Project: Arizona Health Matters

About Project

Arizona Health Matters brings non-biased data, local resources and a wealth of information to one, accessible, user-friendly location. The intent is to give communities the tools they need to read and understand the public health indicators that affect the quality of their residents’ lives. The tools can also help those communities set goals and evaluate progress. Community groups, schools, health associations, chambers of commerce, tourism and many other organizations can use this information to show the great benefits of living in Arizona as well as opportunities for improvement, with specific information. Master planners and government can use this data to establish community goals on a variety of platforms. The data is updated whenever source data is updated providing the most up-to-date information of its kind. The evolving nature of this website allows all counties within Arizona to contribute information and ideas. The promising practices section highlights exemplary programs and successes of local, state and national health departments; it also allows individuals to search for information when they face a similar situation or as a resource. AHM goal is to strengthen and build healthier communities through the provision of state-of the art web-based assessment and improvement tools. We hope you find it beneficial.

Promising Practices

Looking for what works? The Promising Practices section informs professionals and community members about documented approaches to improving community health and quality of life. Carefully reviewed, documented, and ranked practices that range from good ideas to evidence-based practices are provided.

1. Keepin’ it R.E.A.L. (Refuse, Explain, Avoid, Leave)


The Keepin’ it R.E.A.L. (Refuse, Explain, Avoid, Leave) program is a video-enhanced intervention that uses a culturally grounded resiliency model that incorporates traditional ethnic values and practices that protect against drug use. A school-based prevention originally designed for middle-school students, the program has been implemented with youths ages 10 through 17. The program teaches youths to live drugfree lives by building on their existing cultural and communication strengths and the strengths of their families and communities. Students are taught how to resist substance use through practical, easy-to-remember and -use strategies that are embodied in the acronym REAL (Refuse, Explain, Avoid, Leave). Using Keepin’ it R.E.A.L. strategies, students learn how to recognize risk, value their perceptions and feelings, embrace their cultural values (e.g., avoiding confrontation and conflict in favor of maintaining relationships and respect), and make choices that support them. Distinct Mexican-American, African-American/Non-Latino, and multicultural versions of keepin’ it R.E.A.L. were developed so students could recognize themselves in the prevention message and see solutions that are sensitive to their unique cultural environments.

Goal / Mission

The objective of this program is to increase life skills such as risk assessment, decision-making and drug resistance, while enhancing anti-drug norms and attitudes.

Results / Accomplishments

The initial keepin’ it R.E.A.L. evaluation was conducted over 48 months. The study sample consisted of 3,318 Mexican or Mexican-American students (47 percent female), 1,141 students of other Latino or multiethnic Latino origin (e.g., Mexican and white, Mexican and American Indian; 50 percent female), 1,049 non-Hispanic white students (48 percent female), and 527 African-American students (44 percent female). The evaluation findings suggest that keepin’ it R.E.A.L. succeeded in decreasing substance use, in reducing negative attitudes/behaviors, and in improving positive attitudes/behaviors. The data showed a 32 percent to 44 percent reduction in marijuana, tobacco, and alcohol use; a 29 percent to 34 percent decrease in intent to accept substances; and a reduction and cessation of substance use. Improvements in antidrug attitudes/behaviors were apparent in the 30-38 percent increase in knowledge about and negative attitude toward drug use, increased repertoire of resistance skills, more frequent use of those skills, and increased adoption of strategies to resist using alcohol, cigarettes, and marijuana. Other types of outcomes included significantly less substance use (especially alcohol), retention of unfavorable attitudes against someone their age using substances, and perception that their peers’ increase in substance use experimentation was significantly less than previously believed.

About this Promising Practice

Primary Contact

Patricia Dustman, Ed.D. Southwest Interdisciplinary Research Center Arizona State University-Downtown Phoenix Campus 411 N. Central Avenue, Suite 720 Phoenix, AZ 85004-0693 (602) 496-0700


Health / Substance Abuse Health / Teen and Adolescent Health


Southwest Interdisciplinary Research Center Source The Office of Juvenile Justice and Delinquency Prevention’s Model Programs Guide (MPG)

