The URL can be used to link to this page

02-09-22 Mayor's Council on Health and Well-Being - Agenda - PdfCity of Atlantic Beach Agenda Mayor's Council on Health and Well -Being Meeting Wednesday, February 9, 2022 - 12:00 p.m. Commission Chamber, City Hall 800 Seminole Road Atlantic Beach, FL 32233 and Virtual (via Zoom) Page(s) ROLL CALL ELECTION OF CHAIR AND VICE -CHAIR CALL TO ORDER APPROVAL OF MINUTES Approve minutes of the January 12, 2022 meeting 3 - 4 Mayor's Council on Health and Well -Being - 12 Jan 2022 - Minutes - Pdf ADMINISTRATIVE MATTERS May 4, 2021 Board and Committee Training Session Atlantic Beach, FL 5 (swagit.com) On -Line Form Meeting Agenda (documents reviewed in training) 2022 MCHWB Calendar BLUE ZONES R3BlueZones Jacksonville Results 07.16 copy 2 'Blue Zones' author 9 secrets to live a long life copy JAX-Beach-Communities FINALv2-9.28.21 copy 7-29 MISCELLANEOUS 20191108 CRC Duval County Health Zone Data Cuseo-chapter-NavigatingStudentWellnessinHigherEducation-SteveHighlights 31-73 TOPICS Possible Council Topics 01.20.2022 75 NEXT STEPS PUBLIC COMMENT Page 1 of 78 Mayor's Council on Health and Well -Being - 09 Feb 2022 01-12-22 Notice and Instructions for Public Commenting for Feb. 9 2022 Mayor's Council on Health and Well -Being Meeting 77 - 78 ADJOURNMENT Any person wishing to speak to the Mayor's Council on Health and Well -Being on any matter at this meeting should submit a Comment Card located at the entrance to Commission Chamber prior to the start of the meeting. This meeting will be live -streamed and videotaped. To access live or recorded videos, click on the Meeting Videos tab on the city's home page at www.coab.us. In accordance with the American with Disabilities Act and Section 286.26 of the Florida Statutes, persons with disabilities needing special accommodations to participate in this meeting should contact City Clerk Donna Bartle at 247-5809 or at City Hall, 800 Seminole Road, Atlantic Beach, Florida not less than three (3) days prior to the date of this meeting. Page 2 of 78 Agenda Item # 09 Feb 2022 MINUTES Mayor's Council on Health and Well -Being Workshop Wednesday, January 12, 2022 - 12:00 PM Commission Chambers and Zoom Present: Steve Piscitelli, Member Joyce Freeman, Member Jim Belich, Member Jessica Ring, Member Lisa Herrold, Member Tracy Marko, Member JoAnn Wallace, Member Ellen Golombek, Michael Lanier, Member Absent: Kyle Brady, Member Michael Hosto, Member Also Present: Ellen Glasser, Mayor Shane Corbin, City Manager Abrielle Genest, Planner 1. CALL TO ORDER Following the Pledge of Allegiance, Mayor Glasser called the workshop to order at 12:OOpm. 2. ROLL CALL Council members went around the room and said their names. Steve Piscitelli attended via zoom. 3. PURPOSE & VISION Mayor Glasser reviewed Resolution No. 21-78 which establishes the Council. City Manager Corbin read the 2040 Vision Statement and explained the steps done to create the statement. 4. ADMINISTRATIVE MATTERS Mayor Glasser spoke about establishing topics for discussion, public participation via Zoom, training and certification required for all Council members, establishing a meeting date, and selecting a Council Chair and Vice -Chair. The Council decided they would meet the 2nd Wednesday of the month from February to October and the 1st Wednesday of November. 5. SELF -INTRODUCTIONS Council members went around the room and introduced themselves. 6. DATA Abrielle Genest gave a presentation on census data. Mayor Glasser reviewed data from the 2019 Youth Risk Behavior Survey and 2018 FYS Report -Duval County Tobacco and Vaping. Michael Lanier spoke about Duval County Health Zone Data. Mayor's Council on Health and Well -Being January 12, 2022 Page 1 of 2 Page 3 of 78 Agenda Item # 09 Feb 2022 7. NEXT STEPS Mayor Glasser stated at the February meeting Council members will elect a chair and vice -chair, there will be a presentation on Blue Zones, and topics will be selected. 8. PUBLIC COMMENT There were no speakers. 9. ADJOURNMENT There being no further discussion, Mayor Glasser declared the meeting adjourned at 1:36 p.m. Attest: Chair Abrielle Genest Mayor's Council on Health and Well -Being January 12, 2022 Page 2 of 2 Page 4 of 78 Agenda Item # 09 Feb 2022 City of Atlantic Beach MAYOR'S COUNCIL ON HEALTH AND WELL-BEING 2022 Schedule for Meetings Month Meeting Date January January 12 February February 9 March March 9 April April 13 May May 11 June June 8 July July 13 August August 10 September September 14 October October 12 November November 2 ❖ Meeting dates are subject to change but will be advertised at least 48 hours in advance if changed. ❖ Meetings start at 12:00 PM and are held in Commission Chambers at 800 Seminole Road. In accordance with the Americans with Disabilities Act and Section 286.26 of the Florida Statutes, persons with disabilities needing special accommodations to participate in this meeting should contact the City not less than three (3) days prior to the date of each meeting at 800 Seminole Road or (904) 247-5809. Please note that two (2) or more elected officials may be in attendance. Page5of78 Page 6 of 78 BLUE ZONES PROVEN RESUL Fort Worth, Texas Agenda Item # 09 Feb 2022 Blue Zones helps transform communities across the nation into areas where the healthy choice is easy and people live longer with a higher quality of life. The below reflects, but is not limited to, the proven results of Blue Zones Project in various communities, cities, and states across the U.S. Q 31% decrease in smr, , reducing smoking rate to 13.5% Q Nine -point increase in residents who exercise at least 30 minutes three or more days of the week, now at 62% Q Overall 2018 Well -Being Index score rose to 62.5, a gain of 3.7 points or 6% since 2014 © $20B Lifetime Reduced Smoking Value Since the launch of Blue Zones Project in Fort Worth, the health and well-being of residents has surged while the U.S. overall health score has dropped. According to the annual Gallup-Sharecare Well -Being Index®, Fort Worth's overall 2018 Well -Being Index score rose to 62.5, a gain of nearly four points since 2014, when the city began working with Blue Zones Project'. Each point increase in well-being for a population leads to approximately a 2% reduction in ER visits and hospital utilization, and to approximately a 1% reduction in total health care costs. This equals tens of millions of dollars of healthcare savings per year. Meanwhile the U.S. Well -Being Index score -which outpaced the Fort Worth score by 3 points in 2014 -is 61.3, a decline of 0.5 over the same period. Compared annually to close to 190 metro areas reported nationally, Fort Worth's equivalent rank for well-being rose from 185" in 2014 to 58°h in 2017. According to the Gallup-Sharecare Well -Being Index (WBI): • Adult residents of the Fort Worth have reported substantially elevated levels of overall well-being in the four years since measurement began in 2014. • Fort Worth's Well -Being Index score 2018 = 62.5 • Fort Worth's Well -Being Index score 2014 = 58.8 The section of the city with the lowest well-being, East Southeast, saw the greatest improvement. With a 10.9% well-being improvement over five years, which is a 6.1 -point increase moving from 55.9 in 2014 to 62.0 in 2018. What happens when you increase w by 1 -point? 2.2% less likelihood of hospital admission 1.7% less likelihood of ER visit 1.0% less likelihood of incurring healthcare costs Whnt hnnpens when you increase w by 10%? 5.0% fewer unscheduled absences 5.0% higher reported job performance ' 6.0% more days of 'best work' in 28 -day period Fort Worth moved from 185" to 58" in the Gallup-Sharecare annual database of around 190 U.S. communities. Fort Worth has also had statistically significant improvement in all five elements of well-being since baseline year. Reduced Smoking Rates in Fort Worth, TX: • Adult Smoking Rate in 2018 = 13.5% • Adult Smoking Rate in 2014 = 19.6% Fort Worth has saved an estimated $268 million in 2018 compared to 2014 based due to the reduced smoking rate among its adult residents. Gallup estimates Fort Worth's lost productivity due to smoking (at a rate if 19.6%) was about $602 million per year across all of its employers in 2014. In 2018 Gallup estimates that these lost productivity costs were reduced by about $187 million per year as a function of the lower smoking rate, likely representing a substantial boost to the economy. In Fort Worth, the 6.1 percentage point estimated reduction in adult smoking translates to 38,074 fewer smokers than in 2014, yielding a savings in health care utilization of about $81 million per year compared to that year. Other well-being improvements: • Exercise 30 plus minutes, 3x days, week: Improved 9 points from 53% in 2014 to 62% in 2018. • Agree city/area is perfect place for you: Improved from 61.9% in 2014 to 65.6% in 2018. • Agree proud of community: Improved 5.6 points from 63.8% in 2014 to 69.4% in 2018. • Won $3.2 million in Safe Routes to School funding for seven FWISD schools. • Youth smoking decrease: Percentage of youth who report currently smoking cigarettes at least once in the last 30 days has declined from 9% in 2015 to 5.5% in 2017, according to the Youth Risk Behavior Surveillance Survey (YRBS). Youth e -cigarette decrease: Percentage of youth who report currently using electronic vaping products at least once in the last 30 days has declined from 19.9% in 2015 to 7.4% in 2017, according