1. CHESAPEAKE THRIVES
Updates on the Health and
Early Childhood Priority Areas
Presentation to the
Commission on Health and Well-being
August 17, 2023

2. Social Determinants of Health
• The Social Determinants/Drivers of
Health (SDOH) are the backbones to
make our city a better place to live,
visit, learn, work, play and farm.
• SDOH have a major impact on
people’s health, well being, quality
of life, and a wide range of health
outcomes and risks.

4. Health Priority Area
• Strengthen, expand and diversify prevention-oriented
wellness programming.
– Increase utilization of pre and postnatal care – to be discussed
under Early Childhood.
– Promote the availability and access to prevention and wellness
resources.
• Strengthen, expand, and diversify intervention strategies.
– Increase health screening opportunities
• Strengthen, expand, and diversify treatment services
– Mobile Medical Clinic – Rotary Club of Chesapeake & CRH
• Adopt and support a holistic approach to integrate
somatic care with behavioral health.

5. • Health literacy is one of the biggest predictors of long-term health outcomes. It
impacts a person’s ability to act on health information and engage in self care.
It also impacts the ability to prevent, understand and manage health problems
that arise.
• Chesapeake Health Literacy Coalition – a partnership with Chesapeake Public
Libraries, Chesapeake Regional Healthcare, Chesapeake Redevelopment
and Housing Authority, City Planning, Human Services, Health Department,
Chesapeake Integrated Behavioral Health, Chesapeake Juvenile Services,
and Healthier757 – is working to increase participation in and improve
knowledge through the free Rewards for Healthy Living Platform.
https://www.rewardsforhealthyliving.com/
Health Literacy

6. Health Literacy
Working with Literacy for Life and Chesapeake
Public Schools Adult and Community Education
Program to bring The HEAL Program to
Chesapeake.
• An 8-week course that increases the participants knowledge of
health topics, basic medical terminology, and standard
practices (such as how to describe one’s symptoms to a doctor
or when to use an Urgent Care vs. an Emergency department).
• Involves 3 tiers – beginner, intermediate, advanced for both
those who have no/very limited English skills as well as English
speakers with literacy challenges.
• The graduation gift is a first aid kit and a field trip to a
healthcare provider.

7. Screening and Access –
Adults with Diabetes

8. Screening and Access
• Chesapeake Regional Healthcare’s Lifestyle Health and Fitness Center
has increased screening (including A1C testing, the gold standard in
diabetes prevention and care) and educational opportunities across
the city.
• Healthy Chesapeake’s HUB Program, an educational and social
support program for underserved patients with diabetes and
hypertension, provides quarterly A1C testing for the participants.
• Rotary Club of Chesapeake, Chesapeake Regional Healthcare, and
Healthy Chesapeake have submitted a grant to Rotary International
to bring a mobile medical clinic to serve the underserved
communities in the city. The outcome should be known by the end of
2023. Preliminary planning has already begun.

9. Early Childhood Priority Area
• Support the success of prenatal and parenting families.
– Increase referrals to home visiting programs via universal screening
at Chesapeake Regional Medical Center and referrals to home
visitation programs serving Chesapeake.
– Provide prenatal and parenting education
– Creation of Sankofa Family Center in South Norfolk
• Improve early care and educational supports.
– Information about changing landscape in childcare
• Increase knowledge about and access to early childhood
behavioral health.
– Incorporate developmentally appropriate behavioral health practices
in all childcare settings
– Increase resources and partners to provide behavioral health
supports in childcare settings
– Expand capacity for administering consistent universal screenings
(ASQ) for all 0-6 settings

10. Why is Prenatal to 5 years of age
so critical?
The first 1,000 days of a baby’s life are a critical and important period of
development.
The brain is the only organ not fully developed at birth. 90% of critical brain
development happens in the first 5 years of life.
• At birth, the average baby brain is about a ¼ of the size of an adult brain.
• In the first year, the brain doubles in size.
• By the age of 3, it is 80% of the adult size.
• By the age of 5, it is 90% of the adult size.
• At birth, the brain has billions of neurons. But, for the most part, they are not
connected. From birth to age 3 there are more than 1 million neural
connections every second. These connections between the neurons is what
makes the brain work. These connections grow in the first 5 years more than
any other time in life.

11. The Brain on Trauma – Prenatal to 5
• Like muscles, neuron connections that are used
frequently become stronger and more efficient with
time. “Neurons that fire together, wire together.”
• From 0 to age 3, trauma (an event that is perceived as
a threat or danger) can impact the developing and
vulnerable mind. The body reacts protectively with the
“fight, flight, or freeze” response.
• If the baby experiences too many traumatic events,
the brain becomes primed for fear and rewires the
neural pathways functioning from the limbic system.
This makes it more difficult to access the cerebral
cortex, or the thinking brain.
• These changes have a lifelong impact on the child.