Date of publication


Geographic Type



Phoenix, AZ

For more details…

Target Audience

Children, Teens

2. Challenging College Alcohol Abuse


Challenging College Alcohol Abuse (CCAA) is a social norms and environmental management program aimed at reducing high-risk drinking and related negative consequences among college students (18 to 24 years old). The intervention was developed at the University of Arizona based on work previously done at Northern Illinois University. CCAA uses a campus-based media campaign and other strategies to address misperceptions about alcohol and make the campus environment less conducive to drinking. Studies have shown that college students tend to perceive their peers’ level of drinking to be higher than it actually is, which in turn influences their own drinking behavior. CCAA’s media campaign addresses these misperceptions by (1) communicating norms using data from surveys conducted at the university, (2) educating students on less-known or less-understood facts related to alcohol, and (3) offering an opportunity to change the “public conversation” around alcohol use among students, staff, and the local community. Advertisements and articles in the school newspaper, press releases, campus displays, and other media are used to communicate factual information about alcohol and drugs and related topics such as health and wellness, sexual assault, and sexually transmitted diseases. CCAA provides small grants to fund and promote non-alcohol social events that compete with traditional drinking occasions. Some media coverage is targeted to higher-risk groups such as fraternity and sorority chapters, freshmen, women, and students living in residence halls. CCAA also includes components aimed at faculty and staff, parents, and the local community, such as encouraging increased restrictions and monitoring of on-campus and off-campus alcohol use.

Goal / Mission

The goal of this program is to reduce the negative impact of alcohol abuse on campus life by correcting students’ perceptions about alcohol use and by making the campus less conducive to drinking.

Results / Accomplishments

CCAA was first implemented at the University of Arizona in 1994. It has been continually implemented, evaluated, and refined each year since then, and as of 2007 continues to be an active component of the university’s Campus Health Service. Results of the program include the following:

Over 3 years of implementing CCAA at the university (1995 to 1998), the percentage of surveyed freshmen who reported having five or more drinks per occasion at least once in the last 2 weeks decreased from 43% to 31% (p < .01). Over the same time period, the percentage of surveyed freshmen who reported using alcohol three or more times per week in the past year decreased from 22% to 17% (p < .05). The study also found positive changes in students’ attitudes and beliefs about alcohol and a decrease in negative consequences of alcohol abuse such as getting in fights, getting in trouble with campus police, and sexual incidents.

About this Promising Practice

Primary Contact

Peggy Glider, Ph.D. University of Arizona, Campus Health Service 1224 E. Lowell Street Tucson, AZ 85721-0095 (520) 621-5973


Health / Substance Abuse Health / Prevention & Safety Public Safety / Crime & Crime Prevention


Health Promotion and Preventive Services; University of Arizona


SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP)

Date of publication

Jan 2007

Date of implementation


Geographic Type



Tucson, AZ

For more details…

Target Audience


AHM Department – Maricopa County Health Matters

Maricopa County Health Matters is an up-to-date source of population health and socio-economic data, providing local resources for community assessment, health improvement planning, collaboration, and policy-making.

Priority Area: Diabetes

Diabetes is linked to many complications including heart disease, stroke, high blood pressure, kidney disease and more. One in ten county residents have been told by their doctor that they have diabetes, and rates of illness are even higher among certain ethnic groups. That’s why it was chosen as a health priority area of focus in the Maricopa County Community Health Improvement Plan.

The Time is Now: Get Fully Vaccinated for Measles

“If you are unsure of your vaccination status, talk to your health provider about getting an MMR vaccine. That is the best prevention method we have against measles,” said Dr. Cara Christ, director of the Arizona Department of Health Services. “ Learn more about the latest Measles outbreak.

Hospital Assessments: Community Benefits Reporting

Hospital Community Health Assessment Efforts

The Patient Protection and Affordable Care Act (ACA) added new requirements which nonprofit hospital organizations must satisfy to maintain their tax-exempt status under section 501(c)(3) of the Internal Revenue Code. One such requirement added by ACA Section 501(r) of the Code, requires nonprofit hospitals to conduct a Community Health Needs Assessment (CHNA) and adopt implementation strategies to meet the identified needs at least once every three years. As part of the CHNA, each hospital is required to collect input from designated individuals in the community, including:

  • public health experts;
  • residents;
  • representatives or leaders of low-income, minority, and medically underserved populations;
  • and individuals with chronic conditions.

The community health needs assessment process offers an opportunity for the entire community to work together to collectively improve health. As of early 2015, the following facilities, in partnership with in the Maricopa County Coordinated Health Needs Assessment (CCHNA) collaborative, will conduct an assessment of the health needs of residents in the communities they serve:

  • Adelante Healthcare
  • Banner Health
  • Dignity Health
  • Mayo Clinic Hospital
  • Mountain Park Health Centers
  • Native Health
  • Phoenix Children’s Hospital.

The Shift Toward a Collaborative, Coordinated Health Assessment

ACA community benefits reporting requirements are mirrored in the Public Health Accreditation Board’s (PHAB) standard mandating that health departments participate in or conduct a comprehensive community health assessment (CHA) every three to five years. Other PHAB standards require that health departments conduct a comprehensive planning process resulting in a community health improvement plan (CHIP), and implement strategies to improve access to health care. Maricopa County Department of Public Health completed its first CHA in 2012 with the subsequent 2012-2017 CHIP underway.