to the YRBS Policy Impact & Funding. Partnered with City and community partners to secure over $9.9 million in funding for built environment policies and infrastructure projects and $656 thousand in funding for community and school gardens, increasing fresh fruits and vegetables in schools, and a corner store transformation. Confidential. ©2021 Blue Zones, LLC. All Rights Reserved. Page 7 of 78 • $15 million allocated for sidewalks and bicycle infrastructure and $5 million allocated for Safe Routes to School improvements out of 2018 bond, ten -fold increase in SRTS funding from previous bond. • Significant increase in the number of miles of bicycle infrastructure: Miles of bike lanes have increased from 9.6 miles in 2010 to 86.8 miles in 2018, and miles of bike routes (sharrows or bike route signage) have increased from 68 miles in 2010 to 87.2 miles in 2018. Food Systems Case Study: • City Healthy Food Financing Initiative - with low to no interest loans, retailers can open, renovate or expand retail outlets that provide fresh produce. Urban Agricultural Ordinance - allows vacant lots within the city to be used for the development of urban farms with rezoning. Community and backyard gardens allowed to have small temporary sales on-site. Media Valuation: • Media mentions at $4,424,635 advertising equivalency • 2.3B total reach • 100% positive or neutral coverage • 2,195 total news stories "Fort Worth showed early promise in its efforts to improve the well-being of its residents with impressive gains in 2015 and 2016 compared to its baseline year of 2014. After mirroring national trends and taking a step back last year, Fort Worth's latest jump in well- being in 2018, as the U.S. continues to decline, securely establishes it as a best practice example of what a community can accomplish when it sustains a focused commitment to well-being. The work of the Blue Zones Project in Fort Worth is playing an important role in the improving well-being culture and associated outcomes of the community." Gall Hawaii While national well-being has been declining since 2016, the well-being of Blue Zones Project Hawaii communities has remained steady since their baseline year of 2015 or 2017. Blue Zones Project Hawaii communities appear to be rebounding from 2019 to 2020 despite the survey window coinciding with the COVID-19 pandemic. IN 4M & WAHIAWA 4M Communities 2017-2019 Value Accrued: 7.2% decrease in risk = $4M in generated value 10 -year value projection from 2019: 27.7% decrease in risk = $124M in generated value Wahiawa 2017-2020 Value Accrued: 10.1% decrease in risk = $3.9M in generated value Wahiawa 10 year value projection from 2019: 30.8% decrease in risk = $78M in generated value The Blue Zones Project Wahiawa team partnered with other organizations and the County to help leverage $223 thousand in grant funding for policies, programs in Wahiawa. $13.5 million has been allocated toward bicycle and pedestrian projects in the form of the Wahiawa Bridge Project for shared use paths. • The percentage of adults utilizing public transportation or bicycles to actively commute to work increased from 10.2% in 2017 to 12.5% in 2019 (Census). • 20% of Wahiawa residents report that it is easier to walk or bike in their community today compared to five years ago (WBI). • Added 21.6 miles of new bike lanes County -wide. • 21 businesses donated 3,272 pounds of healthy food during a Give Healthy Food Drive in 2019 which will be an annual event. • According to FeedingAmerica.org, the percent of Honolulu County residents who are food insecure declined from 11.8% in 2016 to 10.4% in 2018. IN WEST HAWAII The Healthways Simulation Model, developed in collaboration with the World Economic Forum, Harvard, Johns Hopkins School of Public Health, and Boston Consulting Group, is a predictive population health simulation model that can calculate health care -related costs associated with conditions and behaviors, forecast the incidence and progression of these diseases over time, and determine the medical and productivity value of changes in health conditions over time. The accuracy of this model was scientifically and independently tested using data available from the Framingham Heart Study, the longest - running longitudinal epidemiologic public health study of its kind, to ensure validity of the model using real data points. According to this simulation model, West Hawaii has outperformed state of Hawaii well- being trends since its baseline year of 2017, seeing 10.5% fewer health risks than expected if the community had followed state trends (listed below). This risk avoidance equates to $2.96 million in avoided medical and productivity costs to the community from 2017 to 2019. • Adult smoking: According to the Behavioral Risk Factor Surveillance Survey (BRFSS), the adult smoking rate on Hawaii Island has declined from 16.2% in 2015 to 14.9% in 2017. The percentage of adults using e -cigarettes has declined from 6.1% in 2015 to 5.1% in 2017. Confidential. ©2021 Blue Zones, LLC. All Rights Reserved. Page 2 Agenda Item # 09 Feb 2022 Page 8 of 78 Agenda Item # 09 Feb 2022 • Adult obesity: Decreased island -wide from 25% in 2015 to 23.3% in 2017, according to BRFSS. In Kona, adult obesity has declined from 57% in 2015 to 52% in 2017. • Adult depression: Island -wide, the percentage of adults with depression has declined from 15.1% in 2015 to 13.4% in 2017, according to BRFSS. Adult depression in Kona has also declined, from 13.3% in 2015 to 9.5% in 2017. • Youth smoking: Island -wide, cigarette use by high school youth has decreased from 11.4% in 2015 to 10.1% in 2017, according to the Youth Behavioral Risk Survey. • Youth physical activity: The percentage of Hawaii Island middle school youth meeting recommended physical activity guidelines increased from 16.3% in 2015 to 17.8% in 2017. • Produce consumption: Fruit consumption has increased island - wide and for Kona. Across Hawaii Island, the percentage of adults reporting that they consume more than three servings of fruit daily has increased from 16.2% in 2015 to 18.9% in 2017. For Kona, the percentage of residents reporting this has increased from 17.7% to 20.9% from 2015 to 2017. • BZP has partnered with organizations and the County to help bring $1.39 million in grants to Hawaii Island since the Project's start in 2015. • Over 14 miles of new bicycle lanes have been added in the County from 2015-2019. • 50% increase in the number of farmer's markets accepting SNAP/EBT across the County, from 10 farmers markets in 2015 to 15 in 2019. • Successfully advocated for the state's passage of House Bill 1895 which requires retailers of electronic smoking devices to register with the Attorney General's office in order to sell and creates a civil offense if the retailer is selling unregistered. IN CENTRAL HAWAII The Healthways Simulation Model, developed in collaboration with the World Economic Forum, Harvard, Johns Hopkins School of Public Health, and Boston Consulting Group, is a predictive population health simulation model that can calculate health care -related costs associated with conditions and behaviors, forecast the incidence and progression of these diseases over time, and determine the medical and productivity value of changes in health conditions over time. The accuracy of this model was scientifically and independently tested using data available from the Framingham Heart Study, the longest - running longitudinal epidemiologic public health study of its kind, to ensure validity of the model using real data points. According to this simulation model, Central Maui has outperformed state of Hawaii well-being trends since its baseline year of 2017, seeing 4.4% fewer health risks than expected if the community had followed state trends. This risk avoidance equates to $1.24 million in avoided medical and productivity costs to the community from 2017 to 2019. • 40% of Central Maui residents are aware of Blue Zones Project and 18% are engaged with the Project. • Central Maui residents who are engaged with the Project are more likely to be thriving in their life evaluation; 80% of those engaged are thriving in life evaluation compared to 50% of those who are aware but not engaged. • Engaged residents have higher purpose well-being with 56% thriving in purpose, compared to only 24% of non -engaged residents. • Adult smoking rate in Kahului has declined from 14% in 2016 to 10% in 2017. • Adult obesity: BRFSS data shows that the adult obesity rate in Kahului has declined from 60% in 2016 to 55% in 2017. • Over 21 miles of new bicycle lanes have been added in the County from 2015-2019. Media Valuation: • Media mentions at $6,694,742 advertising equivalency • 5.1B total reach • 100% positive or neutral coverage • 3,130 mentions `Selected communities stated. Klamath Falls, Oregon In 2015, Klamath Falls was selected to be the first Blue Zones Project demonstration site in the Pacific Northwest. Since then, local leaders, volunteers, and organizations throughout the community have worked to achieve certification status. As a result of its efforts, Klamath Falls can celebrate: More than $1.3 million in grant funding to support community well-being projects including Safe Routes to Parks, Safe Routes to Schools, a Cigarette Litter Prevention Program (resulting in a nearly 80% reduction in tobacco litter downtown), supporting a preventative food pantry, increasing wayfinding