The Healthiest Cities & Counties Challenge will put $1.5 million into a tried-and-true public health equation: Social determinants of health + investments = measurable health improvements.

Yesterday, leaders from challenge co-partners APHA and the National Association of Counties joined an AtlanticLIVE forum, sponsored by the Aetna Foundation, to explore how the equation can become a nationwide reality. Aetna CEO Mark Bertolini shared his own inspiration: a discussion last year with renowned British epidemiologist Sir Michael Marmot.

“I was talking about how our economy has laid bare social determinants in health care. And he said, ‘Mark, we’ve known that since World War II,’ Bertolini said. “The United States is now 12th in total spending on social determinants among (Organization for Economic Cooperation and Development) nations but we spend more than 70 percent on health care, while those countries spend less than 50 percent. So there’s something wrong with the balance.

“How can we figure this out? We need to get the communities, we need to get the counties, we need to get the cities. We need to hear what they need specific to their own communities and that’s why we’ve launched Healthiest Cities & Counties Challenge. We can bring resources and ideas; how can we work with cities and counties to develop programs to get at these issues of the balance between social determinants of health and health care spending?”

The forum featured success stories from city and county leaders in tailoring interventions to match their unique specific community needs. Oklahoma City Mayor Mick Cornett described how fixing the built environment — specifically transforming from “the most unfriendly city to pedestrians imaginable” to one that’s much more walkable — helped 47,000 people lose more than 1 million combined pounds in five years.

Fairfax County (Virginia) Sheriff Stacey Kincaid testified to the police department’s unique approach to combating the state’s mental health epidemic. With “Diversion First,” a countywide program enacted in 2016, the county is emphasizing treatment, instead of incarceration, for people who come into contact with the criminal justice system for low-level offenses.

In six months, the program diverted nearly 300 people experiencing a mental health crisis into treatment, instead of jail.

“Jails and prisons were not designed to be psychiatric hospitals,” Kincaid said. “Not only is it the right thing to do — diverting people who are mentally ill into treatment instead of jails — but you have a lot better outcomes. The costs vs. benefits are stunning. Millions and millions of dollars can be saved by doing what’s right.”

Read how 50 award-winning communities are prioritizing social determinants of health.