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Additionally, federally funded community health centers must ensure their target communities are of high need. They must also address the shortage of health services that are occurring within these communities. The similar requirements from IRS, PHAB and the United States Department of Health and Human Services provide an opportunity to catalyze stronger collaboration and better shared measurement systems among hospitals, health centers and health departments. Additionally, limited resources for comprehensive health assessments and the move toward new population health models have created the need for an organized, collaborative public-private approach for conducting assessments.

Maricopa County hospitals and health centers play significant roles in the region’s overall economy and health. In addition to providing safe and high-quality medical care, these institutions work to improve regional health through programs that promote health in response to identified community needs. Maricopa County’s hospitals and health centers have joined forces with Maricopa County Department of Public Health to identify the communities’ strengths and greatest needs in the first Coordinated Community Health Needs Assessment (CCHNA).

Hospital assessment processes will run concurrently with the county’s community-based health assessment process. The Maricopa County assessment will be completed with information obtained through written questionnaires and focus groups attended by key informants and community leaders representing the various needs and interests of Maricopa County. The assessment also draws from county health status report data, the Arizona Department of Health Services Vital Statistics, Primary Care Area Statistical Profiles, and the U.S. Census Bureau.

Nonprofit Hospitals in Arizona

A nonprofit hospital is a healthcare facility that is organized as a nonprofit organization and operates for the primary purpose of providing medical care to the community. These hospitals are considered to be public charities and are expected to provide a certain level of community benefit, such as providing free or discounted care to low-income patients, offering health education and wellness programs, and participating in community health initiatives. They are not motivated by generating profit for shareholders or owners, but rather by serving the community and providing healthcare services to those in need.

You can check a list of nonprofit Hospitals in Arizona by counties here.

While this primer focuses on the requirements of nonprofit hospitals, it is important to note that other hospitals do provide benefits to the communities they serve although they are not required to do so. “Safety net” hospitals, like Maricopa Integrated Health System, function similarly to nonprofit hospitals in their commitment to serving lower income patients. This financial commitment can run into the hundreds of millions of dollars in a given year. Because of uncompensated care costs and Medicaid and Medicare reimbursement rates that do not fully cover the true costs, these hospitals provide an important community benefit.

Contact AHM

Partnership Development and Strategy

Seth Fritsch Maricopa County Department of Public Health Strategic Initiatives Coordinator 602-372-0456

Communications and Website Support

Courtney Kreuzwiesner Maricopa County Department of Public Health 602-506-6098

Evaluation, Data and Performance Improvement

Becky Henry Maricopa County Department of Public Health

Performance Improvement Coordinator

602-372-8402 Community Health Assessment Coordination Denise Lopez

Maricopa County Department of Public Health

Community Health Assessment Coordinator 602-372-0521

HIPMC Partner Initiatives

The Health Improvement Partnership of Maricopa County (HIPMC) is a collaborative effort between Maricopa County Department of Public Health and public and private organizations addressing priority health issues through the 2012-2017 Community Health Improvement Plan (CHIP). Many participants are from organizations that have been involved since the Community Health Assessment process, and others have joined as the CHIP has taken shape.

Whether your organization is large or small, health-related or not, the HIPMC brings together all those passionate about promoting health and wellness within their respective organizations and communities. The Community Health Improvement Plan process provides an open forum to share ideas and resources as well as to identify gaps and barriers to existing services in Maricopa County. There are many benefits to joining the HIPMC; find out how you can get started today!

AHM Sectors

Partner initiatives are aligned along four sectors: Worksites, Community, Education and Healthcare. (Note: Click links to be taken to sector Initiative Centers).

The Worksite Sector focuses on improving health status within places of employment in Maricopa County. Workplaces may be public or private, and includes both the perspectives and needs of employees and employers. This sector is also interested in engaging employers, organizations, associations, insurers, and other groups that support worksite health and employee wellness initiatives.

The Community Sector focuses on improving health outcomes by addressing issues and activities that touch people through the course of everyday life in Maricopa County. This sector is also where health issues relating to physical, environmental, social, or cultural characteristics may be addressed.

The Education Sector focuses on positively affecting health within learning environments or settings, both public and private in Maricopa County. This includes pre-K, elementary schools, middle schools, high schools, charter schools, colleges, and universities as well as before- and after-school programs for children that are offered in school or a community-based facility. This sector is also interested in engaging with organizations, associations, and advocacy groups within the education spectrum.