signage, and increasing park access. New ordinances that are paving the way for smoking cessation and tobacco prevention through smoke-free city parks, smoke- free events, and increased education around smoking cessation, leading to a 24% decrease in smoking rates since 2015. New city policies that support healthy eating through the creation of the county food policy council, the county nutrition options resolution, and the adoption of many healthy meeting protocols in workplaces across the community. Increased physical activity among approximately 4,400 students in the local schools by participating in Walking School Bus Days. Twelve approved restaurants that offer a combined 37 new healthier menu items for adults and children. Klamath Falls has also become home to a vegan eatery and juicing company, offering even more options to the community's residents. • Increased demand for produce, which prompted a regionally owned grocery store to increase its produce section resulting in a 12% increase in produce sales. • More than 1,113 individuals joined a Moai®. walking group that promotes building friendships and moving naturally. • More than 715 individuals have volunteered to support the Blue Zones Project in Klamath Falls. Confidential. ©2021 Blue Zones, LLC. All Rights Reserved. Page 9 of 78 Agenda Item # 09 Feb 2022 Since 2015, Klamath Falls has seen a 24% decrease in smoking following Blue Zones Project implementation, advocacy, and policy work. Klamath Falls' adult smoking rate now stands at 13.1%, down from 17.3% in 2015 according to the Gallup-Sharecare Well -Being Index. Youth smoking has also decreased, with the percentage of youth who report having smoked cigarettes in the past 30 days declining among 8th and 11th graders between 2015 and 2017. According to the Youth Behavioral Risk Survey (YBRS), for 8th graders, the percentage dropped from 6.7% in 2015 to 4.7% in 2017, and for 11th graders the percentage dropped from 11.2% in 2015 to 8% in 2017. Frequent e -cigarette use among 11th graders has also declined in Klamath Falls while it has risen nation-wide. According to the YBRS, the percentage of 11th graders who smoked e -cigarettes 3-5 days within the last 30 days declined from 4.2% in 2015 to 1.3% in 2017. Blue Zones Project Klamath Falls results include: • 20 Blue Zones Project Approved worksites • 8 Blue Zones Project Approved schools • 10 Blue Zones Project Approved restaurants • 2 Blue Zones Project Approved grocery stores • 27 participating faith -based, neighborhood and community organizations More than 6,000 residents have taken the Personal Pledge or participated in a Blue Zones Project activity, like volunteering; attending a Purpose Workshop, cooking demonstration, or Blue Zones Project Story; or joining a Moai®. The city of Klamath Falls and Klamath County have implemented key food, built environment, and tobacco policies and projects. Food Systems Case Study: • Established on-line Farmers Marketplace: online food hub connecting local producers with consumers. Provides the only year-round location where SNAP recipients can purchase fresh produce year-round. Produce Connection: a network of eight drop sites where free produce is provided. Over 790,000 lbs. of produce distributed in 2018. Media Valuation: Media mentions at $2,754,967 advertising equivalency • 1.5B total reach • 99% positive or neutral coverage • 2,428 total news stories Southwest Florida 5 health risks statistically lower in Southwest Florida versus the state of Florida: O 36% lower in tobacco use © 28% lower in poor nutrition © 17% lower in stress © 23% lower in obesity O 9% lower in lack of exercise SWFL Medical and Productivity Value of $40,313,800 (accrued in 4 years 2015-2019): • 7.2% decrease in risk • $27.80 avg. savings PMPY • $635.9M projected savings in 10 years Value in Ad Equivalency of $10,150,195 (2015-2020) • 5.3B total reach • 100% positive or neutral coverage • 6,824 mentions • 4 million total social media impressions Grant Value of $14,590,385 over 4.5 years: • $13,132,691 TIGER Grant Collier County • $907,694 Safe Routes to School • $200,000 MPO Grant Bonita Springs • $250,000 Terry Street Project Bonita Springs • In addition, helped support purchase of Edison Farms, a 4,000 acre preserve in Estero and the Gore property in Golden Estates which put 180 in preservation for trails and passive recreation (Letter of Support, Proof of Community Collaboration). $100,000 to establish and sustain the first SWFL Food Policy Council. Total SWFL Value 2015-2019: • $40.3M Community Well -Being Value • $10.1M Media Value/Ad Equivalency • $14.5M Grant Value • $64.9M Total Value • 5.0 ROI NCH • • • • • Healthcare System (3 years) A 4.9 point jump in overall well-being among employees 54% decrease in healthcare expenditures over six years $27 million reduction in self-insured medical claims Nearly 60% of all employees pledged participation 40% decline in lost work days due to injury Confidential. ©2021 Blue Zones, LLC. All Rights Reserved. Page 4 Page 10 of 78 Agenda Item # 09 Feb 2022 Spencer, Iowa After launching Blue Zones Project, Spencer, Iowa saw: © 11% improvement in fruit and vegetable consumption © Workers' healthcare claims reduced by 20% © Metabolic syndrome risk factors fell from 43% to 13% at the Spencer Hospital © From 2010-2015, according to the Gallup-Healthways Well -Being Index, Iowa outpaced the nation in overall well-being, improving twice the rate of the national average • More than 50% of community believes Blue Zones Project helped create a positive impact. • 84 Iowa communities submitted interest, an elite 15 were chosen. 520,000 lives impacted by environmental changes designed to help people move naturally, eat wisely, develop the right outlook, and connect with others. 430,000+ actions taken by individuals to improve well-being for themselves, their families, and friends. 610 worksites, schools, grocery stores, and restaurants achieved Blue Zones Project designation. 180,245 total feet of bike lanes, trails, and sidewalks built to encourage people to move naturally. 142 Walking School Bus routes created to encourage students to move naturally. All 15 communities passed new Complete Streets policies to enable safe access for all users. In 2014, more than 25% of elementary students in Spencer, Iowa moved naturally to and from school. 60% of Spencer, Iowa's public schools are Blue Zone Schools and 67% of its grocery stores are Blue Zones Grocery Stores. Media Valuation: • Media mentions at $6,970,397 advertising equivalency • 3.6B total reach • 99% positive or neutral coverage • 4,222 mentions Beach Cities, California © 68% drop in childhood obesity rates at Redondo © 15% drop in adult obesity and overweight rates © 36% drop in smoking © 10% drop in significant daily stress since 2010 Beach K-5 schools Local officials engaged Blue Zones Project because their childhood obesity levels were higher than the national average (pre -2010). Stress levels were high, particularly in affluent Manhattan Beach, measuring the same as New Orleans post -Katrina, or in Detroit. At higher than the national average, significant daily stress was an important unhealthy indicator in the Beach Cities. These three beach cities in Southern California continue to show dramatic improvements since launching with Blue Zones Project in 2010. Obesity and Overweight Rates: 15% drop in obese and overweight adults (between 2010-2017). At 12.1%, the rate of obesity in the Beach Cities is less than half of the U.S. rate of 28.1% - meaning just one in eight Beach Cities residents are obese compared to one in four Americans nationally. 68% reduction in childhood obesity from 2007 to 2019 at Redondo Beach K-5 schools. The number of Beach Cities residents who are above normal weight (obese or overweight) fell from 60 to 50.8% In contrast, 63.7% of U.S. adults and 58.7% of Californians are above normal weight. Smoking Rates: 36% drop in smoking (between 2010-2017). The smoking rate in the Beach Cities fell to just 8.9% of residents - a rate significantly lower than the U.S. (18.8%) and California (13.7%). Exercise: Now, 65.8% of Beach Cities residents report exercising at least 30 minutes a day, three days a week—a 9% increase since 2010—compared to just 53.2% of adults nationally and 57.7% statewide. Overall Well -Being Score: The Beach Cities collectively earned the highest 2015 Well -Being Index score (65.9) in the U.S., outpacing all 190 metropolitan areas measured. Individually, Manhattan Beach (68), Hermosa Beach (67) and Redondo Beach (64.8) placed first, second and fifth in the U.S. respectively. Confidential. ©2021 Blue Zones, LLC. All Rights Reserved. Page 5 Page 11 of 78 Creating Value for Beach Cities: Since the inception of Blue Zones Project in 2010, improvements in community well-being are valued at: • Savings of $21M in direct medical expenses • Reductions in projected lost productivity of $21M • A cumulative total of $42M in value • $341 average annual per capita value Based on trends over the past 5 years, we project the total value of well-being improvement by 2020 to be: • Savings of $74M in direct medical expenses • Reductions in projected lost productivity of $51M • A cumulative total of $125M in value • $1,011 average annual per capita value Albert Lea, Minnesota O $7.5M in savings in annual healthcare costs for employers © 2.9 years added to lifespans within one year of participating in