | Technical Assistance Team
Missouri Department of Social Services | MO HealthNet Division
Missouri Developmental Disabilities Council
Missouri Family Health Council
Missouri Foundation for HealthMissouri Health Care Association
Missouri Hospital Association
Missouri Institute for Community HealthMissouri League for Nursing
Missouri Primary Care Association
Missouri Public Health Association
Morgan County Health Center
New Madrid County Health Department
Newton County Health Department
Nodaway County Health Center
Ozark County Health Department
Ozarks Public Health Institute | Missouri State University
Perry County Health Department
Pettis County Health Center
Putnam County Health Department
Ralls County Health Department
Randolph County Health Department
Reynolds County Health Center
Ripley County Health Center
Saline County Health Department
Shelby County Health Department
Saint Louis University College for Public Health And Social JusticeSpringfield-Greene County Health Department
St. Joseph Health Department
St. Louis City Department of Health
St. Charles County Department of Public Health
St. Charles County Department of Public HealthSt. Francois County Health Center
Ste. Genevieve County Health Department
Stone County Health Department
Sullivan County Health Department
Taney County Health Department
University of Missouri - Kansas City Institute for Human Development
University of Missouri - Kansas City School Of Medicine
Vernon County Health Department
Warren County Health Department
Webster County Health Unit
Wright County Health Department

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INTRODUCTION

The State Health Improvement Plan Review Team included:
Bootheel Perinatal Network

Missouri Department of Mental Health

Butler County Health Department

Missouri Department of Social Services

Cole County Health Department

Missouri Foundation for Health

Columbia/Boone County Public Health & Human Services

Missouri Hospital Association

Community Asset Builders

Missouri Primary Care Association

Council for Public Health Nursing

Missouri State University

Delta Dental

Missourians for Responsible Transportation

Generate Health St. LouisMU School of Health Professions

Health Forward Foundation

Nurture KC

HealthierMO

Ozark Public Health InstituteKansas City Health Department

Polk County Health Center

Lincoln University - Paula J. Carter Center for Minority HealthSoutheast Hospital

Missouri Academy of Family Physicians

SSM Health - St. Mary’s Hospital

Missouri Area Health Education Center

St. Louis City Department of HealthMissouri Bootheel Regional Consortium

St. Louis County Department of HealthMissouri Cancer Consortium

St. Louis University

Missouri Center for Public Health ExcellenceState Emergency Management Agency

Missouri Coalition for Oral HealthTobacco Free Missouri

Missouri Community Action Network

University of Missouri

Missouri Council for Activity and Nutrition

University of Missouri Center for Health Policy

Missouri Dental Association

University of Missouri Interdisciplinary Center for Food Security

Missouri Dental Hygiene Association

Uzazi Village

Missouri Department of Health and Senior Services

Washington County Ambulance District

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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Missouri’s SHIP. The goals listed in thisMISSOURI STATE HEALTH IMPROVEMENT PLAN

SHIP Priority Issues

document represent the “big ideas”
under each priority and are divided into
more targeted objectives designed todrive progress towards their associatedgoals. Lastly, specific activities and

The State Health Partner Group (SHPG) organizedissues identified in the SHA into six SHIP priority
issues and assembled teams around each theme.
These teams consisted of members of the SHPG,
internal and external stakeholders, and subject
matter experts. Each team explored the key healthissues from the SHA that contributed to theirassigned strategic priority issue and identified theoverarching goals, objectives and activities designed
to address those issues.
These priority issues differ from the
key health issues named in the SHA
in a number of ways. Firstly, the SHA’s
indicators are just that: indicators of thegeneral health of Missouri’s citizens andhealth system.
The strategic priority issues identified
represent areas that require concerted
focus and energy from every level of the
public health system. These are largescale concerns that affect the State ofMissouri as a whole. These SHIP priority
issues force the public health system
to innovate and integrate collaborative
action steps from partners at the stateand local levels.
The SHIP priority issue teams came
together to kick off a review of the SHIP
on June 16, 2023. Each team then met
virtually over the next three months
to review and revise the existing goals
and objectives in the 2021 version ofpotential resources were identified
as the best methods to achieve thoseobjectives. The State Health Partner
Group seized this opportunity to review
the 2021 version of the SHIP throughthe lens of a post-pandemic publichealth world. This 2023 edition of theSHIP represents the renewed focus on
systems-level thinking.
To best serve its purpose as the core
structure of the public health system’splanning efforts to improve healthoutcomes in the State of Missouri,
the SHIP is a living document. Annual
reviews and check-ins on progressaround the goals and objectives
outlined in the SHIP present theopportunity to revise specific language,
determine areas of need and redirect
resources to priority areas lagging
behind in progress. The DHSS Office of
Performance Management coordinates
health planning activities and assures
accountability for goals set in theseplans, including the SHIP.
The goals and objectives listed undereach SHIP priority area are set on a
five-year project scale. Work aroundeach priority will be ongoing throughout
the five-year timespan; however, eachspecific action item lists a target dateto create a phased approach to theimprovement strategies.

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SPI 1: PUBLIC HEALTH SYSTEM BUILDINGSHIP PRIORITY ISSUE 1:

Public Health
System Building2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SHIP PRIORITY ISSUE 1

Public Health System Building
According to the Centers for Disease Control
and Prevention (CDC), “Public health systems
are commonly defined as ‘all public, private, andvoluntary entities that contribute to the deliveryof essential public health services within ajurisdiction.’” The priority issue regarding the overallpublic health system grew out of an identificationof concerns around the Missouri public healthworkforce and its capacity to collaboratively affectchange. The following goals and objectives arefocused on creating a sustainable high-performing
public health system.

Key Health Issues
targeted▶

Workforce Development & Training▶

Collaboration & Collective Impact▶

Foundational Local Services

Goal 1: Integrate the Missouri Foundational Public Health Services (FPHS) modelthroughout the Missouri public health system
The integration of the FPHS throughout the Missouri health system will help address many of the larger concerns about the system as awhole. This includes, but is not limited to, issues of workforce development, evidence based decision-making, equity and inclusion built into
the system and strategic thinking.

Learn more on

14-15

Goal 2: Strengthen Missouri’s public health system by increasing the number ofaccredited local public health agencies in Missouri
Accreditation within public health can lead to many benefits for the agencies who undergo the process as well as for their constituents. The
Public Health Accreditation Board survey data shows that quality improvement, transparency, accountability and the team’s capacity toprovide high quality services all increase, among other benefits.

Learn more on

16

Goal 3: Improve the Missouri public health data landscape

Data is foundational to all public health decision making. To that end, this goal seeks to increase both the capacity and effectiveness of theoverall public health data system.

Learn more on

17-18

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SPI 1: PUBLIC HEALTH SYSTEM BUILDING

Goal 1: Integrate the Missouri Foundational Public Health Services (FPHS) modelthroughout the Missouri public health system

Overview
The integration of the FPHS Modelthroughout the Missouri health system will
help address many of the larger concerns
about the system as a whole. This includes,
but is not limited to, issues of workforce
development, evidence based decisionmaking, equity and inclusion built into thesystem and strategic thinking.

Objectives▶

Create a unified culture that fully
supports the implementation of theMissouri FPHS model in order tostrengthen relationships, operations

Objective 1: Create a unified culture that fully
supports the implementation of the Missouri
FPHS model in order to strengthen relationships,
operations and coordination across the public healthsystem by December 31, 2026.
Activities:▶

Create and implement a communication plan to define the purpose, value andimpact of public health system building efforts.

▶

Establish standard language to align system building efforts.

▶

Share best practices from across the public health system.

▶

Leverage existing resources from partners to ensure consistency and reduce
duplication.

▶

Promote shared learning opportunities.

Metrics:▶

and coordination across the public▶

health system.
▶

Compare ongoing self-reported
local public health capacity with
#HealthierMO LPHA Capacity
Assessment Report.

▶

Percentage of LPHAs that self-report adequate service delivery within theirjurisdiction for each FPHS area of expertise and capability.
Emergency Preparedness and Response▶

Policy Development and Support▶

Communications▶

Community Partnership Development▶

Organizational Administrative Competencies▶

Accountability and Performance Management▶

Assessment and Surveillance

Operationalize the Missouri FPHS Model▶

Communicable Disease Control

using an action plan.

▶

Chronic Disease Prevention▶

▶

Linkage to Medical, Behavioral and Community Resources▶

Injury Prevention▶

Maternal, Child and Family Health▶

Environmental Public HealthResponse rate by LPHAs to annual capacity assessment surveys

Collaborators and Responsible Organizations:

▶

DHSS

▶

#HealthierMO▶

Local Public Health Agencies▶

University of Missouri2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 1: PUBLIC HEALTH SYSTEM BUILDING

Goal 1: Integrate the Missouri Foundational Public Health Services (FPHS) modelthroughout the Missouri public health system

Overview

Objective 2: Train the public health workforce on the
Missouri FPHS model by December 2025.

The integration of the FPHS Modelthroughout the Missouri health system will
help address many of the larger concerns
about the system as a whole. This includes,
but is not limited to, issues of workforce
development, evidence based decisionmaking, equity and inclusion built into thesystem and strategic thinking.

Objectives▶

▶

Partner with MOCPHE and #HealthierMO to develop new and enhance existing
training materials, establish standard definitions and a training plan.

▶

Support hands-on practicum learning experiences with an emphasis on thescalability of the Missouri FPHS model.

▶

Connect the Missouri FPHS model with existing leadership and workforce
development initiatives, including the 8 core competencies of public healthprofessionals.

Metrics:▶

Percentage of state and local public health workforce trained

supports the implementation of the▶

Number of training activities performed by #HealthierMO and/or MOCPHECollaborators and Responsible Organizations:strengthen relationships, operations▶

#HealthierMOand coordination across the public▶

MOCPHE

health system.

▶

DHSS

Compare ongoing self-reported
local public health capacity with
#HealthierMO LPHA Capacity
Assessment Report.

▶

Leverage existing meetings, events, online resources and learning management
systems to repeat the training message around the Missouri FPHS model.

Create a unified culture that fully
Missouri FPHS model in order to▶

Activities:▶

Operationalize the Missouri FPHS Modelusing an action plan.

Objective 3: Operationalize the Missouri FPHS Modelusing an action plan by FY 2027.
Activities:▶

Encourage the inclusion of the Missouri FPHS model in public health agency
strategic plans.

▶

Tailor training materials and approach to address any identified knowledge
gaps.

▶

Integrate the goals of the Missouri FPHS costing project to streamline the work.

▶

Create focused learning opportunities and communities around individualcomponents of the Missouri FPHS model to enable deeper understanding.

Metrics:▶

Proportion of state funding secured to operationalize FPHS Model relative tocost gap identified through costing project

Collaborators and Responsible Organizations:

▶

DHSS

▶

#HealthierMO▶

MOCPHE▶

MPHA▶

University of Missouri2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 1: PUBLIC HEALTH SYSTEM BUILDING

Goal 2: Strengthen Missouri’s public health system by increasing the number ofaccredited local public health agencies in Missouri

Overview
Accreditation within public health canlead to many benefits for the agencies
who undergo the process as well as fortheir constituents. The Public HealthObjective 1: Create an infrastructure to support
LPHA progress towards accreditation activities by
November 20, 2027.
Activities:▶

Accreditation Board survey data shows▶

that quality improvement, transparency,
accountability and the team’s capacity toCreate a central location for guidance documents and resources for thecommunity of practice, including templates and links to organizations.

▶

Integrate the goals of DHSS’ Public Health Infrastructure Grant activities
supporting LPHA accreditation:

Objectives▶

Create an infrastructure to support▶

LPHA progress towards accreditation
activities.

Assure the community of practice remains agnostic to the accrediting
body of the LPHA’s choice.

▶

provide high quality services all increase,among other benefits.

Create communities of practice for LPHAs actively engaged in the accreditation
process.

▶

Accreditation cost reimbursement.

▶

LPHA accreditation and governing body education incentives.