12. Prenatal Care in Chesapeake
90.6%
89.1%
89.7%
89.0%
91.3%
83.0%
85.0%
87.0%
89.0%
91.0%
93.0%
2016 2017 2018 2019 2020
Percent of women seeing a healthcare provider during the
first 13 weeks of pregnancy.
VA Rate
79.4%

13. Maternal Mortality by State –
American Health Rankings 2022
VA = 21.6

15. Maternal Mortality Rate
and Numbers

16. Virginia Mortality Rates by Region

20. Social Determinants of Health
Team members from Chesapeake Regional Healthcare, CHIP-SHR, Chesapeake
Health Department’s BabyCare, and Healthy Chesapeake designed a tool to
assess Social Determinants of Health (SDOH) for prenatal patients. The pilot,
using the SDOH tool, began in the OB ED on May 1, 2023.
20
May and June Respondents –
Positive Screens
Completed forms 124
Unduplicated patients 113
May and June - Number of
Screens Performed
Negative Screens 164
Positive Screens 123
Total 335

21. Demographics
Chesapeak
e Suffolk
Virginia
Beach Norfolk
Portsmout
h Peninsula
North
Carolina
23320 8 23434 2 23451 4 23502 3 23701 5 23604 1 27909 0
23321 4 23435 1 23452 3 23503 2 23702 1 23605 1 27958 1
23322 4 23438 1 23453 1 23504 2 23704 8 23608 1 27974 1
23323 8 23454 5 23505 3 23707 1 23662 0
23324 10 23455 3 23508 1 23663 2
23325 4 23456 1 23510 1 23666 0
Unk 1 23462 8 23513 2 23669 1
23464 3 23518 2 Unk 1
Unk 1
TOTAL 39 4 29 16 15 7 2
21
Age of Respondents
<17 1
17-19 7
20-24 39
25-34 64
35-44 12
45+ 0
Note: 11 participants did not list location

22. Responses
Total responses to questions 1-19 327
"Chose not to answer" selected in questions 1-19 (included in previous count) 28
22
• The highest responses include
– Question 9: Do you need a doctor for your baby? (73)
– Question 6: Do you need supplies to take care of your baby or family at home? (47)
– Question 10: Do you need a medical doctor for yourself (other than your OB)? (39)
– Question 3: Are you having trouble paying your rent, heating, water, electricity, or other
bills right now? (25)
– Question 2: Within the past 12 months, were you worried your food would run out
before you got money to buy more? (20)
– Question 14: Do you experience stress that makes it hard to care for yourself or work?
(20)

23. Questions by Referral Category
23
Question
Positive
Respons
e
Chose not
to answer
1. Within the last 12 months has lack of transportation kept you from medical appointments,
meetings, work, or getting medications or other things for your home and family?
10 0
2. Within the past 12 months, were you worried your food would run out before you got money to
buy more?
20 0
3. Are you having trouble paying your rent, heating, water, electricity, or other bills right now? 25 0
4. In the past 12 months, has the electric, gas, oil, or water company threatened to shut services off
in your home?
10 1
5. Do you worry about being able to provide care for your baby or having the skills to do so? 14 3
6. Do you need supplies to take care of your baby or family at home? 47 1
7. Do you have trouble with childcare or the care of a family member? 7 2
8. Do you have trouble paying for medicines that you need? 6 1
9. Do you need a doctor for your baby? 73 1
10. Do you need a medical doctor for yourself (other than your OB)? 39 0
11. Do you need someone to help with day-to-day activities? 6 2

24. Questions by Referral Category
Question
Positive
Response
Chose
not to
answer
12. What is your housing situation today?
8 3
13. Are you worried in the next 2 months you may not have your own housing to live in or have a safe
and reliable place to sleep?
2 1
24
14. Do you experience stress that makes it hard to care for yourself or work? 20 3
15. Does anyone, including family or friend, verbally or physically hurt you? 2 2
16. Does anyone, including family or friend, threaten to harm you? 0 2
17. Does your partner/family have problems with alcohol or drug use? 2 2
18. Before you were pregnant, did you have problems with alcohol or drug use? 2 2
19. In the past month, did you drink beer, wine, or liquor or use any drugs? 6 2

25. Outcomes to Date
• Information packages to provide to women who
are 20 weeks pregnant and beyond have been
developed and distributed to participating OB
offices
• 14 women have been enrolled into home visitation
programs.
• 18 women have received information and
assistance from the HOPE Program (Healing
Opportunities Providing Empowerment).
• One woman was in an abusive situation (physical,
emotional, fiscal) has gotten out and into a safe,
supportive environment.

26. The Sankofa Family Center
The African symbol of the Sankofa Bird, with its feet firmly pointing
toward the future while looking to the past, reminds us that we can honor
our past and our heritage while moving forward, planting a seed for future
generations, symbolized by the egg.