the Blue Zones Project O The Downtown Streetscape revitalization has increased private investment, tourism, and the tax base Suffering in the face of the 2008 economic downturn, Albert Lea, Minnesota, was determined to transform its situation. Its leaders eagerly teamed up with Blue Zones in 2009, making Albert Lea the first Blue Zones Pilot Project, applying principles from areas around the world where people lived longer, healthier lives. Pleased with the results of the nine month pilot, Albert Lea has continued on as a Blue Zones Project community addressing built environment, tobacco policy, citizen engagement, and bringing back the downtown. The commitment to well-being has resulted in numerous measurable impacts for Albert Lea leading incremental changes and sparking chain reactions. Impacts such as: $8.6 million—savings in annual health care costs for employers as a result of a decline in smokers. • 34th place—in the Minnesota County Health Rankings (up from 68 out of 87 counties). • 2.9 years—added to lifespans (projected) within one year of participating in the Blue Zones Project. When Blue Zones and Blue Zones Project began working with Albert Lea in 2009 to transform its policies, places, and people, the focus was on helping people move naturally, eat wisely, connect, and have the right outlook—all of which can lead to living longer, better. To make transformation a reality, city leaders and the Blue Zones Project identified key opportunities for impact and sought pledges from businesses and residents. Community Design Improvements In 2009, Blue Zones' expert Dan Burden led a walking audit of Albert Lea, identifying ways to create more active and healthy living environments centered around people. A Bike and Pedestrian Master Plan was created that identified areas needing improvement to align with the Complete Streets Policy, which Albert Lea was an early adopter of in 2009. Armed with inspiration and grant money, Albert Lea created bump outs to ensure safe pedestrian crossings and wider sidewalks that provided space for outdoor dining. A five -mile route that was added around a lake within the city was affectionately named the Blue Zones Walkway by Albert Lea, and it now connects to neighborhoods, parks, downtown and past the local hospital. Stop signs were replaced with traffic lights to maintain a smooth traffic flow. Community message boards were added, and a complete park renovation with amphitheater seating provided additional community gathering space. The improvements sparked a chain reaction of economic development. New businesses relocated to downtown Albert Lea, and the city initiated a mixed-use project to open room for income -limited housing units and commercial space in the historic downtown area. Healthier Workplaces Blue Zones Project offered local businesses the opportunity to become a designated Blue Zones Worksite by completing an assessment and improvements to increase the long-term well-being of employees, customers, or students. The simple changes were designed to provide lasting benefits to people's physical health, emotional health and social relationships. More than 45 worksites have registered with Blue Zones Project and made varying levels of change, the City of Albert Lea being one. Blue Zones Project also recommended worksite clinics for some of the larger employers in Albert Lea to increase well-being for employees and reduce healthcare costs. Five of the top 20 partnered together to provide their employees with a dedicated worksite clinic, serving approximately 1,650 employees. Two other area worksites also opened clinics. These efforts resulted in considerable savings. Healthy Foods To make healthy food the easy choice for everyone in the community, Blue Zones Project provided guidance on how to offer and bring attention to foods that are more nutritious and tasty. As a result, one of the local grocery stores implemented changes to its environment, selection of healthy options, and education and promotions to make healthier choices easier for customers. Grab -n -go breakfast and healthy snack cart programs were introduced in various public schools to help children create healthy habits, and they've been highly received by students, educators and parents. An indoor sports arena added healthier options to its concession stand and saw a bump in sales. And the City of Albert Lea has expanded the community garden space 150%, giving residents an opportunity to grow healthy food and socialize in an agricultural environment. Tobacco Cessation Starting in 2009, Blue Zones Project began working with the City of Albert Lea to drive policy and environmental changes for a measured reduction in tobacco usage. Confidential. ©2021 Blue Zones, LLC. All Rights Reserved. Page 6 Agenda Item # 09 Feb 2022 Page 12 of 78 Agenda Item # 09 Feb 2022 This included changes for public housing, public parks and events, outdoor dining, as well as partnering with local businesses. Out of 18,000 residents, 4,140 were smokers in 2010, and success had the potential of reducing health care costs by $6,000 per year, per smoker. Given the challenge of trying to implement this change and provide a new outlook toward this important public health issue, the city chose to make incremental moves over time, which have made a big impact. MEASURABLE IMPACTS THAT TRANSFORMED THE COMMUNITY The following progress indicators were reported by the City of Albert Lea in 2015, dating back to 2009 if the data was available. Impact of Community Design Improvements: Added more than nine miles of new sidewalks and three miles of bike lanes. More than a dozen businesses relocated to downtown Albert Lea. • Outdoor dining facilities created by three restaurants. • 96% increase in pedestrian traffic on Broadway from 2014 to 2018. 38% average increase in biking and walking throughout the community since 2009. Ranked above the national and state average for people feeling active and productive according to the July 2014 Gallup- Healthways Well Being Index°. More than $2.5 million invested in downtown building permits since 2013. • 25% increase in property value in the downtown area. • Year -over -year increase in lodging taxes due to an increase in visitors. $400,000 in revenue and a return of a $1.2 million property to taxable status expected from the mixed-use downtown development. Impact of Healthier Workplaces: 300% increase in funds given to the City of Albert Lea by its insurance carrier for its wellness program in 2014, and medical premium increases avoided for city workers in 2014 and 2015. $128,000 in health care costs saved by a Blue Zones Project worksite within a year of opening a worksite clinic for its 500 employees. The School District experienced no increase in Health Care Premiums and an 11% decrease in prescription costs as a result of their on-site clinic from 2014-2015. Impact of Healthy Foods Initiative: Increase sales of 130.35% from the Health Market, 12% from produce, 35.31% from frozen fruit and vegetables, 52.3% from water, and a decrease of 4.66% in soda sales at the Hy -Vee grocery store from 2009 through 2015. 59% increase in concession sales from 2014 through 2018 at City Arena after healthy options were added. 60% increase in breakfast participation from 2014 to 2015 in schools where the Grab -n -Go breakfast program was implemented. 17% increased participation in the Healthy Snack Cart program in the 2014 - 2015 school year. Results of Tobacco Cessation Initiatives: • Tobacco use eliminated at 550 units of public housing, 14 of the top 20 worksites as well as select other businesses, public parks, county fairs, other outdoor events, and outdoor dining. • Decline in smokers from 23% of adult residents in 2009 to 14.7% in 2016. • $8.6 million savings in annual health care costs for Albert Lea employers from the decline in smokers. Additional impact: • 2.9 projected years added to participants' lifespan within a year of participating in the Blue Zones Project. • $120,000 worth of media impact created from being featured in local and nationwide media, publications, and websites. • Jump to 34th place in the Minnesota County Health Rankings (previously 68 out of 87 counties). • Ranked third in "The top 10 most affordable small towns in the United States that you would actually want to live" by Realtor. com in the fall of 2015 (lakes, parks, walking paths and Blue Zones Project listed as "quality of life" indicators). Confidential. ©2021 Blue Zones, LLC. All Rights Reserved. Page 7 Page 13 of 78 Agenda Item # 09 Feb 2022 Analysis of Employer Medical Claims and Well -Being in Hawaii: A Comparison between Certified Blue Zones Worksites and Blue Zones Project Approved Worksites and a Control Group Health Economy, LLC 1 February 2019 Objectives: To determine whether employers who adopted Blue Zones Project® interventions had lower medical - claims costs or fewer patients for certain illnesses, and whether their employees had different health attitudes or behaviors, compared to employers who did not adopt any Blue Zones Project interventions. Study design: Retrospective observational cohort study using medical claims, eligibility, and Healthways Well - Being Assessment (WBA) and Gallup-Healthways Well -Being 5 (WB5) survey data from people receiving medical coverage from Hawaii Medical Services Association (HMSA) over a 48 -month period from January 1, 2014, through December 31, 2017 (1,869,480 -member months total). Five employers were included in the Blue Zones Project intervention group: Hale Koa, Roya Kona Resort, Castle Medical Center, HMSA, and Foodland. Six employers constituted the control group: Pinahou School, Zippy's, Bank of Hawaii, Queens Medical Center, Costco, and Servco. Methods: Compared slopes of medical costs for selected illnesses from intervention employers to those of control employers. Costs were broken down into each target illness, and comparisons were calculated for each. Target illnesses include anxiety, coronary heart disease, depression, diabetes (Type 2), hypertension, lipoid metabolism, osteoarthritis, sleep apnea, and stroke. Frequency of the diagnosis was also calculated and compared between the intervention and control groups. Changes in health behaviors and attitudes were calculated from average responses to selected well-being survey questions, comparing the respondents' first responses to their last during the time period. Results: The intervention group had lower medical -claims costs than the control group before Blue Zones Project interventions were adopted, and these costs became even lower over the four-year period of this study. At the twelfth month, the intervention group's weighted per -member, per -month (PMPM) cost was $29.17, representing 83 percent of the control group's per -member, per -month cost of $35.06. By the fourth year, the intervention group's PMPM cost was $40.59, which was 62 percent of the control group's PMPM cost of $64.96. Frequency of the target illnesses was also slightly lower in the intervention group before Blue Zones Project interventions were adopted. However, the intervention group's frequency diverged further from the control group's from month 18 onwards. The difference became statistically significant in month 22, then grew until month 30, after which has remained steady (for the final 18 months). Well-being survey respondents from the intervention group showed improvement in four out of five survey questions analyzed: life evaluation; two self-assessment questions about physical health; and produce consumption. Both control and intervention group respondents slightly worsened on getting adequate exercise, but the decline in the intervention group was less than in the control group. Conclusions: The intervention group's trends in costs and frequency of selected illnesses were lower than the control's at the outset and became even lower during the 48 -month time period. The intervention group would have had higher costs and more patients in Year Four if its performance compared to the control group had remained steady; instead, its performance improved, contributing to an estimated savings of $1.8 million. The intervention group also had improvement (or less deterioration) in relevant health attitudes and behaviors compared to the control group. Confidential. ©2021 Blue Zones, LLC. All Rights Reserved. Page 9 Page 14 of 78 Agenda Item # 09 Feb 2022 USA TODAY RESOURCE GUIDE Navigating COVID-19 FOR OUR SUBSCRIBERS Text our fact checkers U.S. CAPITOL RIOTS Database of arrests NEWS TO YOUR INBOX Start the day smarter News Sports Entertainment Life Money Tech Travel Opinion 47°F ;.; Hi, ELLEN v OM* SUBARU. JACKSONVILLC 1 ATLANTIC OLVO ■O.JA M -CDM NEWS Advertisement - scroll for more content 2022 ' OUTi C WILDERNESS 'Blue Zones' author: 9 secrets to live a long life Janice Lloyd, USA TODAY Published 7:33 a.m. ET Nov. 3, 2012 1 Updated 12:13 p.m. ET Nov. 4, 2012 A Dan Buettner, right, poses with Mihalis Gerakis, 85, of Ikaria, Greece. Buettner has continued his research on longevity and is updating his book 'Blue Zones' with a new chapter. Michael Turek, National Geographic Story Highlights • Author examines the habits of long-lived people in the world's "Blue Zones" • Book has a new segment on residents of a Greek island • You don't need to pump iron to extend your life, writer says Living a long life is almost a given now in many parts of the USA, but is it long and healthy enough, author Dan Buettner asks. Not by a long shot, he says. Healthier living and medical advances have pushed life expectancy in the USA to 79 (81 for women, 76 for men), but some people live much longer than that. Buettner knows a strong gene pool is important, but anyone can add on an extra 12 years, he says. You don't have to take a supplement to do it, he says, or take up jogging. Since the 199os, Buettner has been traveling with teams of researchers to areas around the world where people live the longest. They observe how lifestyle and environment come into play. He has written two books and is working with Healthways to help cities and businesses in the USA make healthy changes. His latest update hits bookstores this week: Blue Zones (National Geographic) adds a segment on Ikaria, Greece, a 99 -square -mile island 3o miles off the coast of Turkey. After the first edition was published in 2008, he says Greek researchers contacted him about Ikaria. "They gave us the tip" that the island has 10 times as many siblings over the age of 90 compared with any other place in Europe," says Buettner, 52. "Then we got a grant from National Geographic to go there. The first expedition was to look at birth and death records. The second expedition was to tease out what's going on." They confirmed the longevity numbers and found Ikarians also have less cancer, cardiovascular disease, depression and dementia than other parts of Europe, and men outlive women. "4 must -read if you want to stay young!" —DR. MEHMET C. OZ wYork 'I' H E Trmes Bestseller ones S E C O N In Frail -ION 9 LESSONS FOR LIVING LONGER from the people who've lived the longest DAN BUETTNER Author of Thrive "The Blue Zones" sheds light on the habits and values of people who live long. National Geographic •USA TODAY Many policymakers want a change to the Senate's filibuster rules. What is your opinion on changing the filibuster? Get rid of it Keep it with reforms Keep it as is No opinion About this survey In addition to eating a healthy Mediterranean diet (fruits, vegetables, whole grains, beans, nuts, healthy fats and fish and seafood), there are other key habits and values embraced by the Ikaria inhabitants. He has seen those same habits in the other four Blue Zones: Sardinia, Italy; Nicoya Peninsula, Costa Rica; Loma Linda, Calif.; and Okinawa, Japan. The Blue Zones get their name from the blue pen used to draw circles on a map locating the areas. Advertisement He' d like to draw a big blue circle around the entire USA. "I think this can really apply to Middle America," he says. He lives in Minneapolis and was walking while being interviewed on the phone for this story. The nine lessons: 1. Move naturally. Don't do marathons or pump iron; work around the house, garden, walk, cycle, walk when talking on the phone. 2. Know your purpose. Have a reason for waking up in the morning. 3. Kick back. Find ways to shed stress, whether it's praying, napping or going to happy hour. 4. Eat less. Stop eating when you are 8o% full. 5. Eat less meat. Beans are a cornerstone of most centenarians' diets. 6. Drink in moderation. Only the Seventh -day Adventists in California didn't have one to two glasses a day. 7. Have faith. Denomination doesn't seem to matter, but attending faith -based services (4 times a month) does. 8. Power of love. Put families first, including committing to a partner and keeping aging parents and grandparents nearby. 9. Stay social. Build a social network that supports healthy behaviors. The principles have been adopted by Healthways, a business dedicated to improving well-being, in its Blue Zones Project. Buettner works with them to encourage cities and businesses to draw up comprehensive plans (make walking paths in communities, point out tasty and healthy choices in grocery stores, work with restaurants to improve menus, encourage people to have best friends at work). A current project: a goal to make Iowa the healthiest state, which Gov. Terry Branstad, local business leaders and health care officials have endorsed. "It thrills me to no end to take wisdom from a place like Ikaria and try to put it in place in Iowa," says Buettner. "We have 110 evidence -based strategies that have measurable impact on life." Tabula Feed It's Time for a Long -Haul Mask Like This Israeli Mask Sonovia Ad These Cars Are So Loaded It's Hard to Believe They're So Cheap New cars are selling for a fraction of their value! Luxury SUVs 1 Search Ads 1 Ad Surgeon Reveals How To Fill In Balding Eyebrows Concerned with sparse, thin, and spotty brows? Dr. Layke shares his at home... Beverly Hills MD 1 Ad Most Affordable Camper Vans Camper Van Warehouse I Sea... 1 Ad Everything You Need To Know About Honeylove Shapewear Trueself for Honeylove 1 Ad Mature Trainer: This Is What "Ripped" Old Guys Do Differently (Genius!) Power Life 1 Ad No Appointment? No Problem - Upgrade to the World's Smartest CPAP Without Leaving Home The Easy Blog by EasyBreath... 1 Ad The New KF94 Fish Type Mask Is Taking Florida By Storm Hilipert KF94 Masks 1 Ad Advertisement Read More Reserve Yours Q 1 Advertisement A LUXURY MATTR,ESS WITHOUT A LUXURY PRICE More Stories MLK real name: Why Martin Luther King Jr.'s father changed his name NEWS Winter storm: Snow, power outages, tornados in East; flights canceled NEWS It's Time for a Long -Haul Mask Like This Israeli Mask Sonovia 1 Ad We're always working to improve your experience. Let us know what you think. Advertisement Know when your customer needs you most with Customer 360_ Learn Mote Advertisement X © 2022 USA TODAY, a division of Gannett Satellite Information Network, LLC. D Page 15 of 78 Page 16 of 78 BLUE ZONES - live longer, better® Blue Zones in Jacksonville BEACH COMMUNITIES ao o (D to (D CT N (D o3 *k Our Calling With all individuals, organizations and communities .