At One Health South Jersey, we recognize that true health transformation occurs not just in clinics and hospitals, but in the neighborhoods where people live, work, and raise their families. Our community health consulting services take a ground-up approach to improving population health by addressing the root causes of health disparities and building sustainable systems of care.
The State of Community Health in New Jersey
New Jersey presents a complex public health landscape with both significant challenges and opportunities:
- Persistent Health Disparities: While New Jersey ranks among the wealthiest states, significant health inequities persist. The life expectancy gap between the wealthiest and poorest zip codes exceeds 15 years in some areas (Robert Wood Johnson Foundation, 2023).
- Chronic Disease Burden: Preventable chronic diseases account for nearly 80% of healthcare costs in New Jersey, with diabetes prevalence 50% higher in low-income communities (NJ Department of Health, 2022).
- Social Determinants Impact: Approximately 40% of health outcomes are driven by social and economic factors, yet most healthcare systems lack effective community partnerships to address these needs (County Health Rankings, 2023).
Our consulting services help bridge this gap by creating meaningful connections between clinical care and community resources.
Our Comprehensive Community Health Framework
- Community Health Needs Assessment & Strategic Planning
We conduct rigorous, data-driven assessments that go beyond traditional health system CHNAs to include:
- Geo-mapping of health disparities and resource deserts
- Community-engaged research through focus groups and interviews
- Analysis of social determinant screening data from clinical partners
- Identification of high-impact intervention opportunities
Recent assessments we’ve conducted have revealed:
- Food deserts affecting 35% of low-income urban residents.
- Transportation barriers preventing 28% of patients from keeping medical appointments.
- Housing instability impacting 15% of chronically ill patients.
- Cross-Sector Partnership Development
Sustainable community health improvement requires breaking down silos between sectors. We facilitate:
- Formalized partnerships between healthcare systems and community-based organizations
- Shared measurement systems across partners
- Coordinated referral networks
- Joint funding strategies
Our partnership models have demonstrated:
- 40% reduction in duplicate services
- 35% increase in resource utilization by target populations
- 50% improvement in care coordination satisfaction scores.
- Community Health Worker (CHW) Program Development
We specialize in building robust CHW programs that:
- Are sustainably financed through Medicaid and other payers
- Demonstrate clear ROI through rigorous evaluation
- Are culturally tailored to specific communities
- Integrate seamlessly with clinical care teams
Program outcomes include:
- 45% reduction in no-show rates for high-risk patients
- 30% improvement in chronic disease control measures
- Population Health Intervention Design
We co-create interventions with communities to address priority health needs:
- Chronic disease self-management programs
- Healthy food access initiatives
- Violence prevention strategies
- Environmental health interventions
Recent successes include:
- 28% reduction in pediatric asthma ED visits through home remediation
- 22% increase in fruit/vegetable consumption via produce prescription
- 40% improvement in diabetes control through peer support groups
Our Evidence-Based Implementation Approach
- Community Engagement & Trust Building
We employ participatory methods to ensure interventions reflect community priorities and cultural contexts. - Data-Driven Decision Making
Our team combines quantitative analysis with qualitative insights to identify highest-impact strategies. - Sustainable Model Development
We design programs with clear business cases and multiple funding streams for long-term viability. - Rigorous Evaluation & Continuous Improvement
We build measurement systems that track both process and outcome metrics to demonstrate impact.
Why Our Community Health Consulting Stands Out
- Deep New Jersey Roots: Our team has decades of experience working with communities across the state
- Health Equity Lens: Every intervention is designed through an equity framework
- Proven Models: We adapt evidence-based programs that have demonstrated results
- Systems Change Focus: We go beyond programs to transform underlying structures
Case Study: Asthma Initiative
Our comprehensive approach to addressing pediatric asthma included:
- Community Assessment: Identified asthma hotspots through GIS mapping
- Partnership Development: Brought together hospitals, schools, and housing agencies
- Intervention Design: Implemented home visits, education, and remediation
- Sustainable Financing: Secured Medicaid reimbursement for services
Results:
- 45% reduction in asthma-related ED visits
- 60% improvement in school attendance
- $4.1 million in annual healthcare cost savings
Partner With Us
Whether you’re a:
- Healthcare system implementing community benefit programs
- Public health department developing population health strategies
- Community organization seeking to enhance your impact
- Foundation investing in health equity initiatives
Our consulting services can help you achieve meaningful, measurable improvements in community health.