27. What does a healthy
neighborhood look like?
• Affordable and adequate housing
• Affordable cost of living
• Jobs/Workforce development
• Living wages
• Working families – low/no
unemployment
• Low crime rates
• People buying homes
• Green spaces
• Clean, no litter
• Community gardens
• Places to play
• Recreational centers/venues
Access to
 Healthcare & other necessary resources
 Affordable high-quality childcare
 Mental health programs
 Grocery stores
• Happy kids
• Students who are supported and have access to
resources (example – tutoring, mentoring)
• Safe, inviting schools and safe passage to schools
• Opportunities for youth, funding for programs
Neighbors helping neighbors – Networking
Sense of belonging – Non-judgmental
No isolation
Trust
Security
Safety
Happiness
• Transportation
• Internet access
• Good political representation
• Individuals who are emotionally stable
• Programs for the elderly
• Diversity and Inclusion
• Variety of religions

28. Programming for the
Family Protective Factors
• Family Protective Factors
– Increase family stability
– Enhance child development
– Reduce child abuse and neglect
• Goals of the Sankofa Family Center
– Provide programming and services to support all five of the Family Protective Factors.
– Expand needed services throughout Chesapeake
• The goals will be accomplished through collaboration
with CHIP and wonderful community partners
• The following slides indicate requested programming
by all participants and are color-coded to reflect what
is already offered and currently being planned. Other
listed requests will be added to the action plan for
future rollout.

29. Positive relationships that provide
emotional, informational,
instrumental, and spiritual support.
 Hispanic Support Group
 Create Learned Experience Leaders Advisory Board
 Parent Café
 Circle of Parents
 “A Great Start to a Positive Day” – refreshments and conversation at the
school bus stop or at schools
 Opportunities to connect with neighbors (movie nights, game nights) and
other family activities
Social connections
KEY
Bold – Offered
Bold – Planned

30. Managing stress and functioning well when
faced with challenges, adversity, and trauma.
 Economic Mobility
o Aspire Mobility Program
o Strive Mobility Program
 Safe Passage to School
 Violence Interrupters Education
 Job interview training (resume writing, interview techniques) – clothes for
interviewing
 Skills training
 Mental Health Support/Classes (relationship with CIBH, telehealth, etc.)
 Classes on how to recognize predatory vendors
KEY
Bold – Offered
Bold – Planned
Parental resilience

31. Understanding child development and
parenting strategies that support
physical, cognitive, language, social, and
emotional development.
 Home Visitation Program
 Sleeptight
 Stork’s Nest
 LENA Start/LENA Grow
 Gentle Parenting Classes
 Grandparent Classes
 CHKD’s “Parenting on the Sidelines” and/or newest classes for coaches
Knowledge of
parenting and child
development
KEY
Bold – Offered
Bold – Planned

32. Access to concrete support and services that
address a family’s needs and help minimize
stress caused by challenges.
 Connection to resources – care coordination
 Distribution site for the Foodbank of Southeastern Virginia and the Eastern Shore – explore
increase in that presence, increase distribution capacity to meet immediate needs?
 Winter coat drive – distribution site for WAVY-TV 10
 Partner with healthcare partners to hold/increase involvement in health fairs
 Financial Literacy Classes, to include budgeting
 Food literacy – nutrition, cooking classes
 Assistance with finding childcare
 Assistance with finding medical care
 Kids Café (summers)
 Toddler Court
Concrete support in
times of need
KEY
Bold – Offered
Bold – Planned

33. Family and child interactions that help children
develop the ability to communicate clearly, recognize
and regulate their emotions, and establish and
maintain relationships.
 Tutoring Programs/Homework Assistance
 Play Groups
 Mentoring Programs
 Botvin Life Skills Training Program (Kids Kin ‘Kids Caregivers)
 Summer learning programs and/or other extra-curricular activities
Social and emotional
competence of
children
KEY
Bold – Offered
Bold – Planned

34. Source: https://www.medicaid.gov/state-overviews/scorecard/well-child-visits-first-15-months-of-life/index.html
Well-Child Visits in the First 15 Months of
Life: Virginia Medicaid and CHIP Population

36. Early Childhood
• Increase resources and partners to
provide behavioral health supports in
childcare settings
– Additional Infant Toddler Specialist
• Expand capacity for administering
consistent universal screenings (ASQ)
for all 0-6 settings
– United Way South Hampton Roads

38. Chesapeake Childcare Subsidy
Impact
Fiscal Year # of Families
Served
# of
Children
2024 884 1346*
2023 1211 1899
2022 966 1575
2021 697 1156
*June/July to date
Fiscal Year Budget
2024 $15, 199, 756.93
2023 $7,570,013.63
2022 $6,968,432
2021 $6,422,866.77

39. Childcare Business Supports

40. Questions?
Phyllis Stoneburner, MBA, BSN, RN
Executive Director
phyllis.stoneburner@healthychesapeake.org
Office: (757) 690-8973
Cell: (757) 641-9569
667 Kingsborough Square, Suite 102
Chesapeake, VA 23320
Healthy citizens are the greatest
asset any country can have.
Winston Churchill
Emily Edmonds
Early Childhood Program Coordinator
Department of Human Services
eedmonds@cityofchesapeake.net
Office: (757) 382-2322
Cell: (757) 799-6153
www.cityofchesapeake.net