•••••••• ..... ..... -.... .•••• .• • • • .. ... •. • • ...". To empower everyone, everywhere to live longer, better Co -create the opportunities, tools, process and environment • ... • ... .....**** ...-*** '..........*** Have a healthy, purposeful long-lasting life Blue Zones - Solution Model LIFE RADIUS° Almost all Americans spend 90% of their lives within 20 miles of home. We call this the LIFE RADIUS. That's where we focus—implementing permanent and semi-permanent changes to where people spend the majority of their waking lives. At homes, schools, worksites, grocery stores, restaurants, and faith -based organizations. We make healthy choices easier—even unavoidable. Where you spend your time and who you spend it with is the intervention that transforms well-being. BLUE ZONES CONFIDENTIAL I 2021 PAGE 3 PLACES 'NM¢ Cas Sdiools 1a3••afs 6rrr Slooa FaitMood Orpnliallon& Hilt ie iroonn rt (IQ O (D tom T1 CL (D CT N (D O3 *k Examples of Deployed Interventions BEACH CITIES, CALIFORNIA • Smoking banned on all city -owned property, on beaches, • parks and all recreation areas with cigarette receptacles installed throughout the Beach Cities • Over 100 restaurants achieved Blue Zones Certification • • More than 2000 Blue Zones Ambassadors (trained community volunteers) supported healthy transformations • Walking School Bus programs adopted in 14 schools • • 23,000 residents took personal pledges to live better, longer 3LUE ZONES- CONFIDENTIAL 2021 PAGE 4 The 3 beach cities worked collaboratively together to adopt the Beach Cities Livability Plan and the South Bay Bicycle Master Plan - working together to secure millions of dollars in grant funding for associated projects and improvements Place Of Last Drink (POLD) adopted with law enforcement intervening with repeat DWI offenders to support positive changes to drinking behaviors Complete Street projects made walking and biking easier and more convenient, increasing physical activity levels CfQ 0 C t.o� T1 CL CT (D N co o3 N *k Measurable Results BEACH CITIES, CALIFORNIA 55% drop in childhood obesity rates at Redondo Beach K-5 schools 15% drop in overweight/obese adults 10% increase in exercise 17% drop in smoking 12% rise in Life Evaluation* $72M in productivity improvements and medical cost savings ULUE ZONES CONFIDENTIAL I 2021 PAGE 5 • LivoWall Etas K-5 OBESITY RATE MORE SHAN A DECADE AGO, Beach Cities Health District (BCHD), in partnership with Redondo Beach Unified School District, launched a pair of programs to stem rising rates of obesity in Redonda Beach elementary schools. Since, the K-5 obesity rate has fallen 55%. *As measured by the Gallup Well -Being Index is a measure of people's future outlook. Respondents were asked, "Looking at the life ladder, on which step do you think you will stand 5 years from now?" ao o (D tom T1 CL (1)al CT N (D o3 *k Mapping Well -Being in Beach Communities LUE ZONES CONFIDENTIAL I 2021 PAGE 6 ZIP Code Life Satisfaction 32208 32226 32233 32257 32223 32258 32222 32256 32202 32266 32254 32217 32204 32221 32225 32277 32205 32224 32250 32216 32246 32209 32218 32207 32234 32211 32210 32206 32219 32244 32220 7.341 7.286 7.265 7.244 7.213 7.172 7.160 7.156 7.111 7.048 7.034 7.019 7.017 6.994 6.971 6.949 6.905 6.894 6.883 6.873 6.866 6.859 6.858 6.852 6.796 6.786 6.770 6.753 6.735 6.601 6.533 v om NJ rD UJ 0 -h00 Positive & Negative Affect in Jacksonville 91.60 - 92.54 88.67 - 91.60 88.59 - 88.67 87.40 - 88.59 • 86.36 - 87.40 85.63 - 86.36 84.68 - 85.63 83.60 - 84.68 82.72 - 83.60 74.60 - 82.72 There are significant differences in positive emotions (happiness and enjoyment) across ZIP codes in Jacksonville with some regions close to the happiest countries in the world, whereas parts of the region score much lower. BLUE ZONES CONFIDENTIAL I 2021 I PAGE 7 I. 35.85 - 38.63 35.28 - 35.85 34.29-35.28 32.97 - 34.29 31.67-32.97 30.46 - 31.67 29.53 - 30.46 28.86 - 29.53 27.41 - 28.86 22.50 - 27.41 There are significant differences in experience of negative emotions (stress and worry) across Jacksonville. Some ZIP codes only have about 20% of residents experiencing stress or worry in the previous day while other ZIP codes have residents reporting experiencing such negative emotions almost 40% of the time. Such high numbers are well above world averages for the experience of negative emotions and are often reflective of war-torn or highly impoverished areas. Blue Zones Project Jacksonville COMMUNITY BLUEPRINT SUMMARY Built Environment Top Opportunities Countywide: Advance a 'Health in All Policies' Approach Integrate health and equity in plans, partnerships, and processes to impact decision making, the prioritization of projects, and implementation practices. Neighborhood -Driven Pop -Ups Engage local community in demonstration projects, for example, activation of segments of the Emerald Trail. Potential Opportunities for the Beaches: Build Community Capacity Host a Complete Streets Implementation Workshop in the Beach Communities and provide training on long-term economic costs of sprawl and benefits of healthy re -development. Crossing Installation Options Showcase crossing installation options along A1A and engage the community around trying different approaches at various locations/intersections prior to permanent implementation. Form an Active Transportation Group to Coordinate Efforts in the Beach Communities Form a committee of advocates, city staff, and regional partners — including East Coast Greenway representatives — to connect efforts and infrastructure among the Neptune, Atlantic, and Jacksonville Beach communities to increase momentum and coordination around public space activation (murals, parklets, demonstration projects). Food Environment Top Opportunities Countywide: Create Development Standards to Improve Healthy Food Access Create or update zoning to support healthy food infrastructure like farmers markets, community gardens, food hubs, and preservation of farmland. Expand Fresh Access Bucks Program This Florida program doubles the value of SNAP purchases on fruits and vegetables and is only offered at farmers markets and one store in Jacksonville. Program can be expanded with financial and program support to expand to additional retail outlets and the large Jacksonville Farmer Market. Transform Jacksonville Farmers Market into Healthy Food Center The market can become a community destination with an economic incubator for new food businesses, a food skills center, and healthy retail food options. Expand Community Gardening Work with local schools, worksites, faith organizations, and community organizations to expand community and home gardening to improve food education and nurture the passion for growing fruits and vegetables. Potential Opportunities for the Beaches: Healthy Corner Store Initiatives Help convenience and corner stores improve offerings to increase healthy food access in underserved areas. Increase Food Skills Conduct an inventory of existing food skills resources and programs to guide development and passage of a comprehensive, community -wide strategy designed to increase food skills of adults and youth in the community. Create Land Use Policy to Protect and Promote Farmers Markets Enact a land -use policy that allows farmers markets to locate in public parks, on school property, and in other public spaces; supports the establishment of markets in underserved area; and doesn't require permits or has low-cost permits. Blue Zones Project Jacksonville COMMUNITY BLUEPRINT SUMMARY Tobacco Policy Top Opportunities Countywide: Establish Tobacco Retailer Licensing Program Businesses will need to purchase retail licenses to sell tobacco products, including vaping products. Policy that restricts availability of fruit and candy flavorings Restrict incentives for marketing to youth, including restricting any free or reduced -price product samples. Assist schools implementing supportive and progressive interventions for tobacco intervention and control on school and campuses. Potential Opportunity for the Beaches: Explore and expand parks, greenspace, and beach - area smoke-free policy efforts Move from a voluntary effort to codified policy. CLUE ZONES CONFIDENTIAL I 2021 I PAGE 9 TA1coho1 Policy Top Opportunities Countywide: Place of Last Drink (POLD) Reporting Information is entered into a database and used to identify patterns of problematic locations and serving practices. Responsible Beverage Service and Management Training Responsible beverage service (RBS) training programs provide service staff knowledge and skills to serve alcohol in a responsible manner and comply with legal requirements. Screening, Brief Intervention and Referral to Treatment (SBIRT) Systematic screening and brief interventions for people who need help, but do not require full treatment. Potential Opportunity for the Beaches: Communications and Social Marketing Campaign A public education campaign to key stakeholders, leaders and the general public on the need for additional efforts to address the "White