Financial support for steps towards accreditation (readiness assessments, PHAB
Pathways program)

Metrics:▶

Percentage of LPHAs pursuing accreditation or reaccreditation

Collaborators and Responsible Organizations:

▶

DHSS

▶

MOCPHE

▶

PHAB

▶

MICH

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SPI 1: PUBLIC HEALTH SYSTEM BUILDING

Goal 3: Improve the Missouri public health data landscape

Overview

Objective 1: Map the current public health data
landscape by December 2025.

Data is foundational to all public healthdecision making. To that end, this goal
seeks to increase both the capacity andeffectiveness of the overall public healthdata system.

Objectives▶

Map the current public health data
landscape.

▶

Establish data governance and sharing
guidelines.

Activities:▶

Determine which data points are needed, who needs the data, how timely thedata must be shared, and how the data should be shared.

▶

Identify experts in data who can analyze the public health data system andguide changes.

▶

Document and prioritize the steps needed to strengthen the public health data
landscape.

▶

Create a partnership to discuss ongoing data needs with LPHAs, DHSS,
academic partners and associations.

Metrics:▶

Number of data points assessed▶

Number of systems assessed

Collaborators and Responsible Organizations:

▶

DHSS

▶

LPHAs

▶

MOCPHE▶

MU▶

MSU/OPHI▶

MHA

Objective 2: Establish data governance and sharing
guidelines by December 2025.
Activities:▶

Create a data governance workgroup or committee to draft guidelines.
▶

Ensure legal representation is present at workgroup sessions for LPHAs,
DHSS, academic partners and associations.

Metrics:▶

Participation rate of data governance workgroup or committee▶

Number of organizations that adopt and implement guideline data governanceand sharing guidelines

Collaborators and Responsible Organizations:

▶

DHSS

▶

LPHAs

▶

MOCPHE▶

MU▶

MSU/OPHI

▶

MHA

▶

MPHA

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SPI 1: PUBLIC HEALTH SYSTEM BUILDING

Goal 3: Improve the Missouri public health data landscape

Overview
Data is foundational to all public healthdecision making. To that end, this goal
seeks to increase both the capacity andeffectiveness of the overall public healthdata system.

Objectives▶

Map the current public health data
landscape.

▶

Establish data governance and sharing
guidelines.

Objective 3: Create and Implement the Missouri
Master Public Health Data Modernization Plan byJune 2026.
Activities:▶

Ensure representation from LPHAs, DHSS, academic partners and associations
during drafting sessions.

▶

Integrate project goals with the DHSS strategic planning objective for the Data
Modernization Plan.

▶

Work with partners to implement the Missouri Master Public Health Data
Modernization Plan.

▶

Evaluate the outcomes of the Missouri Master Public Health Data Modernization
Plan based on the public health data landscape map.

Metrics:▶

Participation rate of representation during drafting sessions▶

Number of priorities implemented from Missouri Master Public Health Data
Modernization Plan▶

Web analytics for Modernization Plan website

Collaborators and Responsible Organizations:

▶

DHSS

▶

LPHAs

▶

MOCPHE▶

MU▶

MSU/OPHI

▶

MHA

▶

MPHA

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SPI 2: INFANT & MATERNAL HEALTH

SHIP PRIORITY ISSUE 2:

Infant &Maternal Health2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SHIP PRIORITY ISSUE 2

Infant & Maternal Health
Infant Mortality is an internationally regarded
measure of a population’s health, providing insight
into a country or state’s ability to care for the healthand well-being of its citizens and ensure the safetyof future generations. Infant mortality refers to thedeath of an infant before the first birthday. The
infant mortality rate is defined as the number ofdeaths among all live births in one year. Rates of
infant deaths have been decreasing since 2013 forBlack or African American infants, while the rate forwhite infants increased slightly.

Key Health Issues
targeted▶

Infant & Maternal Mortality

Goal 1: Advance equitable infant health to decrease infant mortality and improveoverall infant healthA number of different factors contribute to infant mortality and this goal seeks to address the leading causes. One of thebiggest ways to reduce infant mortality is to ensure the mother receives adequate prenatal care.
Learn more on

21-23

Goal 2: Advance/ensure equitable health during the childbearing continuum toimprove health outcomes of childbearing people
Infant and maternal health are intrinsically linked and both must be addressed.
Learn more on

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SPI 2: INFANT & MATERNAL HEALTH

Goal 1: Advance equitable infant health to decrease infant mortality and improveoverall infant health

Overview
A number of different factors contributeto infant mortality, and this goal seeks toaddress the leading causes. One of thebiggest ways to reduce infant mortality is
to ensure the mother receives adequateprenatal care.

Objectives▶

Reduce the rate of Non-Hispanic black/

Objective 1: Reduce the rate of Non-Hispanic black/
African American infant deaths (birth to 12 months)
by 15 percent from 12.3 deaths per 1,000 black live
births (2018-2022) to a rate of 10.5 by Dec. 31, 2027.
Activities:▶

Promote optimal and equitable perinatal health through the Perinatal Quality
Collaborative (PQC).

▶

Promote optimal and equitable perinatal health through implementation of theMaternal Mortality Prevention Plan.

▶

Implement a statewide FIMR network with 10 regional FIMR teams.

▶

Analyze PRAMS data on topics that include timing of prenatal care, barriers toreceiving prenatal care, experiencing stressful life events, attending postpartum
visits, experiencing postpartum depression, breastfeeding and bedsharing. Use
PRAMS data to help inform efforts to reduce black infant mortality.

▶

Analyze birth and death certificate data to identify leading causes of infant
death and risk factors.

▶

Partner with DSS MO HealthNet and traditional maternal care providers,such as doulas, midwives, CHWs, etc., to increase access to and utilization ofcommunity-based maternal care services, especially for black families.

▶

Development of a MCH specialty curriculum for CHWs, with a focus on perinatal
health.

African American infant deaths (birth
to 12 months) by 15 percent from 12.3
deaths per 1,000 black live births (20182022) to a rate of 10.5 by Dec. 31, 2027.
▶

Increase the percent of 12 month olds
who are up to date on all vaccinations
10% from baseline by Dec. 31, 2027.

▶

Creation of a website directory of car safety trainings and child seat provision.

▶

Encourage safe sleep certification of hospitals.

▶

Use CFRP data to inform efforts to reduce accidental infant death.

▶

Develop and coordinate a network of home visiting programs throughout thestate to assess access to perinatal home visiting in high-risk communities.

▶

Strategies from MCH State Action Plan:▶

Distribute information and education about sleep-related infant deaths.

▶

Support programs that provide cribs for low-income families.

▶

Collaborate with partners to distribute safe sleep resources to low-income
families.

▶

Assess baseline and post-intervention safe sleep practices amongprogram participants and families.

▶

Partner with community service providers and other agencies to conduct
trainings on infant safe sleep that target parents, child care providers,
grandparents, home health care professionals, staff of obstetric andpediatric clinics, retailers and faith-based organizations.

▶

Facilitate partnerships with other state agencies, hospitals, nonprofits,
media and other stakeholders to develop innovative programs andpolicies that promote safe infant sleep, reduce infant mortality, encouragesmoking cessation and promote breastfeeding, immunizations andprenatal care.

▶

Promote inclusion of community-based programs and resources, including
home visiting programs, as part of existing digitized resource and referral
networks (i.e., Unite Us platform, Uplift Connection, etc.)▶

Encourage collaborating agencies/organizations to partner with multi-sectored
local partners and include local partner efforts and accomplishments inreporting to SHIP IMH Priority Group.

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 2: INFANT & MATERNAL HEALTH

Goal 1: Advance equitable infant health to decrease infant mortality and improveoverall infant health

Overview
A number of different factors contributeto infant mortality, and this goal seeks toaddress the leading causes. One of thebiggest ways to reduce infant mortality is
to ensure the mother receives adequateprenatal care.

Objectives▶

Reduce the rate of Non-Hispanic black/
African American infant deaths (birth
to 12 months) by 15 percent from 12.3▶

Metrics:▶

Black infant mortality rate▶

Preterm birth rate of black infants (2019-2021: 15.3%; 15% reduction = 13.0%)▶

Rate of low birthweight black infants (2019-2021: 15.6%; 15% reduction = 13.2%)▶

Accidental death rate (per 100k live births) (2018-2022: 8.3 per 10,000 for all MO
infants; 19.5 for Black infants▶

15% reduction = 7.1 for all infants and 16.6 for Black infants)

Collaborators and Responsible Organizations:▶

MCH Title V Program▶

Missouri Safe Sleep Coalition▶

DSS MO HealthNet▶

DSS Child Fatality Review Program (CFRP)▶

Children’s Trust Fund▶

MHA (MO PQC/MC-LAN)deaths per 1,000 black live births (2018-▶

DESE Office of Childhood2022) to a rate of 10.5 by Dec. 31, 2027.

▶

MO Community Doula Council (Uzazi Village, Jamaa Birth Village, Mid-MissouriBlack Doula Collective, MBRC)

Increase the percent of 12 month olds▶

MBRC Community Doula Services

who are up to date on all vaccinations▶

Healthy Start grantees (MBRC & Nurture KC)

10% from baseline by Dec. 31, 2027.

▶

The Doula Foundation▶

St. Louis Doula Project▶

Doulas of Greater St. Louis▶

Nurture KC▶

Missouri Foundation for Health▶

MOAIMH-EC▶

Faith Based Partners/Organizations▶

Injury Prevention Program▶

MIVPAC▶

Safe Kids Coalitions

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 2: INFANT & MATERNAL HEALTH

Goal 1: Advance equitable infant health to decrease infant mortality and improveoverall infant health

Overview
A number of different factors contributeto infant mortality, and this goal seeks toaddress the leading causes. One of thebiggest ways to reduce infant mortality is

Objective 2: Increase the percent of 12 month olds
who are up to date on all vaccinations 10% frombaseline by Dec. 31, 2027.
Activities:▶

Encourage well child visits.

to ensure the mother receives adequate▶

Creation of a user-friendly reminder of vaccination timing for parents.

prenatal care.

▶

Patient outreach and follow-up.

▶

Engagement of Community Health Workers, Doula, home visitors and othercommunity-based maternal/infant health care providers.

▶

Promote child, adolescent and adult immunizations, especially for thosecommunicable diseases significantly impacting infant health, such as Pertussis,
Measles, Pneumococcal disease, Influenza, etc.

▶

Encourage collaborating agencies/organizations to partner with multi-sectored
local partners and include local partner efforts and accomplishments inreporting to SHIP IMH Priority Group.

Objectives▶

Reduce the rate of Non-Hispanic black/
African American infant deaths (birth
to 12 months) by 15 percent from 12.3
deaths per 1,000 black live births (20182022) to a rate of 10.5 by Dec. 31, 2027.

▶

Increase the percent of 12 month olds
who are up to date on all vaccinations
10% from baseline by Dec. 31, 2027.

Metrics:▶

Percent of 12 month olds up-to-date on vaccines (ShowMeVax)

Collaborators and Responsible Organizations:▶

MCH Title V Program

▶

DHSS

▶

Missouri Immunization Coalition

▶

LPHAs

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SPI 2: INFANT & MATERNAL HEALTH

Goal 2: Advance/ensure equitable health during the childbearing continuum toimprove health outcomes of childbearing people

Overview
Infant and maternal health are intrinsicallylinked, and both must be addressed.

Objectives▶

Increase the percent of women ofchildbearing age who have received
selected women/maternal preventive
health services as determined by DHSS

Objective 1: Increase the percent of women ofchildbearing age who have received selected women/maternal preventive health services as determined by
DHSS by Dec. 31, 2027.
Activities:▶
▶

Partner with community-based organizations to provide prenatal care.

▶

Strategies from MCH State Action Plan:

by Dec. 31, 2027.
▶

Increase the percent of women ofchildbearing age who self-report having▶

Implement community-based health promotion efforts.

▶

Communicate the value of and collaborate with partners in maternal
health initiatives.

▶

Raise awareness of the importance of reproductive life planning.

▶

Educate women on the importance of immunizations.

baseline by Dec. 31, 2027.