The Healthcare Sector focuses on improving the health status of the community via settings in Maricopa County in which clinical decisions are made or where medical services are provided. This includes hospitals, urgent care centers, primary care facilities, mobile medical facilities, physician’s offices, community health centers, and other clinically-oriented settings. This sector is also interested in engaging advocacy groups, associations, and organizations concerned with the provision of healthcare services and health-related products.

AHM Department – Pima County Health Matters

About Pima County

Covering an area of approximately 9,200 square miles, Pima County is locatedcactus in southern Arizona and is one of the oldest continuously inhabited areas of the United States. Pima County is adjacent to six Arizona counties and shares 132 miles of an international border with Mexico. Native Americans have lived in this region from prehistoric times to the present, with the Tohono Oodham reservation the second largest in the nation. From a population of 395 in 1820, Pima County now has a population of slightly more than 980,000, by the 2010 Census count.

Photo looking East from Gates Pass on November 30, 2011.

Aside from our vibrant multicultural diversity, we’re also unusual in that we’re a very urbanized County, with more than a third of our population living outside of any incorporated cities or towns. The majority of residents live in the Tucson metropolitan area with other population centers that include Green Valley, Marana, Oro Valley, Sahuarita, South Tucson, Vail, and the sparsely populated towns of Ajo and Sells, the capital of the Tohono Oodham Nation. The population of Pima County is projected to reach 1.4 million by 2041.

2013-2017 Community Health Improvement Plan

From 2010 to early 2013, under the leadership of the Pima County Health Department (PCHD), organizations and community members engaged in a comprehensive community health assessment and improvement planning process. The goal of this intensive, community-driven process was to examine the current health needs of Pima County residents and determine how to best address them.

Developing strong and lasting partnerships is fundamental to a healthy community. The Healthy Pima initiative was formed to inspire, lead, and ultimately own the community health assessment and improvement planning process. Healthy Pima currently has over 200 members from government, for-profit, and not-for-profit organizations, representing advocacy, behavioral health, community and faith-based services, health care, education, employers, unions, American Indian communities, and philanthropy. Its members are all invested in the health of our community and have a strong inclination to collaborate and are able to influence others.

The priorities that comprise the Community Health Improvement Plan are:

  • Healthy Lifestyles
  • Health Literacy
  • Access to Care
  • Health Disparities

Action groups have been formed around these health priorities and have formed work plans, established time lines, developed evaluation benchmarks, and are implementing the Community Health Implementation Plan.

The Healthy Pima initiative is now well into the action phase of our community health assessment and improvement planning process. Healthy Pima membership will continue to be fluid as new members are always welcome and needed as the implementation phases unfold. Rather than this being a finite initiative with a clear end in sight, it is an ongoing process to address the health priorities of our community.

Editorial Policy


The Arizona Health Matters website is intended to be a place where community members and policy makers can learn about the overall health of Arizona residents. It is a website dedicated to providing state and local health data, promising practices, as well as related news and reports.


No advertising will be permitted unless the Editorial Board approves it.

Editorial Board

The Editorial Board and the Arizona Health Matters website do not endorse or advocate any political initiatives or political figures.

Community Indicator Data

Indicators are presented in the nine topic areas to provide a measure of how our communities are doing. For each indicator, the actual value is shown as well as information about how we are doing compared to other geographic areas (the red-yellow-green gauge) or how we are changing over time (green or red up and down arrows) or how we compare to a national or state average (blue/white or tri-color gradation gauge) to give some context to the information. It is important to remember that while we may be doing better on some indicators than other parts of the country or compared to a state or national average value that does not mean that we should not be working on improving all indicators. Indicators are described and links given to the source of the data and what the values mean. The primary aims of the indicator system are to inform and facilitate positive change. To inform, we must provide accurate, reliable, and timely data at a geographically-meaningful level. We accomplish this by selecting sources that meet the following criteria:

  • Validated methodology for data collection and analysis
  • Regular, scheduled publication of findings
  • Focus on data values for small geographic areas, such as counties and postal codes that are available for all county-level locations in the U.S or locally through our community partners.


Through the Healthy Communities indicator system, community members have easy access to critical information about the community. The status of the community can be displayed in several ways that are easy to understand.

Links to government sites, academic centers, and some community-based organizations and foundations will be permitted only if the other site includes health-related information and data. Links will not be provided to advocacy organizations and organizations that offer or support products or services that are detrimental to health, such as tobacco products.

AHM Commitment To Privacy

Your privacy is important to us. To better protect your privacy we provide this notice explaining our online information practices and the choices you can make about the way your information is collected and used. To make this notice easy to find, we make it available on our homepage and at every point where personally identifiable information may be requested.

Should you have any questions or concerns about our privacy police, please send us an email at or call us at 866-499-6423.

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