Claw" culture, excessive drinking, and the consequences that result. Foundation Period Foundation 9 Months 0 0 O Hiring and Training of the Core Team Establishment of Committee Structure and Training Establishment of Volunteer Base and Training O 0 C Global Expert Summits Gallup Community Oversample: Baseline Baseline Metrics and Annual Targets - Dashboard LLUE ZONES CONFIDENTIAL I 2021 1 PAGE 10 OPR Media and Marketing/ Engagement Outreach O Web and Social Media Engagement with Tools 0 Community Engagement Events Master Blueprint: All Sectors & Marquee Projects Detail* Central Team Implementation Project Management Oversight *The recommendations set for the Phase 1 assessment were preliminary. The Master Blueprint is designed during the Foundation period with community leaders and will be the final set of recommendations for the community. O CSD to CT (D � N(D O3 *k v as 0 - h00 Post Blue Zones Post -Certification Structures 0 Assess Foundation Transformation PHASE I CERTIFICATION • • 9 Months 5 Years 0 MINIMUM TIME TO CERTIFICATION (Foundation + 5 Years of Transformation) Certification Criteria • Awareness & Engagement of Leadership, Citizens and Organizations • Improvement in Key Components and/or Overall Well -Being • Reduction in Health and Well -Being Risks • Evidence of Change Deployed to People, Places, and Policy • Improvement in Key Community Self -Reported Metrics LUE ZONES- CONFIDENTIAL I 2021 I PAGE 11 PHASE II & Sustainability 0 POST -CERTIFICATION RIGHTS Continue Managed Model Move to Enabled Model Move to License Model J O (D tID cr (D r+ NJ (D O0 N N �# Focused Blue Zones Project BEACH COMMUNITIES Zip Codes: 32250, 32266, 32233 Total Population: 59,325 % Adults: 75.2% Total Adults: 44,630 Total Fees: $2,034,000 (Foundation +Transformation) Dedicated FTEs: 2.0 LUE ZONES CONFIDENTIAL I 2021 PAGE 12 ao o (D tom T1 CL (D D) CT N(D O3 *k UU� Thank You 0 CD ao tJD CL CT N (D O3 *k Page 30 of 78 Agenda Item # 09 Feb 2022 Duval County Health Zone Data The Duval County health zones are made up of zip codes. Duval County is unique in that it comprises urban, suburban and rural areas (see Figure 4 below for Population Density Per Square mile). Health Zone 1 is considered to be the most urban area with a population density of 2766.5 people per square mile while Health Zone 5 is considered to be the most rural area with a population density of 177.1 people per square mile. Figure 4 Population Density Per Square Mile, by Health Zone, Duval County, 2000 *MA Z ri 5 - 177.1 Heath Lone 3 •11011 wyih Yana 1 . 1357.6 14a11h lana 3 • Z272.2 FYaYh Z ,r 8 • alma 64a#h io." 1 . MA Health Zone Population (2006) Health Zone 1 - 128,613 Health Zone 2 - 267,857 Health Zone 3 - 141,047 Health Zone 4 - 176,881 Health Zone 5 - 82,006 Health Zone 6 - 67,763 Page 31 of 78 Agenda Item # 09 Feb 2022 Demographic Profile of Duval County Figure 5 Minority Population by Health Zone, Duval County. 2006 Percent of Mn, nIy Poputr>ica I hlerthZane1&2 HthZone3=Health Zne2Hth lone Health Zone 1 = 63.2 •We.+ieo art �.ac�34 �i�. tilr+ir •ei Yww+Y ow...aWO.rP. Irk Socioeconomic Profile of Duval County Figure 6 Average Household Income by Health Zone, Duval County, 2005 moats Ho -soh z®no 1 ' 521,916 Health Zone 4 = 539.6141 Health Zone S = 542,1540 Wealth Zone 2 = 544,5379 lleallh Z4r14 6 . 544,7,55 Health Zone 3 = 553.972 Duval County = S41 11 H a.9v.d..sr9,1, MCI me... CV. relm =.rt.a•M. E. ..fr .W • mewl .0. We ■ PIMP Page 32 of 78 Agenda Item # 09 Feb 2022 Health Zone 1 contains the largest number of minority residents in all of Duval County boasting a population of 107,001, which is 83% of the Health Zone 1 population. In fact, 41% of all blacks in Duval County live in this zone. Health Zone 4 has the next highest minority population with 32.6%. Census data show that zip codes in Health Zone 1 have the lowest average household income with $21,815 Health Zone 1 also has the highest poverty level with 26% of the population living below the poverty level. Socioeconomic Profile of Duval County Figure 7 Percent of Population with Greater than High School Education by Health Zorie, Dural County, 2000 Perm rtt :14a,allh Lame 1 = 32.1 FleaIhZpno 5=362 F1eaIlh Zc roe 3 = 36.8 lil Health Ione 1 = 59.1 Flealdh Zane 2 = 58.9 1�4 JItk ZDrra 6 = 65.1 Duval County = 53.6 a... ._•as Want r.DOM d.Y..Imm.a •1•111 W �spew sane,.. , �. Better educated people have fewer health problems, tend to live longer and have less disease than those with lower education levels. Health Zone 1 has the lowest level of education with 32.1% having more than a high school graduation, compared to 65.1% in Health Zone 6. Page 33 of 78 Agenda Item # 09 Feb 2022 Unempolyment Rate by Health Zone, Duval County, 2G06 Purnr l eanh Pone 3 = z.a+ in Health Zorn 6 = 2.76 1-4eanh Zone 4 3,08 Heallh Zone 5 = 3.66. Ii411 ZGre 1 & Z A LO3 lt County = 3.5 FhlA1140p.t.w-ws w+w,.ir. unto Mori ee ayr.narr WAD r e. ,ruin Pa6tTosi l..irr rt.ru, . w Yxtrt. Ira psei.nailse ie* Mal mripz• mi•010.11 0511r, ire "Ora. r..rr-1:A.ar.r.airr.s..tnrvlk..nrr The unemployment rate is highest in Health Zones 1 and 2 at 7.03%. This is 100.9% higher than the overall unemployment rate in Duval County, 3.5%. The lowest unemployment rate in Duval County is in Health Zone 3, with 2.41%. Page 34 of 78 Agenda Item # 09 Feb 2022 HeartDisease Mortality by Health Zone, Duval County, 2006 Ago aw1Fulitcl�� RAW pot 100.13179EHeak'h Zone G = 113.8 Walt h Zt no 3 r 14 .9 Hearth Ztama 2 & 177.& Hnakh Zta ns 4 . 1624 Hearth Zana 6 200.9 Fba+FRhZiano 1.238,9 Duval County = 187 4 s.e�. itA d Nom AM li toerdead Itim n.rwm pcort 15.100.1¢ 14.1pr Irpin. lora . maga, No moos Limn ;Mb �wr.:au,:ey Fpn/1ppa ya.Y 11.1'Ti bk..a..W.I.;• 11r usra Mr�erari M9OIN94 two. .1 PI# OW46�.�..M s I. fr * �rairXal' ibiY .1.1I. P. rrw '+•I mop.YF RI 061:1511PMc4ipl41d iMM G Id} 4E1 O'c I,i11 Of all 6 Health Zones, Zone 1 has the highest mortality rate from heart disease. The rate in Zone 1 is 64.7% higher than the rate in the Zone with the lowest rate of all, Zone 6. Page 35 of 78 Agenda Item # 09 Feb 2022 Cancer Mortality by Health Zone, Duval County, 2006 Rale Per 100,000 N9ailte Zone 6 =16270 E MM#I Zone 4 ms 173.84 Health Amy 3 = 107.99 r4aaMh Imre 2 =188_70 I-Yt}alh Zone 1 = 213.50 H+�alih Zorw 5 224.2 Duval County = 192.9 1 Muir a1 ra. a. lid Monads C :Erl +elrrd Ey tett' :mhrfl Yle.ir Aacy madErrhmtcriglr.mrch Imo.•::[ Oa: 1 4. ty W6'4.41. NTy &4.O 4X..rt., Ary T¢RU t0,11.44.."4.1/r 4411144:.84' 15 Ilp. 114 FIC.41 =u4.+9rr,ar kI417, UV .'4 47095 1111 m1 wrount4.r. 1,:....u1..Y,:stworlMrser.rdrfhy..+.a.bgh..'v+ The mortality rate for cancer in Duval County is very similar to the national rate at 192.9 but nearly 17% higher than Florida's rate. Health Zone 5 has the highest cancer mortality rate with 224.9 per 100,000 residents followed by Health Zone 1 with 213.5 deaths per 100,000. Page 36 of 78 Agenda Item # 09 Feb 2022 Diabetes Mortality by Health Zone, Duval County, 2006 Ag t-Attjuted Rale per 104,600 7 NOM Zo6 • 58.30 Healthrh ion* 3 • 63.10 Health Zone 2 = 7410 Health Zane 4 _ #6.70 6Health Zang 6=101_TO Flealth Zane 1 = 11 16.20 Duval County = 82.1 BISF4Y ANN 5.41.155* Or K.55 L504 EE5, 154.mmtlair DCHE 1.I51+I4•sh ['515Y.rx[.aa15.:411•aa, '4,5,44 24E45 Th.pmiud r.4. -m• ,ry w5 4545 qn co-a-sai a . WWI 515c_rro-4 kg. 14015r45e555 N. Filbr,511, ,14,e, a.lT. .as .pen Fn.l. rar* OR 9+.11 M YY.F .r. f. ttr m.510.1.m.51m.510.1.. n: =.wi .aft =4`, Wid M'.-A,-<WsY GM 4.4t44F In Duval County, residents in Health Zone 1 have the highest rate of mortality due to diabetes related conditions. The rate is 116.2 per 100,00 residents, approximately twice as many deaths as in Health Zone 6. Health Zone 5 has the second highest rate of diabetes related mortality followed by Health Zones 4, 2, and 3. Health Zone 6 has the lowest death rate due to diabetes with a rate of 58.2 per 100,000 which is half of the rate in Health Zone 1. Page 37 of 78 Agenda Item # 09 Feb 2022 Unintentional Deaths by Health Zone, Duval County, 2006 A Adjusted Rhe per 100,404 Filth Zonis 3 w 27.3 Health tone 6 • 34? tileafth Zone 2.• 40,0 d^caMth Zonal ■ 46.2 heath Zp rle 4. 52.9 Health Zor* 5 # 76,8 Duval County = 45 7 saw imp a,'Ar bra Cir,__ dla:dd b/ d CL h,iii knrwe,.!'MsT NM SeArlIYI h ,.. 4M 4 M t4'4!M 64 woo IWF', d�4 a611.F+ VI! .1Itr T4.1.4i14 UV 11o!*1•14..+T "lifts VIMFlbik ilii mpn! W1ti rrhuo dlaft rMkaal. miaiwisi WE.!}daFteq-jry Deaths from unintentional injuries have been on the rise over the past 10 years locally and statewide. The rate in Duval County is 45.7 per 100,000 and Florida's rate is 45.0 per 100,000.2 Health Zone 5 has the highest mortality rate from unintentional injuries at 78.8 per 100,000. Health Zone 4 has the second highest rate at 52.9 per 100,000. Page 38 of 78 Agenda Item # 09 Feb 2022 Homicide Deaths by Health Zone, Duval County, 2006 Age-Apiusked Rata per 100,000 Health Zane 3 = 5.5 Health Zone 2 = G.7 f eafth Zone 6 = 5.1 Health Zane 4 = 9.7 Heafth ZOne. 5 ■ 13.5 FieattO Zone 1 ■ 4.4 , Duval County 13 5 `rw Pk= &rb••d WI Ilomc..4.. Me Repro op i4O 'was r.wrF +thea EviSrumiliiimo. VENOMS 1.64 . +.,.r.e,o.,.q, fog AM.,..d f. a.IRO+a.r�d Pew MIMI= a p_ whammilan cerinewlI._ t.lisphmlamnra wq nmr :Cti..r+i e+...rexq+. f.Y rrhVnar.a.r:lF e..,P40,1h11WMMityiki'�'ia4Mr f IFk Health Zone 1 has the highest rate in Duval County with 43.4 per 100,000 population. This is 221.5% higher than the second highest rate which is in Health Zone 5. These rates reflect the residence of the homicide victim. In addition, a majority of the homicides occurred in Health Zone 1 as well. Almost three-quarters (73.7%) of all homicides were in the black population. Page 39 of 78 Agenda Item # 09 Feb 2022 Suicide Deaths by kith Zone, Duval County, 2004-2006 A.ge-Actitratell Rate per 100,000 5 Haan Zone 3 =10.9 I-EalthZone f = 11.2 F- althZane 2=126 Health Zone 5 s 13 6 FlealtICZeproe 4±150 HitathZoe 6217.7 Duval County = 12.6 r: d W GC'+G 11 ra F Sa®ai swot _... p-s.a. odmrmen1.0 .rrbr.la.arsbi,,.es.