▶

Promote comprehensive health care for pregnant women, postpartum
women and women of childbearing age.

Reduce the percent of preventable▶

Support activities and facilitate partnerships to create environments that
support healthy eating and active living.

▶

Partner with tobacco control programs and community-based partners toassure delivery of effective tobacco cessation services.

▶

Participate in maternal and women’s health partnerships by convening
public health and advocacy partners for strategic thinking and action,
engaging clinicians as partners and engaging collaboratives to improvematernal health and health care equity.

▶

Address underlying social drivers of health.

received “respectful care” 10% from▶

Engagement of Community Health Workers, Doulas and other communitybased maternal health care providers.

maternal deaths with underlying
mental health issues including SUD by
10% annually by Dec. 31, 2027.

▶

Encourage collaborating agencies/organizations to partner with multi-sectored
local partners and include local partner efforts and accomplishments inreporting to SHIP IMH Priority Group.

Metrics:▶

Percent of women, ages 18 through 44, with a preventive medical visit in thepast year (BRFSS)▶

Oral health visits by women during pregnancy as measured by PRAMSCollaborators and Responsible Organizations:▶

MCH Title V Program▶

American College of Obstetricians and Gynecologists▶

Missouri Immunization Coalition▶

DHSS Office of Dental Health▶

Women’s preventative services initiative▶

MMHLA perinatal mental health screening recommendations▶

Maternal Health Multisector Action Network

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 2: INFANT & MATERNAL HEALTH

Goal 2: Advance/ensure equitable health during the childbearing continuum toimprove health outcomes of childbearing people

Overview
Infant and maternal health are intrinsicallylinked, and both must be addressed.

Objectives▶

Objective 2: Increase the percent of women ofchildbearing age who self-report having received“respectful care” 10% from baseline by Dec. 31, 2027.
Activities:▶

Education to providers on the 12 domains of respectful care: being free fromharm and mistreatment; maintaining privacy and confidentiality; preserving
women’s dignity; prospective provision of information and seeking of informed
consent; ensuring continuous access to family and community support;enhancing quality of physical environment and resources; providing equitablematernity care; engaging with effective communication; respecting women’s
choices that strengthen their capabilities to give birth; availability of competentand motivated human resources; provision of efficient and effective care; andcontinuity of care. (NIH)▶

Partner with academic institutions to include respectful care into the education
curriculum for all health care professionals (physicians, nurses, social workers,
APRNs, nutritionists, health care administrators, etc., including facilityrelated issues such as women’s perception of incompetence or disrespect ofprofessionals attending delivery, unhygienic facilities and unavailability of basic
supplies.

▶

Qualitative phenomenological study with focus group discussions (FGDs) withprimipara and multipara women using a semi-structured discussion guide toelicit discussion and audio recording and transcribing interviews verbatim.

▶

Analyze data using thematic analysis approach to describe the prevalence ofvarious categories of mistreatment during admission, labor and delivery andpostpartum care (losing self-control, being overlooked, being informed of bad
news without proper preparation, repeated examination without being properly
communicated/informed, disallow companions and left unattended duringlabor).

▶

Encourage collaborating agencies/organizations to partner with multi-sectored
local partners and include local partner efforts and accomplishments inreporting to SHIP IMH Priority Group.

Increase the percent of women ofchildbearing age who have received
selected women/maternal preventive
health services as determined by DHSS
by Dec. 31, 2027.

▶

Increase the percent of women ofchildbearing age who self-report having
received “respectful care” 10% frombaseline by Dec. 31, 2027.

▶

Reduce the percent of preventablematernal deaths with underlying
mental health issues including SUD by
10% annually by Dec. 31, 2027.

Metrics:▶

Number of Phase 9 PRAMS question added to survey▶

Percent of women of childbearing age who self-report having received“respectful care”

Collaborators and Responsible Organizations:▶

MCH Title V Program

▶

MHA

▶

MO PQC/MC-LAN▶

American College of Obstetricians and Gynecologists

▶

MPCA

▶

Maternal Health Multisector Action Network

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 2: INFANT & MATERNAL HEALTH

Goal 2: Advance/ensure equitable health during the childbearing continuum toimprove health outcomes of childbearing people

Overview
Infant and maternal health are intrinsicallylinked, and both must be addressed.

Objectives▶

Increase the percent of women ofchildbearing age who have received

Objective 3: Reduce the percent of preventablematernal deaths with underlying mental healthissues including SUD by 10% annually by Dec. 31, 2027.
Activities:▶

Implement Domain 2 of the Maternal Mortality Prevention Plan: establish a
Perinatal Health Access Project.

▶

PAMR Recommendations:▶

selected women/maternal preventive
health services as determined by DHSS
by Dec. 31, 2027.
▶

▶

received “respectful care” 10% frombaseline by Dec. 31, 2027.
▶

▶

Increased community outreach; and▶

Increased knowledge of how to treat mental health conditions during
pregnancy.

Increase the percent of women ofchildbearing age who self-report having

Reduce the percent of preventablematernal deaths with underlying

Strategies from MCH State Action Plan:▶

Create supportive environments that promote healthy and empoweredindividuals, families and communities.

▶

Foster positive public dialogue; counter shame, prejudice and silence; andbuild public support for suicide prevention.

▶

Address the needs of vulnerable groups, tailoring strategies to match thecultural and situational contexts in which they are offered, and seek toeliminate disparities.

▶

Coordinate and integrate existing efforts addressing…behavioral health toensure continuity of care.

▶

Promote changes in systems, policies and environments that will support
and facilitate the prevention of suicide and related problems.

▶

Collaborate with behavioral health agencies/partners to implement theStrengthening Families Protective Factors Framework.

▶

Promote efforts to reduce access to lethal means among individuals withidentified suicide risks.

▶

Apply the most up-to-date knowledge base for suicide prevention.
Implement and spread evidence-based suicide and self-harm prevention
strategies and programs.

▶

Strengthen collaboration across agencies, develop new tools andcapacity, and implement evidence-based change in suicide and self-harmprevention strategies.

▶

Implement and spread evidence-based prevention and emergency
mental health programs.

mental health issues including SUD by
10% annually by Dec. 31, 2027.

▶

Use of validated screenings of mental health conditions and substanceuse disorder to be conducted at multiple intervals during pregnancy andthe postpartum period;

Encourage collaborating agencies/organizations to partner with multi-sectored
local partners and include local partner efforts and accomplishments inreporting to SHIP IMH Priority Group.

Metrics:▶

Percent of preventable pregnancy-related deaths due to underlying mental
health issues, including SUD.

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 2: INFANT & MATERNAL HEALTH

Goal 2: Advance/ensure equitable health during the childbearing continuum toimprove health outcomes of childbearing people

Overview
Infant and maternal health are intrinsicallylinked, and both must be addressed.

Objectives▶

Increase the percent of women ofchildbearing age who have received
selected women/maternal preventive
health services as determined by DHSS

Collaborators and Responsible Organizations:▶

MCH Title V Program▶

MO PAMR▶

Department of Mental Health▶

Maternal Health Multisector Action Network

▶

MHA

▶

MO PQC/MC-LAN▶

MU Telehealth Network (Perinatal Access Project)▶

Faith Based Partners/Organizations▶

Injury Prevention Programby Dec. 31, 2027.
▶

Increase the percent of women ofchildbearing age who self-report having
received “respectful care” 10% frombaseline by Dec. 31, 2027.

▶

Reduce the percent of preventablematernal deaths with underlying
mental health issues including SUD by
10% annually by Dec. 31, 2027.

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 3: HEALTH BEHAVIORSHIP PRIORITY ISSUE 3:

HealthBehavior

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SPI 3: HEALTH BEHAVIORSTRATEGIC PRIORITY ISSUE NO. 3

Health Behavior
This priority issue is focused on helping Missourians
with foundational health behaviors. People area product of their environment, and this ripples
throughout the three goals contained in thisissue. The SHIP proposes a two-pronged approachto dealing with these goals—addressing boththe individual behavior, and the environments,
policies and systems that have led to the behavior’s
prevalence.

Key Health Issues
targeted▶

Obesity▶

Heart Disease▶

Smoking and Tobacco Use▶

Diabetes

Goal 1: Reduce the inequities in chronic disease rates and support optimal
health by increasing access to healthy foods that enable consuming a dietconsistent with the Dietary Guidelines for Americans.
The Dietary Guidelines for Americans are research-based guidelines that outline what people should eat and drink to meet
nutritional needs, prevent or manage disease and achieve optimal health. Some people do not have the information theyneed to choose healthy foods. Others do not have access to enough affordable healthy food. Strategies that focus on helping
everyone get healthy foods are key to reducing food insecurity and improving health.
Learn more on

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Goal 2: Reduce inequities in disease, disability and injury to improve healthoutcomes by increasing access to safe places to be physically active.
Lack of physical activity is correlated to many negative health outcomes, including diabetes, heart disease, obesity, as wellas accidental injury and disability. Regular physical activity is critical for achieving and maintaining good health. Being
physically active at least 150 minutes per week is associated with reduced risk for chronic diseases including cardiovasculardisease, hypertension, diabetes and certain cancers. Not all communities have the same opportunities for physical activity
for reasons including higher rates of crime; lack of green space, recreational facilities and infrastructure such as bike lanes
and sidewalks; and lack of resources to create this infrastructure.
Learn more on

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SPI 3: HEALTH BEHAVIORSTRATEGIC PRIORITY ISSUE NO. 3

Health Behavior
This priority issue is focused on helping Missourians
with foundational health behaviors. People area product of their environment, and this ripples
throughout the three goals contained in thisissue. The SHIP proposes a two-pronged approachto dealing with these goals—addressing boththe individual behavior, and the environments,
policies and systems that have led to the behavior’s
prevalence.

Key Health Issues
targeted▶

Obesity▶

Heart Disease▶

Smoking and Tobacco Use▶

Diabetes

Goal 3: Prevent tobacco-related illness and death by decreasing commercial
tobacco product use and related inequities and disparities.
Tobacco use, including the use of all tobacco products including e-cigarettes, in Missouri continues to be a priority healthconcern. This goal seeks to reduce the percentage of current users, and prevent initiation of tobacco use among youth andyoung adults.
Learn more on

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SPI 3: HEALTH BEHAVIOR

Goal 1: Reduce the inequities in chronic disease rates and support optimal health byincreasing access to healthy foods that enable consuming a diet consistent with theDietary Guidelines for Americans

Overview
The Dietary Guidelines for Americans areresearch-based guidelines that outline
what people should eat and drink to meet
nutritional needs, prevent or manage
disease, and achieve optimal health. Somepeople do not have the information theyneed to choose healthy foods. Others do
not have access to enough affordable

Objective 1: Increase Missourians eating fruit 1+ times
per day from 56.6% to 59.4% (2021 to 2027) (5%) andincrease Missourians eating vegetables 1+ times per
day from 80.5% to 84.5% (2021 to 2027)
Activities:▶

Monitor trends in food insecurity data and identify disparate populations forfocused work.

▶

Utilize resources such as the Missouri Hunger Atlas, Map the Meal Gap andothers.

▶

Use data to engage local communities in conversations about how best to meet
local food access needs.

▶

Support efforts (HOP, SPAN, REACH) to increase nutrition guidelines in foodassistance programs (food banks, etc.).

healthy food. Strategies that focus on
helping everyone get healthy foods are key
to reducing food insecurity and improving▶

health.

Objectives▶

▶

Increase Missourians eating fruit 1+

Build local and state capacity to address the needs of populations at higher riskof food insecurity, embed food insecurity strategies in larger efforts.
▶

times per day from 56.6% to 59.4% (2021
to 2027) (5%) and increase Missourians
eating vegetables 1+ times per day from
80.5% to 84.5% (2021 to 2027).

Disseminate policy and program resources to communities working toincrease access to healthy foods (Federal Food Service Guidelines, Healthy
Eating Research Guidelines, Eat Smart in Parks).

Incorporate trauma-informed strategies to build capacity to addresscomplex/intersecting needs.

▶

Build understanding among community stakeholders and decision makers of
the barriers for enrollment of food assistance programs.

▶

Center work with input from with people with lived experience.

▶

Increase collaboration with MOCAN workgroups:▶

Food Systems Workgroup to create/expand network of stakeholders
working to address food insecurity and partner with food policy coalitions
to explore opportunities for supporting regional/local food systems thatare responsive to the needs of their communities.

▶

Health Care Workgroup to explore ways to work with health care providers
to support access to healthy foods and assess patients’ food access needs.

▶

Partner with regional food banks to increase mobile pantry stops in local
communities/neighborhoods so that the pantry comes to people.

▶

Partner with public transit and active transportation agencies andorganizations to reduce barriers to accessing healthy foods in both urban andrural communities.

▶

Collaborate with statewide partners to connect food insecure households to
SNAP and other resources. i.e., online citizen portal—no wrong door approach.

▶

Collaborate with state and local partners, such as MDA, University of Missouri
Extension (UME), community-based organizations (CBOs) and the charitable
food system, to increase access to produce through community gardens,
farmers’ markets, Eat Smart in Parks and Supporting Wellness in Pantries
Programs.

▶

Collaborate with state and local partners to support increased affordability of
produce through voucher programs, such as WIC/WIC Farmers’ Market, Double
Up Food Bucks and the Senior Farmer’s Market Program.

▶

Share successes and lessons learned from communities engaging in this work.

▶

Help communities learn more about racial inequities, food insecurity and policy
environment.

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SPI 3: HEALTH BEHAVIOR

Goal 1: Reduce the inequities in chronic disease rates and support optimal health byincreasing access to healthy foods that enable consuming a diet consistent with theDietary Guidelines for Americans

Overview
The Dietary Guidelines for Americans areresearch-based guidelines that outline
what people should eat and drink to meet
nutritional needs, prevent or manage
disease, and achieve optimal health. Somepeople do not have the information theyneed to choose healthy foods. Others do
not have access to enough affordable
healthy food. Strategies that focus on
helping everyone get healthy foods are key

Metrics:▶

Percent of Missourians eating fruit and vegetables

Collaborators and Responsible Organizations:▶

Missouri Physical Activity and Nutrition Program (MPAN)▶

Bureau of Community Food and Nutrition Assistance (CFNA)

▶

DSS

▶

MU Interdisciplinary Center for Food Security▶

MU Extension—SNAP-Ed, Missouri Council for Activity and Nutrition (MOCAN)▶

Feeding Missouri▶

Operation Food Search▶

Regional food banks▶

Missouri Foundation for Health

▶

CCDC

to reducing food insecurity and improving▶

MDA

health.

▶

Missouri Transportation Task Force

Objectives▶

Increase Missourians eating fruit 1+
times per day from 56.6% to 59.4% (2021
to 2027) (5%) and increase Missourians
eating vegetables 1+ times per day from
80.5% to 84.5% (2021 to 2027).

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SPI 3: HEALTH BEHAVIOR

Goal 1: Reduce the inequities in chronic disease rates and support optimal health byincreasing access to healthy foods that enable consuming a diet consistent with theDietary Guidelines for Americans

Overview

Objective 2: Decrease Missouri youth not eating
vegetables from 10% (2021) to 9.5% by 2027.

The Dietary Guidelines for Americans areresearch-based guidelines that outline

Activities:

what people should eat and drink to meet▶

Develop a report on status of youth nutrition behaviors and environments.

nutritional needs, prevent or manage▶

Disseminate policy and program resources to communities working to increase
access to healthy foods (Go NAPSACC, farm to school/preschool, Healthy Eating
Research Guidelines, Eat Smart in Parks).

disease, and achieve optimal health. Somepeople do not have the information they▶

Engage teens/youth in designing solutions.

need to choose healthy foods. Others do▶

Partner with the MOCAN Schools Workgroup.

not have access to enough affordable▶

Partner with DESE/DHSS/MDA/Extension to expand farm to school/preschool
programs in Missouri.

▶

Share successes and lessons learned from communities engaging in this work.

healthy food. Strategies that focus on
helping everyone get healthy foods are key
to reducing food insecurity and improving
health.

Objectives▶

Increase Missourians eating fruit 1+
times per day from 56.6% to 59.4% (2021
to 2027) (5%) and increase Missourians
eating vegetables 1+ times per day from

Metrics:▶

Percent of Missourians eating fruit and vegetables

Collaborators and Responsible Organizations:

▶

MPAN

▶

Bureau of Community Food and Nutrition Assistance (CFNA), WIC▶

DESE—Missouri Healthy Schools, Food and Nutrition Services

▶

MOCAN

▶

MDA

80.5% to 84.5% (2021 to 2027).

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 3: HEALTH BEHAVIOR

Goal 2: Reduce inequities in disease, disability and injury to improve health outcomesby increasing access to safe places to be physically active

Overview
Lack of physical activity is correlated tomany negative health outcomes, including
diabetes, heart disease, obesity, as well as
accidental injury and disability. Regularphysical activity is critical for achieving

Objective 1: Decrease percentage of adults whoreported no physical activity or exercise outside ofwork in the past 30 days from 25.3 (2021) to 22.8% by
Jan. 1, 2027.
Activities:▶

Identify key indicators for physical activity to monitor, and monitor
implementation of public health approaches to promoting active lifestyles(evaluation).

▶

Support safe, affordable and accessible public transportation systems andencourage the inclusion of multi-modal accommodations.

and maintaining good health. Being
physically active at least 150 minutes per
week is associated with reduced risk for▶

chronic diseases including cardiovasculardisease, hypertension, diabetes and certain
cancers. Not all communities have thesame opportunities for physical activity for▶

Develop and maintain a workforce with competence and expertise in physicalactivity and health.

▶

Engage in policy development and advocacy to elevate the priority of physicalactivity in public health practice, policy and research.

reasons including higher rates of crime;
lack of green space, recreational facilities
and infrastructure like bike lanes andsidewalks; and lack of resources to create
this infrastructure.

▶

Objectives▶

Decrease percentage of adults whoreported no physical activity or exercise▶

▶

Participate in development of a statewide active transportation plan.

▶

Support local communities to develop local active transportation plans
and/or adopt/implement complete streets policies.

Disseminate tools and resources important to promoting physical activity,
including resources that address the burden of disease due to inactivity, theimplementation of evidence-based interventions, and funding opportunities forphysical activity initiatives.
▶

Focus on strategies related to early care and education settings, workplace
wellness, complete streets, safe routes to school and built environment.

▶

Focus on disparate populations. People aged 65+ are significantly less likely to
exercise (66% vs 80% under 65). People with disabilities also significantly lesslikely to exercise (49% vs. 80%).

▶

Create, maintain and leverage cross-sectoral partnerships and coalitions that
implement evidence-based strategies to promote PA.

outside of work in the past 30 days from25.3 (2021) to 22.8% by Jan. 1, 2027.

Support implementation of community-based initiatives to promote andsupport active living.

Increase from 28% (2021) to 30.8% the▶

Support the Missouri Complete Streets Advisory Committee to collaborate
with statewide partners to increase opportunities for safe, affordable andaccessible active transportation that connects to everyday destinations.

▶

Support the MOCAN Physical Activity workgroup to create partnerships
with state and local agencies and organizations to support access toaffordable and accessible outdoor/indoor PA opportunities.

▶

Integrate physical activity messages/campaigns throughout MOCAN workgroups.

percent of high school students with60 minutes of moderate to vigorous
physical activity per day.

▶

Partner with health care and community physical activity providers to establish
and maintain physical activity prescription programs.

▶

Align work with strategies supported through HOP grant (2023-2028)(implemented in 10 counties in SE MO), State PA and Nutrition grant (20232028), and REACH grant(s).

▶

Share success stories.

▶

Share opportunities for physical activity across organizations.

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SPI 3: HEALTH BEHAVIOR

Goal 2: Reduce inequities in disease, disability and injury to improve health outcomesby increasing access to safe places to be physically active

Overview
Lack of physical activity is correlated tomany negative health outcomes, including
diabetes, heart disease, obesity, as well as
accidental injury and disability. Regularphysical activity is critical for achieving
and maintaining good health. Being
physically active at least 150 minutes per
week is associated with reduced risk forchronic diseases including cardiovasculardisease, hypertension, diabetes and certain

Metrics:▶

Percent of adults with reported physical activity

Collaborators and Responsible Organizations:▶

DHSS—MCH Title V, MPAN▶

UME—HOP, MOCAN▶

Missouri Complete Streets Advisory Committee

▶

MODOT

▶

Missourians for Responsible Transportation▶

YMCAs/State Alliance of YMCAs▶

Missouri Disability and Health Program

▶

AARP

▶

Area Agencies on Aging▶

Alzheimer’s Association

cancers. Not all communities have the▶

Missouri Association for Councils of Governments

same opportunities for physical activity for▶

Missouri Rural Health Association

reasons including higher rates of crime;
lack of green space, recreational facilities
and infrastructure like bike lanes andsidewalks; and lack of resources to create
this infrastructure.

Objectives▶

Decrease percentage of adults whoreported no physical activity or exercise
outside of work in the past 30 days from25.3 (2021) to 22.8% by Jan. 1, 2027.

▶

Increase from 28% (2021) to 30.8% thepercent of high school students with60 minutes of moderate to vigorous
physical activity per day.

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SPI 3: HEALTH BEHAVIOR

Goal 2: Reduce inequities in disease, disability and injury to improve health outcomesby increasing access to safe places to be physically active

Overview
Lack of physical activity is correlated tomany negative health outcomes, including
diabetes, heart disease, obesity, as well as
accidental injury and disability. Regularphysical activity is critical for achieving

Objective 2: Increase from 28% (2021) to 30.8% (by2027) the percent of high school students with 60
minutes of moderate to vigorous physical activity perday.
Activities:▶

Identify key indicators and monitor trends in data related to objective andincrease stakeholder awareness of the status of PA behaviors and environments
for Missouri youth.

▶

Continue to track implementation of strategies that promote physical activity
for MO kids.

▶

Encourage the inclusion of daily K-12 physical education in school accreditation
standards and local education agency (LEA) curricula.

▶

Link LEAs to resources that enable them to implement safe routes to schools
programs.

▶

Promote and support LEAs to complete the School Health Index assessment
and planning process.

▶

Support school districts in implementation of comprehensive school physicalactivity programs (CSPAPs).

▶

Create, maintain and leverage cross-sectoral partnerships and coalitions that
implement evidence-based strategies to promote PA.

and maintaining good health. Being
physically active at least 150 minutes per
week is associated with reduced risk forchronic diseases including cardiovasculardisease, hypertension, diabetes and certain
cancers. Not all communities have thesame opportunities for physical activity forreasons including higher rates of crime;
lack of green space, recreational facilities
and infrastructure like bike lanes andsidewalks; and lack of resources to create
this infrastructure.

▶

Objectives

Support the MOCAN PA and Schools Workgroups to collaborate withstatewide partners to develop and implement strategies to increase
opportunities for CSPAP in schools.

▶

Support the MO Coordinated School Health Coalition (MCSHC) to create
partnerships with state and local agencies and organizations to support
PA opportunities for youth.

▶

Build partnerships to focus on access to parks, green spaces and gym
opportunities (shared-use agreements).

▶

Decrease percentage of adults whoreported no physical activity or exercise
outside of work in the past 30 days from25.3 (2021) to 22.8% by Jan. 1, 2027.

▶

▶

Collaborate with the Department of Elementary and Secondary Education(DESE)—Missouri Healthy Schools (MHS) Program to support LEAs and schools
with improving quality health education, physical education and physicalactivity through CSPAP by providing technical assistance, professional
development and training.

▶

Provide consistent content across departmental communication channels (i.e.,
webpages, resources).

▶

Use existing communication channels (i.e., coalition and professional
associations) to promote resources.

Increase from 28% (2021) to 30.8% thepercent of high school students with60 minutes of moderate to vigorous
physical activity per day.

Metrics:▶

Percent of children with 60 minutes of moderate to vigorous physical activity
per day (Youth Risk Behavior Surveillance System)

Collaborators and Responsible Organizations:▶

DHSS MPAN, School Health Program, MCH Title V▶

DESE—MHS

▶

LEAs

▶

MO Coordinated School Health Coalition▶

MOCAN Schools Workgroup▶

Missourians for Responsible Transportation▶

Missouri Park and Recreation Association

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SPI 3: HEALTH BEHAVIOR

Goal 3: Prevent tobacco-related illness and death by decreasing commercial tobacco
product use and related inequities and disparities

Overview
Tobacco use, including the use of all
tobacco products including e-cigarettes, inMissouri continues to be a priority healthconcern. This goal seeks to reduce thepercentage of current users and prevent
initiation of tobacco use among youth andyoung adults.

Objectives▶

Decrease the prevalence of youth
grades 9-12 who currently use nicotine

Objective 1: By 2027, decrease the prevalenceof youth grades 9-12 who currently use nicotine
products [cigarettes, electronic vapor products,
smokeless tobacco (chewing tobacco, snuff, dip, snus
or dissolvable tobacco products), cigars (including
little cigars or cigarillos), shisha or hookah tobaccoand pipe tobacco] from 21.91% to 19% from 2021
baseline.
Activities:▶

Support policies to raise minimum legal sales age of tobacco products to atleast 21, including tobacco retail licensing requirements.

▶

Develop and implement a plan to educate state and local stakeholders on theevidence for minimum legal sales age laws (e.g., T21) for the purchase of tobacco
products.

▶

Identify, collect and analyze data needed to frame the problem (e.g., via tobacco
retail assessments and youth decoy checks).

▶

Partner with Missouri Chapter of American Academy of Pediatrics and otherprofessional associations to train pediatricians and other health care providers
working with adolescents.

products [cigarettes, electronic vapor
products, smokeless tobacco (chewing
tobacco, snuff, dip, snus or dissolvabletobacco products), cigars (including
little cigars or cigarillos), shisha or
hookah tobacco and pipe tobacco] from21.91% to 19% from 2021 baseline.
▶

Decrease the prevalence of adults
who currently use nicotine products[cigarettes, electronic smokelesstobacco) from 25.75% to 23% from 2022
baseline.

▶

Increase the percentage of Missourians
protected from secondhand smoke by
a comprehensive community or statesmoke-free law from 28.7% to 35.0%.

▶

Decrease prevalence of cigarettesmoking among adults receiving
Medicaid from 35.9% to 28%.

▶

Increase access to cessation services for adolescents.

▶

Provide audience-specific training to adults working with youth about harms oftobacco/nicotine use, cessation and cessation resources.

▶

Support schools in implementation of comprehensive tobacco-free campus
policies, including support for cessation.

Metrics:▶

Percent of teens who report having smoked cigarettes in the last month (YRBS)▶

Percent of teens who report having used e-cigarettes in the last month (YRBS)▶

Percent of teens who report having used smokeless tobacco products in the lastmonth (YRBS)▶

Percent of teens who report having ever used e-cigarettes (YRBS)

Collaborators and Responsible Organizations:▶

DHSS Tobacco Prevention and Control Program and Missouri Tobacco
Prevention and Control Strategic Plan workgroup▶

Missouri Telehealth Network▶

Missouri Prevention Resource Centers

▶

DESE

▶

Rescue Agency▶

Community-based organizations

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SPI 3: HEALTH BEHAVIOR

Goal 3: Prevent tobacco-related illness and death by decreasing commercial tobacco
product use and related inequities and disparities

Overview
Tobacco use, including the use of all
tobacco products including e-cigarettes, inMissouri continues to be a priority healthconcern. This goal seeks to reduce thepercentage of current users and prevent
initiation of tobacco use among youth andyoung adults.

Objectives▶

Objective 2: Decrease the prevalence of adults whocurrently use nicotine products [cigarettes, electronic
smokeless tobacco) from 25.75% to 23% from 2022
baseline by 2027.
Activities:▶
▶

Support and promote lung cancer screening for longer-term tobacco users.

▶

Expand tobacco use screening and delivery of tobacco treatment for youth andyoung adults, including for use of e-cigarettes.

▶

Educate all types of health care providers (HCPs), including health careextenders, on evidence based cessation options (including pharmacists,
pediatricians, PCPs, social workers, community support workers, etc.).

Decrease the prevalence of youth
grades 9-12 who currently use nicotine
products [cigarettes, electronic vapor
products, smokeless tobacco (chewing
tobacco, snuff, dip, snus or dissolvabletobacco products), cigars (including

Metrics:▶

21.91% to 19% from 2021 baseline.
▶

Decrease the prevalence of adults
who currently use nicotine products[cigarettes, electronic smokelesstobacco) from 25.75% to 23% from 2022
baseline.

▶

Increase the percentage of Missourians
protected from secondhand smoke by
a comprehensive community or state

Decrease prevalence of cigarettesmoking among adults receiving
Medicaid from 35.9% to 28%.

DHSS Tobacco Prevention and Control Program and Missouri Tobacco
Prevention and Control Strategic Plan workgroup

Objective 3: Increase the percentage of Missourians
protected from secondhand smoke by acomprehensive community or state smoke-free law
from 28.7% to 35.0% by 2027.
Activities:▶

Strengthen the Missouri State Clean Indoor Air Law.

▶

Support implementation of comprehensive tobacco-free policies in public
places at the local level.

▶

Provide training and technical assistance to stakeholders to implement
policies to reduce exposure to secondhand smoke in public places (e.g., parks,
restaurants, bars, workplaces).

▶

Train and engage youth to educate and advocate for smoke-free protection.

smoke-free law from 28.7% to 35.0%.
▶

Percent of adults who are current tobacco/vaping users

Collaborators and Responsible Organizations:▶

little cigars or cigarillos), shisha or
hookah tobacco and pipe tobacco] from

Promote health systems changes that support screening for and treatment of
tobacco use and dependence.

Metrics:▶

Percent of people exposed to secondhand smoke

Collaborators and Responsible Organizations:▶

DHSS Tobacco Prevention and Control Program and Missouri Tobacco
Prevention and Control Strategic Plan workgroup2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 3: HEALTH BEHAVIOR

Goal 3: Prevent tobacco-related illness and death by decreasing commercial tobacco
product use and related inequities and disparities

Overview
Tobacco use, including the use of all
tobacco products including e-cigarettes, inMissouri continues to be a priority healthconcern. This goal seeks to reduce thepercentage of current users and prevent
initiation of tobacco use among youth andObjective 4: Decrease prevalence of cigarettesmoking among adults receiving Medicaid from
35.9% to 28% by 2027.
Activities:▶

Build partnerships with organizations serving priority populations to meet
populations where they are.

▶

Determine how to connect tobacco control to organizations’ priorities, andpartner on program efforts that impacts overlapping populations in an
intentional, planned way that facilitates collective impact.

▶

Conduct listening sessions with priority populations and serving organizations
to identify needs, concerns and solutions.

▶

Continue hosting Tobacco Prevention and Control Strategic Plan Disparities
workgroup.

young adults.

Objectives▶

Decrease the prevalence of youth
grades 9-12 who currently use nicotine

Metrics:

products [cigarettes, electronic vapor▶

Percent of adults who are current tobacco/vaping users

products, smokeless tobacco (chewing▶

Percent of adults on Medicaid

tobacco, snuff, dip, snus or dissolvabletobacco products), cigars (including

Collaborators and Responsible Organizations:▶

DHSS Tobacco Prevention and Control Program and Missouri Tobacco
Prevention and Control Strategic Plan workgroup

hookah tobacco and pipe tobacco] from▶

DSS MO HealthNet

21.91% to 19% from 2021 baseline.

▶

MO Primary Care Association

little cigars or cigarillos), shisha or▶

Decrease the prevalence of adults
who currently use nicotine products[cigarettes, electronic smokelesstobacco) from 25.75% to 23% from 2022
baseline.

▶

Increase the percentage of Missourians
protected from secondhand smoke by
a comprehensive community or statesmoke-free law from 28.7% to 35.0%.

▶

Decrease prevalence of cigarettesmoking among adults receiving
Medicaid from 35.9% to 28%.

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SPI 4 : EMERGING PUBLIC HEALTH THREATS PREPAREDNESSSHIP PRIORITY ISSUE 4:

Emerging Public HealthThreats Preparedness

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 4 : EMERGING PUBLIC HEALTH THREATS PREPAREDNESSSTRATEGIC PRIORITY ISSUE NO. 4

Emerging Public Health Threats
Preparedness
Being prepared to respond to, mitigate and recoverfrom unexpected public health threats means
having standard operating procedures in place andthe ability to adapt those procedures according to
any type of hazard. Being prepared also requires
trained state and local staff and partners toeffectively identify and address the public healthimpact of a disaster or threat. The goals relevantto this issue will ensure that systems are in place
to identify public health threats and provide theresources needed to restore health and safety toMissouri citizens.

Key Health Issues
targeted▶

Emerging Public Health Threats▶

Opioid Use

Goal 1: Improve the effectiveness and efficiency of the Missouri public healthdata systems to allow for early identification of emerging public health threats
through better epidemiological and syndromic surveillanceThis goal focuses on the public health system’s capacity for early detection of emerging public health threats. Syndromic
surveillance and epidemiological investigation are Missouri’s first line of defense against disease outbreaks.
Learn more on

43

Goal 2: Mitigate emerging public health threats by helping build community
resilience
Community resilience is the capacity of a community to endure, respond to and overcome a variety of tribulations. This canbe especially helpful when discussing emerging public health threats and disaster recovery. The objectives under this goal
focus on education and training in addition to building self-sufficiency.
Learn more on

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SPI 4 : EMERGING PUBLIC HEALTH THREATS PREPAREDNESSSTRATEGIC PRIORITY ISSUE NO. 4

Emerging Public Health Threats
Preparedness
Being prepared to respond to, mitigate and recoverfrom unexpected public health threats means
having standard operating procedures in place andthe ability to adapt those procedures according to
any type of hazard. Being prepared also requires
trained state and local staff and partners toeffectively identify and address the public healthimpact of a disaster or threat. The goals relevantto this issue will ensure that systems are in place
to identify public health threats and provide theresources needed to restore health and safety toMissouri citizens.

Key Health Issues
targeted▶

Emerging Public Health Threats▶

Opioid Use

Goal 3: Improve the effectiveness of Missouri’s response to public healthemergencies and crises
While the previous goals focus specifically on data and community resilience, Goal 3 is about the overall effectiveness ofMissouri’s response to crisis.
Learnmore on

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2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 4 : EMERGING PUBLIC HEALTH THREATS PREPAREDNESS

Goal 1: Improve the effectiveness and efficiency of the Missouri public health datasystems to allow for early identification of emerging public health threats throughbetter epidemiological and syndromic surveillance

Overview
This goal focuses on the public healthsystem’s capacity for early detection of
emerging public health threats. Syndromic
surveillance and epidemiologicalinvestigation are Missouri’s first line ofdefense against disease outbreaks.

Objectives▶

Create a system/portal that is intuitive,

Objective 1: Create a system/portal that is intuitive,
user friendly and promotes an attitude ofcooperation, by which communicable disease datacollection and/or hospitalizations, including but notlimited to ER/Urgent Care visits, can be systemicallyand uniformly accessed by every local public healthagency (LPHA) and healthcare partners by Jan. 1,
2027.
Activities:▶

user friendly and promotes an attitude

Seek input/feasibility on the commitment to create a common system. If notachievable, outline the barriers.

of cooperation, by which communicable▶

Perform a gap analysis of current data systems.

disease data collection and/or▶

Receive ongoing informational updates/workgroup outcomes from internal
data workgroups. Including:hospitalizations, including but notlimited to ER/Urgent Care visits, can besystemically and uniformly accessed byevery local public health agency (LPHA)
and healthcare partners by Jan. 1, 2027.
▶

▶

Show-Me World Care (current project that includes bringing together
WebSurv, EpiTrax and Envsurv systems).

▶

ESSENCE (Syndromic Surveillance) data integration.

▶

Sewershed data.

▶

Data Modernization Advisory group in conjunction with the Public Health
Infrastructure Grant (PHIG).

Seek funding for hospital/healthcare information portal.

Metrics:▶

Percentage of LPHAs onboarded onto new system/portal

Collaborators and Responsible Organizations:▶

DHSS Data Specialists▶

Local Public Health Agencies (LPHAs)▶

Centers for Disease Prevention and Control (CDC) Public Health Emergency
Preparedness (PHEP) Program▶

Assistant Secretary for Preparedness and Response (ASPR) Hospital
Preparedness Program▶

Missouri Hospital Association (MHA)▶

Healthcare Coalitions▶

Missouri Healthcare Association (MHCA)▶

Missouri Primary Care Association (MPCA)

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SPI 4 : EMERGING PUBLIC HEALTH THREATS PREPAREDNESS

Goal 2: Mitigate emerging public health threats by helping build community
resilience

Overview
Community resilience is the capacity of
a community to endure, respond to andovercome a variety of tribulations. Thiscan be especially helpful when discussing
emerging public health threats andObjective 1: Design and begin implementing a
training for communities around emergency
preparedness and recovery that promotes their selfsufficiency, by June 1, 2025.
Activities:▶

disaster recovery. The objectives under thisgoal focus on education and training in
addition to building self-sufficiency.

Objectives▶

Design and begin implementing a
training for communities aroundemergency preparedness and recovery
that promotes their self-sufficiency, byJune 1, 2025.

▶

Develop a multimedia campaign to

Identify organizations/stakeholders to work with for preparedness and recovery
programs in order outline what information to include and to design anappropriate training.

▶

Analyze for gaps in information needed for implementation.

▶

Work with existing DHSS partners, community programs and community
organizers for distribution of training information.

Metrics:▶

Number of trainings offered▶

Number of participants in the trainings.

Collaborators and Responsible Organizations:▶

CDC PHEP Program▶

State Emergency Management Agency (SEMA)▶

Healthcare Coalitions▶

Organizations/Stakeholders Identified in Activity

better inform the public about publichealth in general, as well as publichealth threats, in order to foster atrusting relationship and to achieve
the top of the mind status, so that
the LPHAs and DHSS become thefirst and foremost purveyor of healthinformation, by Jan. 1, 2027.

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SPI 4 : EMERGING PUBLIC HEALTH THREATS PREPAREDNESS

Goal 2: Mitigate emerging public health threats by helping build community
resilience

Overview
Community resilience is the capacity of
a community to endure, respond to andovercome a variety of tribulations. Thiscan be especially helpful when discussing
emerging public health threats anddisaster recovery. The objectives under thisgoal focus on education and training in
addition to building self-sufficiency.

Objectives▶

Design and begin implementing a
training for communities around

Objective 2: Develop a multimedia campaign tobetter inform the public about public health ingeneral, as well as public health threats, in orderto foster a trusting relationship and to achieve the
top of the mind status, so that the LPHAs and DHSS
become the first and foremost purveyor of healthinformation, by Jan. 1, 2027.
Activities:▶

Design new DHSS Webpage with cohesive look for LPHA websites.

▶

Launch public health multimedia campaign with a focus on leading cause of
disease/death.

▶

Create availability of Linked In Learning for LPHAs (metrics trackable).

▶

Outline a communication strategy within the Public Health Infrastructure Grant
contract for educating the LPHAs and the public:

emergency preparedness and recovery
that promotes their self-sufficiency, byJune 1, 2025.
▶

Develop a multimedia campaign tobetter inform the public about publichealth in general, as well as publichealth threats, in order to foster atrusting relationship and to achieve
the top of the mind status, so that
the LPHAs and DHSS become thefirst and foremost purveyor of healthinformation, by Jan. 1, 2027.

▶

Partnerships with other healthcare organizations.

▶

Partnerships with academia and DESE for inclusion of science education
through the Public Health Infrastructure Grant (PHIG).

▶

Wording for creating trust among the public.

Metrics:▶

Number of organizations participating in the campaign▶

Number of LPHAs utilizing Linked In Learning▶

Number of people reached by campaign (social media, webpage, digital ads,
broadcast)Collaborators and Responsible Organizations:▶

DHSS Office of Public Information▶

Community leaders▶

Academia and Department of Elementary and Secondary Education (DESE)▶

CDC PHEP Program▶

ASPR Hospital Preparedness Program▶

Healthcare Coalitions

▶

LPHAs

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SPI 4 : EMERGING PUBLIC HEALTH THREATS PREPAREDNESS

Goal 3: Improve the effectiveness of Missouri’s response to public health emergencies
and crises

Overview
While the previous goals focus specificallyon data and community resilience, Goal 3 isabout the overall effectiveness of Missouri’s
response to crisis.

Objectives▶

Expand and improve system forproviding support and resources
to organizations, which integrate
continuous improvement into their
response to public health emergencies
and crises, by Jan. 1, 2027.

▶

Analyze existing communication
channels for key public healthemergency stakeholders and develop
recommendations to streamline theinformation pathways, by Jan. 1, 2027.

▶

Coordinate state response actions

Objective 1: Expand and improve system forproviding support and resources to organizations,which integrate continuous improvement into their
response to public health emergencies and crises, byJan. 1, 2027.
Activities:▶

Determine a framework for continuous improvement so there is clear guidanceand baseline criteria identified.

▶

Work toward quality control around after action reports. Including tracking/follow up around improvement plans.

▶

Provide public recognition for organizations integrating continuous
improvement into their crisis response.

▶

Identify/provide where local organizations can go for support.

Metrics:▶

Number of improvement plan tasks completed▶

Number of participants in improvement planning guidance sessions

Collaborators and Responsible Organizations:▶

Office of Performance Management (OPM)

▶

SEMA

▶

CDC PHEP Program▶

ASPR Hospital Preparedness Programwith regional and local agencies andorganizations.

Objective 2: Analyze existing communication
channels for key public health emergency
stakeholders and develop recommendations tostreamline the information pathways, by Jan. 1, 2027.
Activities:▶

Identify and analyze existing communication channels in collaboration with
LPHA and other emergency response organizations (what works and what does
not).

▶

Create process for streamlining updates to local stakeholders. Process to define
consistency of information to be sent through each communication channels.

Metrics:▶

Engagement rate for emergency public health communications

Collaborators and Responsible Organizations:

▶

OPM

▶

Missouri Institute for Community Health (MICH)▶

CDC PHEP Program▶

ASPR Hospital Preparedness Program

▶

LPHAs

▶

Healthcare Coalitions

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SPI 4 : EMERGING PUBLIC HEALTH THREATS PREPAREDNESS

Goal 3: Improve the effectiveness of Missouri’s response to public health emergencies
and crises

Overview
While the previous goals focus specificallyon data and community resilience, Goal 3 isabout the overall effectiveness of Missouri’s
response to crisis.

Objectives▶

Expand and improve system forproviding support and resources
to organizations, which integrate
continuous improvement into their
response to public health emergencies
and crises, by Jan. 1, 2027.

▶

Analyze existing communication
channels for key public healthemergency stakeholders and develop

Objective 3: Coordinate state response actions
with regional and local agencies and organizations
through 2027.
Activities:▶

Strengthen and socialize current response partner coordination structure.

▶

Integrate ICS and emergency management principles into coordination
methods.

Metrics:▶

Number of entities receiving the coordination structure framework▶

Number of after action reports that include successful integration of ICS
principles

Collaborators and Responsible Organizations:▶

DHSS Office of Emergency Coordination

▶

SEMA

▶

Healthcare Coalitions

▶

LPHAs

▶

Local Emergency Management

recommendations to streamline theinformation pathways, by Jan. 1, 2027.
▶

Coordinate state response actions
with regional and local agencies andorganizations.

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 5: SOCIAL DRIVERS OF HEALTH

SHIP PRIORITY ISSUE 5:

Social Driversof Health2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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SPI 5: SOCIAL DRIVERS OF HEALTHSTRATEGIC PRIORITY ISSUE NO. 5

Social Drivers of Health
The Centers for Disease Control and Prevention(CDC) defines Social Drivers of Health (SDoH)
as “conditions in the places where people live,
learn, work and play that affect a wide range ofhealth risks and outcomes.” For the context of
this section, we will use “Social Drivers of Health”.
SDoH include factors like socioeconomic status,
education, neighborhood and physical environment,
employment, social supports and access to quality
health care.

Key Health Issues
targeted▶

Health Equity▶

Built Environment/Neighborhood▶

Economics▶

Health Literacy▶

Violent Crime/Intentional Injury

Goal 1: Advance health equity in Missouri by creating and promoting a set ofactionable resources that address the social drivers of health
The Missouri Health Equity Stakeholder Committee operational definition for health equity is “Every human has a fair andjust opportunity to be as healthy as possible.”
Learn more on

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Goal 2: Improve health equity by building and leveraging collaborative publichealth efforts
Effective partnerships are essential for community-based solutions to make health equity a shared vision and value, increase
the community’s capacity to shape outcomes, and foster multi-sector collaboration.
Learn more on

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SPI 5: SOCIAL DRIVERS OF HEALTH

Goal 1: Advance health equity in Missouri by creating and promoting a set ofactionable resources that address the social drivers of health

Overview
The Missouri Health Equity Stakeholder
Committee operational definition for
health equity is “Every human has a fairand just opportunity to be as healthy as

Objective 1: Conduct a landscape assessment ofexisting health equity tools to address social driversof health by June 1, 2024.
Activities:▶

Research existing Health Equity Tools, e.g. evidence-based.

possible.” Healthy People defines health▶

Survey partners in health equity.

equity as “the attainment of the highest▶

Review results and make recommendations of Health Equity Tools to be utilized
in Missouri.

▶

Share recommendations with the Health Equity Stakeholder Committee.

level of health for all people. Achieving
health equity requires valuing everyone
equally with focused and ongoing societal
efforts to address avoidable inequalities,
historical and contemporary injustices, andMetrics:▶

Number of existing and innovative health equity tools identified and reported to
the Health Equity Stakeholder Committee

Collaborators and Responsible Organizations:the elimination of health and health care▶

Health Equity Stakeholder Committee

disparities. Health is influenced by many

▶

DHSS

factors, which may generally be organized
into five broad and interconnectedcategories known as drivers of health:genetics, behavior, environmental andphysical influences, medical care and social
factors. Social drivers of health encompass
economic and social conditions that areshaped by socioeconomic and politicalfactors (e.g., policies, culture and societal
values) and influence the health and wellbeing of people and the communities withwhich they interact.

Objective 2: Share Health Equity Toolkit
Recommendations by December 31, 2024.
Activities:▶

Make recommendations derived from the landscape assessment available on
the DHSS website.

▶

Share/send to partners, e.g. local public health agencies, hospitals, federally
qualified health centers, community based organizations etc.

Metrics:▶

Number of visits to equity toolkit website

Collaborators and Responsible Organizations:▶

Health Equity Stakeholder Committee

▶

DHSS

Objectives▶

Conduct an assessment of existing
health equity tools and assessments toaddress the drivers of health by June 1,
2024.

▶

Share Health Equity Toolkit
Recommendations by December 31,
2024.

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SPI 5: SOCIAL DRIVERS OF HEALTH

Goal 2: Improve health equity by building and leveraging collaborative public healthefforts

Overview
Effective partnerships are essential forcommunity-based solutions to makehealth equity a shared vision and value,
increase the community’s capacity toshape outcomes, and foster multi-sector
collaboration. Partners are able to deploy
unique skills and access resources toserve a variety of roles in communitybased solutions for health equity. Systems
functioning in silos may increase efficiency,
expertise and logistical flow, but improved

Objective 1: Organize a cross sector Health Equity
Stakeholder Committee by Dec. 31, 2023 to empowerstate and local leaders to advance health equity
system-wide.
Activities:▶

Conduct meetings with internal DHSS programs to evaluate how they are
currently addressing health equity.

▶

Contract with an external facilitator in the creation of a strategic plan for the
Health Equity Stakeholder Committee.

▶

Determine committee chairs (one DHSS staff and one non-DHSS staff).

Metrics:▶

Attendance rate of Health Equity Stakeholder Committee members

Collaborators and Responsible Organizations:outcomes will require innovative ways of

▶

DHSS

defining the challenges and brainstorming▶

External health equity partners, community members and community basedorganizations

how cross-sector partners can cometogether, leverage work from other fields,
and work effectively as a team. Crosssector public sector and public–private
partnership approaches address challenges
to the well-being of local communities by
including a social justice and equity lens inall policies and collaborating to change thelocal conditions for health.

Objectives▶

Activities:▶

Health Equity Action Team (Goal 2, Objective 1).

Organize a cross sector Health Equity▶

External stakeholder participation in the review process and template creation.

Stakeholder Committee by Dec. 31, 2023,▶

Senior leadership sponsor.

to empower state and local leaders to▶

Connection with Health Equity Toolkit (Goal 1, Objective 2).

advance health equity system-wide.
▶

Objective 2: DHSS, with the assistance of the Health
Equity Stakeholder Committee, will work to integrate
health equity principles into all DHSS policies andprograms by Jan. 1, 2027, and create a templatethat state and local leaders could use for theircommunities.

DHSS, with the assistance of the
Health Equity Stakeholder Committee,
will work to integrate health equity
principles into all DHSS policies andprograms by Jan. 1, 2027, and create a

Metrics:▶

Percent of DHSS policies reviewed

Collaborators and Responsible Organizations:

▶

DHSS

▶

External health equity partners, community members and community basedorganizations

template that state and local leaders
could use for their communities.

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SPI 6: WHOLE PERSON HEALTH ACCESSSHIP PRIORITY ISSUE 6:

Whole Person
Health Access

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SPI 6: WHOLE PERSON HEALTH ACCESSSTRATEGIC PRIORITY ISSUE NO. 6

Whole Person Health Access
Whole person health access means having accessto all needed medical, dental and behavioral healthsystems and information about healthy lifestylechoices to address the needs of the entire person.
Each of the goals in this priority issue aim toincrease overall health outcomes by ensuring that
Missourians have the knowledge and access thatthey need to remain healthy and safe.

Key Health Issues
targeted▶

Health Access & Cost▶

Mental Health Access/Suicide Prevention▶

Dental Care

Goal 1: Improve the health of Missourians by increasing equitable access to
medical, dental, maternal and mental health services
Missouri has many areas of the state that lack sufficient providers to provide medical, dental, maternal and behavioral healthservices. The overall goal is to collaboratively work together to address recruitment, but also address barriers that impact
provider coverage.
Learn more on

54-59

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SPI 6: WHOLE PERSON HEALTH ACCESS

Goal 1: Improve the health of Missourians by increasing equitable access to medical,
dental, maternal and mental health services

Overview
Missouri has many areas of the statethat lack sufficient providers to provide
medical, dental, maternal and behavioral
health services. The overall goal is to

Objective 1: By 2027, strengthen the healthcare
workforce and enhance healthcare delivery to meetthe evolving needs of the population.
Activities:▶

collaboratively work together to address

Health Education and Promotion▶

Enhance health education programs and initiatives to attract, train andretain a diverse pool of health professionals, auxiliary team members andsupport staff.

▶

Promote awareness of health careers among students, encouraging themto pursue health education and training.

recruitment, but also address barriers that
impact provider coverage.

Objectives▶

▶

Strengthen the healthcare workforce

Innovative Person-Centered Models of Care▶

Explore and support the implementation of innovative person-centeredcare delivery models, such as but not limited to, telehealth, mobile clinics
and programs that utilize trusted messengers and caregivers such as
but not limited to community health workers, doulas and peer support
specialists, in order to increase access to health services in underserved
areas.

▶

Foster inclusion of and collaboration between all members of the diverse
health team to deliver comprehensive and coordinated care.

and enhance healthcare delivery
to meet the evolving needs of the
population.
▶

Establish an integrated healthcare
system that enhances care quality▶

and efficiency, improves healthInnovative Recruitment and Retention Strategies▶

Develop and implement innovative strategies to improve healthcare
workforce recruitment and retention, such as but not limited
to, mentorship programs, in-state training, career advancement
opportunities and work-life balance initiatives.

▶

Explore, analyze and evaluate emerging and best practices to identify
effective recruitment and retention strategies and adapt them to the local
healthcare context.

outcomes and provides individuals withcomprehensive and seamless accessto medical, dental and mental healthservices.
▶

Ensure individuals have affordable and▶

timely access to necessary healthcare

Workforce Optimization▶

Support initiatives to encourage healthcare professionals to work inunderserved areas or areas with health workforce shortages; eg byoffering financial incentives, loan repayment programs and professional
development opportunities.

▶

Collaborate with educational institutions and healthcare organizations tocreate/maximize/implement targeted programs that attract and retain
healthcare professionals to high-need areas.

services, promote and expand
equitable healthcare delivery anddrive continuous improvement in an
integrated healthcare system.
▶

Empower individuals with health▶

License Portability▶

knowledge, promote health literacy
and provide targeted education andresources to all populations.

Educate and support the adoption of a license portability compact(s) or
similar framework to facilitate the mobility of health professionals acrossstate lines.

▶

Explore options to facilitate international health license portability.

▶

Engage in discussions with relevant stakeholders, such as professional
associations, regulatory bodies and state policymakers, to establish astreamlined process for license portability while ensuring patient safety
and maintaining regulatory standards.

Metrics:▶

Percentage increase in employee retention rates within the healthcare
workforce

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SPI 6: WHOLE PERSON HEALTH ACCESS

Goal 1: Improve the health of Missourians by increasing equitable access to medical,
dental, maternal and mental health services

Overview
Missouri has many areas of the statethat lack sufficient providers to provide
medical, dental, maternal and behavioral
health services. The overall goal is tocollaboratively work together to address
recruitment, but also address barriers that
impact provider coverage.

Objectives▶

Strengthen the healthcare workforce
and enhance healthcare delivery
to meet the evolving needs of the
population.

▶

Establish an integrated healthcare
system that enhances care quality
and efficiency, improves healthoutcomes and provides individuals with

Collaborators and Responsible Organizations:▶

Department of Health and Senior Services▶

Department of Mental Health▶

Department of Elementary and Secondary Education▶

Missouri Dental Association▶

Missouri Dental Hygiene Association▶

Missouri Primary Care Association▶

Missouri dental & medical schools▶

Missouri Hospital Association▶

Mobile Integrated Health Network

Objective 2: By 2027, establish an integrated
healthcare system that enhances care quality andefficiency, improves health outcomes and provides
individuals with comprehensive and seamless accessto medical, dental and mental health services.
Activities:▶

comprehensive and seamless access

Whole Person Care and Outcomes▶

Develop and implement comprehensive care models that address thephysical, dental and mental health needs of individuals, considering theiroverall well-being and social drivers of health.

▶

Define outcome measures that capture the holistic impact of integrated
care, including improvements in health outcomes, patient satisfaction andquality of life indicators.

to medical, dental and mental healthservices.
▶

Ensure individuals have affordable andtimely access to necessary healthcare▶

services, promote and expand

Data Collection and Utilization▶

Establish robust systems for collecting, analyzing and utilizing data acrossmedical, dental and mental health domains to inform care decisions,
identify gaps in services and evaluate outcomes.

▶

Encourage interoperable electronic health records (EHR) systems thatenable seamless sharing of patient information among healthcare
providers, ensuring continuity and coordination of care.

equitable healthcare delivery anddrive continuous improvement in an
integrated healthcare system.
▶

Empower individuals with health▶

knowledge, promote health literacy

Inter-professional Collaboration▶

Foster collaboration and communication among healthcare professionals
from diverse disciplines, including physicians, dentists, mental healthproviders and other allied healthcare professionals.

▶

Encourage the use of platforms or forums for regular inter-professional
meetings, case conferences and shared decision-making, promoting ateam-based approach to patient care.

and provide targeted education andresources to all populations.

▶

Care Coordination▶

Provide assistance with development of and support for care coordination
strategies that facilitate the seamless transition of patients between
medical, dental and mental health services.

▶

Encourage the establishment of care teams or care navigators who work
collaboratively across disciplines to ensure coordinated and continuous
care for individuals.

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SPI 6: WHOLE PERSON HEALTH ACCESS

Goal 1: Improve the health of Missourians by increasing equitable access to medical,
dental, maternal and mental health services▶

Overview
Missouri has many areas of the statethat lack sufficient providers to provide
medical, dental, maternal and behavioral
health services. The overall goal is to

Leveraging Resources across Disciplines▶

Explore opportunities across state entities for collaboration, resourcesharing and expertise.

▶

Identify opportunities for shared resources, infrastructure and expertise
across medical, dental and mental health domains to optimize service
delivery and resource allocation.

▶

Encourage cross-training and skill-sharing among healthcare
professionals to enhance the capacity and efficiency of establishingsystems of integrated care, (eg, fluoride varnish application by
pediatricians, pharmacy technicians being trained as community healthworkers and chronic disease screening across the healthcare spectrum).

collaboratively work together to address
recruitment, but also address barriers that
impact provider coverage.

▶

Objectives▶

Strengthen the healthcare workforce

Standardized Measures▶

Establish and implement standardized measures and quality indicators toassess the effectiveness and performance of integrated care systems.

▶

Regularly monitor and evaluate outcomes based on established measuresto drive continuous improvement, innovation and initiatives that are
grounded in best practices.

and enhance healthcare delivery
to meet the evolving needs of the▶

population.
▶

Establish an integrated healthcare
system that enhances care quality

Leveraging Stakeholders▶

Engage key stakeholders, including healthcare organizations, professional
associations, patient advocacy groups, policymakers and others in thedesign, implementation and evaluation of integrated care systems.

▶

Foster partnerships and collaborations to leverage the expertise, resources
and support of stakeholders to enhance the delivery of medical, dental
and mental health services.

and efficiency, improves healthoutcomes and provides individuals with▶

comprehensive and seamless access

Coordinated Care for Medical, Dental and Mental Health Services▶

Encourage health care entities to coordinate medical, dental and mental
health services to provide comprehensive and complementary care toindividuals.

▶

Explore referral systems and protocols that facilitate seamless transitions
between different care settings within integrated healthcare systems.

to medical, dental and mental healthservices.
▶

Ensure individuals have affordable andtimely access to necessary healthcare
services, promote and expand
equitable healthcare delivery anddrive continuous improvement in an
integrated healthcare system.

▶

Metrics:▶

Improved health outcomes and disease management indicators, such as
reduced hospitalization rates

Collaborators and Responsible Organizations:▶

Department of Health and Senior Services▶

Department of Mental Health

Empower individuals with health▶

Department of Elementary and Secondary Education

knowledge, promote health literacy▶

Missouri Dental Associationand provide targeted education and▶

Missouri Dental Hygiene Association

resources to all populations.

▶

Missouri Primary Care Association▶

Missouri dental & medical schools▶

Missouri Hospital Association▶

Mobile Integrated Health Network▶

Individuals/groups representing persons with lived experiences.

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SPI 6: WHOLE PERSON HEALTH ACCESS

Goal 1: Improve the health of Missourians by increasing equitable access to medical,
dental, maternal and mental health services

Overview
Missouri has many areas of the statethat lack sufficient providers to provide
medical, dental, maternal and behavioral
health services. The overall goal is tocollaboratively work together to address
recruitment, but also address barriers that

Objective 3: By 2027, ensure individuals haveaffordable and timely access to necessary healthcare
services, promote and expand equitable healthcaredelivery and drive continuous improvement in an
integrated healthcare system.
Activities:▶

Decreasing Payment Barriers

impact provider coverage.

▶

Objectives

Identify payment barriers that hinder access to care, such as high out-ofpocket costs, deductibles and copayments and explore policy strategies
that could ameliorate barriers to care.

▶

Develop strategies to reduce financial burdens on individuals, exploring
options such as but not limited to income-based sliding fee scales,
payment assistance programs or subsidies.

▶

Strengthen the healthcare workforce
and enhance healthcare delivery
to meet the evolving needs of the▶

▶

population.
▶

Establish an integrated healthcare

Value-Based Care▶

Medicaid Managed Care▶

system that enhances care quality
and efficiency, improves healthoutcomes and provides individuals with▶

comprehensive and seamless access

Alternative Payment Models
Investigate or assess alternative payment models for efficient and costeffective care delivery.

services.

▶

Monitor the impact of alternative payment models on access, quality andcost of care.

Ensure individuals have affordable and▶

Survey healthcare providers to determine the use of alternative payment
models.

timely access to necessary healthcare
services, promote and expand▶

Affordability Initiatives▶

equitable healthcare delivery anddrive continuous improvement in an
integrated healthcare system.
▶

Collaborate with Medicaid managed care organizations to enhance accessto care and ensure comprehensive coverage, timely access to services andappropriate provider networks.

▶

to medical, dental and mental health▶

Encourage the adoption of healthcare delivery towards value-based caremodels that prioritize quality, outcomes and patient satisfaction.

▶

Empower individuals with healthknowledge, promote health literacy

Health Insurance▶

Enhance outreach and education efforts to increase awareness andenrollment in available health insurance plans.

▶

Collaborate with groups such as community health workers andcommunity organizations to provide assistance and guidance during theenrollment process.

and provide targeted education andresources to all populations.

▶

Technology and Telehealth▶

▶

Partner with other stakeholders to address affordability of healthcare
services, including prescription drugs, preventive care and essential
treatments.

Educate healthcare providers regarding telehealth solutions that may
expand access to care, particularly in rural or underserved areas.

Continuous Evaluation and Improvement▶

Engage in data sharing and collaboration to assess the impact of
initiatives on access to care, affordability and healthcare utilization.

Metrics:▶

Percentage increase in the utilization of preventive care services due toimproved affordability▶

Monitor adoption rates of value-based payment arrangements by healthcare
providers and payers

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SPI 6: WHOLE PERSON HEALTH ACCESS

Goal 1: Improve the health of Missourians by increasing equitable access to medical,
dental, maternal and mental health services

Overview
Missouri has many areas of the statethat lack sufficient providers to provide
medical, dental, maternal and behavioral
health services. The overall goal is tocollaboratively work together to address
recruitment, but also address barriers that
impact provider coverage.

Objectives▶

Department of Health and Senior Services▶

Department of Mental Health▶

Department of Elementary and Secondary Education▶

Missouri Dental Association▶

Missouri Dental Hygiene Association▶

Missouri Primary Care Association▶

Missouri dental & medical schools▶

Missouri Hospital Association▶

Mobile Integrated Health Network▶

Individuals/groups representing persons with lived experiences.

▶

MoHealthNet

Strengthen the healthcare workforce
and enhance healthcare delivery
to meet the evolving needs of the
population.

▶

Collaborators and Responsible Organizations:▶

Establish an integrated healthcare
system that enhances care quality
and efficiency, improves healthoutcomes and provides individuals withcomprehensive and seamless access

Objective 4: By 2027, empower individuals withhealth knowledge, promote health literacy andprovide targeted education and resources to all
populations.
Activities:▶

to medical, dental and mental healthservices.
▶

Ensure individuals have affordable andtimely access to necessary healthcare▶

services, promote and expand

Education and Outreach▶

Develop and implement community health education programs targeting
underserved populations and communities with limited access to care.

▶

Increase awareness about the importance of preventive care, early
detection and timely healthcare utilization through workshops, seminars
and public campaigns.

Health Literacy▶

Improve health literacy by providing easily understandable healthinformation and resources to empower individuals in making informed
healthcare decisions, including translated materials.

▶

Collaborate with community organizations, schools and healthcare
providers to integrate health literacy initiatives into existing programs.

equitable healthcare delivery anddrive continuous improvement in an
integrated healthcare system.
▶

Empower individuals with health▶

knowledge, promote health literacy
and provide targeted education andresources to all populations.
▶

Access to Information▶

Establish and maintain centralized platforms, websites or hotlines thatprovide up-to-date information on healthcare services, resources andeligibility criteria.

▶

Promote the use of digital health tools and mobile applications to facilitate
access to healthcare information and appointment scheduling.

Targeted Initiatives▶

Identify specific health issues prevalent in Missouri communities, such as
chronic diseases, mental health or substance abuse and develop targetededucational campaigns and interventions to address these issues.

▶

Collaborate with local healthcare providers and organizations to offer
screenings, health fairs and community-based interventions focused on
identified health priorities.

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SPI 6: WHOLE PERSON HEALTH ACCESS

Goal 1: Improve the health of Missourians by increasing equitable access to medical,
dental, maternal and mental health services.
▶

Overview

Collaboration with Stakeholders▶

Engage community leaders, healthcare professionals, schools, faith-basedorganizations, community based organizations and local government
agencies to foster partnerships and collaborate on community healtheducation initiatives.

▶

Leverage existing networks and resources to expand the reach and impact
of community health programs.

Missouri has many areas of the statethat lack sufficient providers to provide
medical, dental, maternal and behavioral
health services. The overall goal is tocollaboratively work together to address▶

Measuring Impact▶

Establish measurable goals and objectives for community healtheducation programs, such as the number of individuals reached,knowledge gained and behavior change observed ensuring equity,
diversity and inclusion of everyone.

▶

Conduct periodic evaluations and assessments to measure theeffectiveness and impact of community health education initiatives onaccess to care and health outcomes.

recruitment, but also address barriers that
impact provider coverage.

Objectives▶

Strengthen the healthcare workforce
and enhance healthcare delivery
to meet the evolving needs of theMetrics:▶

population.
▶

Collaborators and Responsible Organizations:

Establish an integrated healthcare▶

Department of Health and Senior Services

system that enhances care quality▶

Department of Mental Healthand efficiency, improves health▶

Department of Elementary and Secondary Education

outcomes and provides individuals with▶

Missouri Dental Association

comprehensive and seamless access▶

Missouri Dental Hygiene Association

to medical, dental and mental healthservices.
▶

Usage metrics of centralized platforms, websites or hotlines providing
healthcare information, such as website visits, hotline calls or downloads ofeducational materials

Ensure individuals have affordable andtimely access to necessary healthcare
services, promote and expand
equitable healthcare delivery and▶

Missouri Primary Care Association▶

Missouri dental & medical schools▶

Missouri Hospital Association▶

Mobile Integrated Health Network▶

Individuals/groups representing persons with lived experiences.

▶

MoHealthNet

drive continuous improvement in an
integrated healthcare system.
▶

Empower individuals with healthknowledge, promote health literacy
and provide targeted education andresources to all populations.

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CLOSING

Closing
To ensure progress towards the goals, objectives and activities
included in this document, DHSS will monitor activities
through its performance management system. Individuals
identified by collaborators and responsible organizations
within each SPI are responsible for providing regular updates
to the data provided for each metric. These activity owners
are granted a user license to the AchieveIt performance
management system in use by DHSS, which allows them toupdate data points and create reports for their SPI.
The DHSS Office of Performance Management administers
the performance management system and conducts
accountability activities to ensure progress towards goals
outlined in various health plans. A formal accountability plan
will follow the launch of the SHIP and includes a detailed
structure for annual reviews of the SHA, SHIP and the DHSS
Strategic Plan.
Through annual reviews, the SHIP remains a living documentthat reflects the current state of health in Missouri and theactivities undertaken by the State Health Partner Group tocontinually improve the health and safety of Missourians.
DHSS would like to acknowledge the extensive and exhaustive
work from the State Health Partner Group that touches
every aspect of the public health system in Missouri. Without
this vital partnership, DHSS would not be able to achieve its
vision of optimal health and safety for all Missourians, in allcommunities, for life. Thank you.

2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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GLOSSARY

TermDefinition

AARP

American Association of Retired Persons

ASPR

Assistant Secretary for Preparedness and Response

BRFSS

Behavioral Risk Factor Surveillance System

CBOs

Community-based Organizations

CCDC

Cancer and Chronic Disease Control

CDC

Center for Disease Control and Prevention

CFNA

Bureau of Community Food and Nutrition Assistance

CFRP

Child Fatality Review Program

CHW

Community Health Worker

CSPAPsComprehensive school physical activity programs

DESE

MO Department of Elementary and Secondary Education

DHSS

MO Department of Health and Senior Services

DSS

MO Department of Social Services

EPHTP

Emerging Public Health Threats Preparedness

FGDs

Focus Group Discussions

FIMR

Fetal and Infant Mortality Review

FPHS

Foundational Public Health Services

HB

Health Behavior

HCPs

Health Care Providers

HOP

Housing and Opportunity Grant Program

ICS

Incident Command System

IMH

Infant and Maternal Health

LEA

Local Education Agency

LPHA

Local Public Health Agency

MBRC

Missouri Bootheel Regional Consortium

MCH

Maternal and Child Health

MCSHC

MO Coordinated School Health Coalition

MDA

Missouri Department of Agriculture

MHA

Missouri Hospital Association

MHCA

Missouri Healthcare Association

MHS

Missouri Healthy Schools Program

MICH

Missouri Institute for Community Health

MIVPAC

Missouri Injury and Violence Prevention Advisory Committee
2024 MISSOURI STATE HEALTH IMPROVEMENT PL AN

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GLOSSARY

TermDefinition

MMHLA

Maternal Mental Health Leadership Alliance

MC-LAN

Maternal-Child Learning and Action Network

MOAIMH-EC

Missouri Association for Infant and Early Childhood Mental Health

MOCAN

Missouri Council for Activity and Nutrition

MOCPHE

Missouri Center for Public Health Excellence

MODOT

Missouri Department of Transportation

MPAN

Missouri Physical Activity and Nutrition Program

MPCA

Missouri Primary Care Association

MPHA

Missouri Public Health Association

MSU/OPHI

Missouri State University/Ozarks Public Health Institute

MU

University of Missouri

NACCHO

Nation Association of City and County Health Officials’

NIH

National Institute of Health

NPAP PH Strategy

National Physical Activity Plan Public Health Strategy

OPM

Office of Performance Management

PA

Physical activity

PHAB

Public Health Accreditation Board

PHEP

Public Health Emergency Preparedness

PHIG

Public Health Infrastructure Grant

PHSB

Public Health System Building

PQC

Perinatal Quality Collaborative

PRAMS

Pregnancy Risk Assessment Monitoring System

REACH

Racial and Ethnic Approaches to Community Health

SDoH

Social Drivers of Health

SEMA

State Emergency Management Agency

SHA

MO State Health Assessment

SHIP

State Health Improvement Plan

SHPG

State Health Partner Group

SNAP

Supplemental Nutrition Assistance Program

SPAN

State Physical Activity and Nutrition

SUD

Substance Use Disorder

UME

University of Missouri Extension

WIC

Women, Infants and Children

YRBS

Youth Risk Behavior Surveillance System

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5-Year Priorities
Invest in innovation to modernize
infrastructure
Re-envision and strengthen theworkforce
Build and strengthen partnerships
Use clear and consistentcommunication to educate andbuild trust
Expand access to services
Include diversity and inclusion in allpractices, programs and services
Plan for the increase in the
aging population

Our Values
Excellence

We strive to empower our teammembers to deliver quality services
and exceed the needs of Missourians

Collaboration

We engage and communicate openly
with a diverse group of partners to
improve health for all Missourians

AccessMission:Promote health and safety
through prevention,
collaboration, education,
innovation and response.

Vision:Optimal health and safety
for all Missourians, in allcommunities, for life.

We deliver services to Missourians
in a manner that is sensitive to theirunique needs and circumstances whilereflecting our rich, diverse community

Integrity

We conduct services with a consistencyof character in a highly principledmanner by honoring our commitments
and maintaining our ethics

Accountability

We embrace responsibility for our workand ensure Missourians view us as atrusted source of information

(573) 751-6400

Health.Mo.Gov

info@health.mo.gov