+. wg is WMFIN Jr.ivrMinr anrbVd'wr A Filo lam'ror hr,raor f r9?r M.4iRrtl f Nr roar m .. Ru�dfw n61MY[AarenlWMI 06imp 1tu On the contrary, suicide deaths are highest in Health Zone 6, one of the highest income and education zones in Duval County. Suicides are typically more prevalent among whites. Following this trend, 90% of all suicide deaths in Duval County were among whites. Page 40of78 Agenda Item # 09 Feb 2022 Figure 15 HIV/AIDS Deaths by Health Zone, Duval County, 2000 - 2006 Rat* per 104.004 pOpu! !atom [ Health Znne6 = MAU Health Zane 3= 2:80 Health Zone 2 = -5:65 Health Zone4 = 670 Health Zane 5 = 8.14 MI Health Zo re 1 = 42,39 Duval County = 11.8 tenaci daeu•LAi fic.a ea: 45t13- RION .r COO wiiiikarrimtr_Palt, wdleotuonnn.rr,an Minn 2.X. a,,. a.sa. l p.i...d, O ..a. Ns he 1.. n:.....a t. *Nematenenee Aey ares win eke ern . wn..e. . w w. _ 1 _.berbin. Ditlemr4 on -with pro writm Alm* ^, "UMW= Health Zone 1 has the highest ageadjusted death rate with 42.4 deaths per 100,000. This is 420.9% higher than the second highest Zone, 5, with 8.14 per 100,000. Page 41of78 Agenda Item # 09 Feb 2022 Figure 16 STD Rate Ages 15-24 by Health Zone, Duval County, 2005 Rote per 100,000 MAI'a m FleaithZmne 3 =1754.5 r� Health Zone 6 A 2036.6 i� I- a♦thZorre 2 3.023.6 Hearth/Jane 5:342&4 Hearth Zone 4.3728.3 HeaithZorle 1 =2633.7 Duval County = 3937J &us tided Frrly ll,mm d1 N..rrm rr2171,...0m MrgardF 4113 rob l.rrrrrr, harem:Ir.lmLar.rer ,i: .32fi Tel rw....rm. ra.-dr.ma lavord,.a. rw' arae.", ✓ frw.wfermi rwp•rwrkarrsklr....,.rrr.....d,.w Tr Rorer : r.^441.r1.1r rrr'lrimus. •c+arrNM • ✓ mr,61 rim NE r. rcrrwa ramr w bar rr+l+-a The STD rate in Duval County is staggering, with 3,937 per 100,000 population ages 15-24 being infected. Health Zone 1 is significantly higher than all other health zones with a rate of 8,633 per 100,000, 131.6% higher than the next highest health zone. Health Zone 3 has the lowest rate of STDs, 48.4% lower than the overall rate of Duval County Page 42 of 78 Agenda Item # 09 Feb 2022 Figure 17 Teen Birth Rate Ages 15 19 by Health Zone, Duval County, 2006 Rate per1,000 Females Ages 15.19 Health Zone 3 = 26.86 Health Zine 6=42.21 H9 aIth Zone 2 = 4T_52 Health Zone 5 55.06 I- th Zone 4 = 61.07 Health Zone 1 = 87.33 Duval County = 51.2 a 414o4.4r�3.4�tl!r goo. 4.1117•1•1b. new Pcirry.dFr.i.am.4 A Ums,ns Tr4anAn9 s+x r0•1..0. 11.4.1.•T b W oarMW I4 1,1011,45.0.4.1.1 ry ■lr e+i^YR +�9rt RrwS 1+�4 n4� • i.iY.Crt The, Strdo rtfwrt N'N.A.! aii twirls i.,. [v mticisia&i fY rti....r9ti Rb+.�is:.:rrCl7�b M1in,r+a. l' Iba �rlliq f. The teenage pregnancy rate in Duval County has decreased substantially overall since 1997, although increased slightly in 2006 to 51.2 per 1,000 female population ages 15-19 years. Health Zone 1 has the highest rate with 81.33 per 1,000 followed by Health Zone 4 with 61.07 per 1,000. Health Zone 3 has the lowest rate of teen pregnancies with 26.86 per 1,000 female population 15-19 years. Page 43 of 78 Agenda Item # 09 Feb 2022 Figure 18 Low Birth Weight by Health Zone, Duval County, 2006 Percent : Health Zone 6 _ 7,00% I- at h Zone 3 _ ®.oQ"o. 1-Eatlii zone 2 .= e.T734 Foetal &die 4 = 2.31% Health Zone 5 = 10.00% hiealth Zone 1 = 13.07% Duval COunty = 9.5 Se..<4 Eton MF+a.L Vee.+4s[mL cu kw.r.lUr e.mr. Iv 1.=111 eka4Y anqleagymnalWA. :1I !...arms., rr r...a. _ .,e.ryez =imam?! •I•sel cliwisrerl n.r l.d.,. a, c,. r '..ro, .-r:ar..r .tea,. as ti.., n a bowl—NO! al.-rre, End 46 c r..ce.railr w. n d e,r.. .�.�:: �rvMeiirkn ae Mit .a.: ^-Y++ti d..rrYa,:. Health Zone 1 has the highest percent of LBW babies with 13.07%, followed by Health Zone 5 with 10.0%. Similarly, Health Zone 1 also has the highest rate of infant mortality with 13.1 per 1,000 live births (see Figure 1). Health Zone 6 has the lowest percent of LBW and infant mortality rates. Page44of78 Agenda Item # 09 Feb 2022 Asthma Related Emergency Room Visits by Health Zone, Duval County, 2005 Rate Per 1 ,I Health Zone 63 MI Health Zane 3. MS Health Zan* i } 40,1 IInalth Ion* 1■ NIL Honig!, UM. 4. pais Health 7f6IF4 1 ■ 1,711. 11iw1�1Courkiy ` 'flf,r147., 1 Mama etor tr c.. ate. .in nes Fwgmp .i.lr{Jin P4.111.1.07,1.1.60444M r,.eewai 11.P.;Y. h. wirdtar raYe..fsifi .da id la Ea tai rude a.i. aisemt ». rm. Droop: srY Pam. der ./h aporiamok, it na;a.ee+r a.rr.s e..•etwr iarrrf\dryanP..sIs^+.rkgIn The rate of asthma related emergency room visits in Duval County is 596.1 per 100,000 residents. Health Zone 1 has the highest rate of asthma emergency room visits with a rate of 1381.8 per 100,000 residents. The rate is 131.8% higher than the overall county rate. Health Zone 4 has the second highest rate even though it is 58% lower than the rate for Health Zone 1. The rate for Health Zone 4 is followed by the rates for Health Zones 5, 2, and 3. Health Zone 6 has the lowest rate of asthma related emergency room visits with a rate of 269.6 per 100,000. Page 45 of 78 Agenda Item # 09 Feb 2022 Figure 20. Emergency Room Visits - Uncontrolled Diatoms by Health Zone, Dtpial County, 2005 Age-AElpusied Rate Per 10,COD Heath Zone 3= 42.46 Heater Zone 6= 17.50 Hath Zorn 2= 30.10 PeathZoe5= 34.30 Heath Zone 4= 35,80 I-,eath Zone 1= 11460 DuvaI County = 40.0 'Fam kWgr.. ..rAlI'.rrrwn 'iiaro+.e .1 taro 1., -akar r+ errb virmree, dU! 19i ewe Ui d.rr re 400 N pawsum6w Munn rq!'wri TY 41+11.4 wort: !M. 1w#lir s:se.rm.+i drr.ir.rv.r. owls r.o.ol r . rh u. A h ri.+AFmmbmi 1m,m+ry Ism,si4 r�rsw Residents of Health Zone 1 have the highest rate of ER visits due to uncontrolled diabetes. The rate, 114.8 per 100,000, is 220.7% higher than the second highest rate of 35.8 for Health Zone 4. Health Zone 3 has the lowest rate of ER visits due to uncontrolled diabetes. Health Zone l's rate is over 9 times the rate of Health Zone 3. Page 46 of 78 Agenda Item # 09 Feb 2022 Emergency Room Visits - Intentional Injuries by Health Zone, Duval County 2005 Rime per loa..a I Elic..oh Z4ne 3* mo I iea ttaor 6 = $1Z9 Health Zone 2 = 5119-3 I oiiih Zone 4 • 611-2 Henan Zona 5 + 640.5 hieallr Ztrrwe 1 d.1438 3 Dural County = 650.9 44.br.se1 Ltill ear Q+Fifty 114!1441 %1.4: awe 1ry9.144.44.19 db n4441•44i44, ..s 44 4)4 ttl Mil •14.4 awnert •1isid.ro4nA4~4444[Y!+#1144+4Ri1Nf:I1r'rem.4 Pro - 1`sdr Omarl:.selioft* . rr44-rrs+c rosnsbM4 R4444P 44P11,44,444i.P.44.114144'44 Intentional injuries are injuries which result from things like violent acts. The ER rates provided are strictly a combination of homicide and suicide. ER visits from violent injuries are primarily due to fights and brawls, followed by gun assaults. Health Zone 1 has the highest rate of ER visits due to intentional injuries at 1438.3 per 100,000 population. Health Zone 5 has the second highest rate at 640.5 which is 55.4% less than the rate for Health Zone 1. Health Zone 3 has the lowest rate at 297.8 which is 79.3% lower than the rate for Health Zone 1, the highest rate. Page 47 of 78 Agenda Item # 09 Feb 2022 Positive Lead Tested Houses by Zip Code, Duval, 2006 A. Positive Lead Tested Houses Bowra !~ rsti+renrnalt/M Otval*1. Ouy:tr Ccianiy Mufti" Department Thi precturtr& t Reifradr! pNp acrd la ma 9elbe, etx ietruwtl,w a I aoa nEN. Mr rlrli#sre cn Hit rr ar riftiliJr}rarannd hn.e,n is r tha am"m awn r1 I The FIGnda oasLsrtraenr or Hearor mrd b wiz. ess..une no resparistiaty tof any Laarn rere 'fl rrnaren coniarn8d harem or any lass r*idbhg,ne,a rrr!'a J Page 48 of 78 Agenda Item # 09 Feb 2022 FDEP and EPA Ash Sites by Zip Code, Duval County, 2006 • EPA Asti. Sites FDE P Ash Sites $PA = ris.irerirrserital Probates, agency frAt. = Fgrvra t7 nine* of E•frworrnrrtw Pr0teci,an Seats EnvarorrnFntes TYmsion Drat Counly HER*, Cipaftrnenl Thin prcmeeb a fo reser r only end al nd 10 oe crosuued as a laps deturn8r1 &Ay MIM! art the it 0r.r etiOn ttrrtas'lea & fl is M toe users awe nit. Toe Fldnda Department al Haalth and ea ag.nim assume ra raapanardlrlp for ■n, use of 11n nfarrna1. n Contaminated Water Wells by Zip Code, Duval County, 2006. 1 Ma>cirilum Conlaminat'Qn Levers • Positive Contaminated WVells BelkOw Mexirrlum Cantamiri- tion Level 50.0013 EnvYanrnerfal Div - 440. Duval COurttF Hsaifi DaPb'Ment This product as fogy ref rent. arty and is viol w be mrwnrery fd • N9+r de u frena Any meta an the irhnnErtron cmlanad batten a at The us every ask the Fkexte Davaren&rrt M 14e uri sol i10 ager{s &siurna na rFSirOrla9111,' 1Gr aril US$ or the irgarm IOn 6004aIne0 rtefae 4r env 1714 MUTT* 1 0r i Page 49 of 78 Agenda Item # 09 Feb 2022 Page 50 of 78 Agenda Item # 09 Feb 2022 Emotional Wellness, Holistic Development, & The First -Year Experience Joe Cuseo, Marymount California University [*NOTE: The yellow highlights have been added by Steve Piscitelli.] Abstract College students experiencing mental health challenges often do not initiate contact with campus counseling centers. Thus, universities need to engage in proactive outreach efforts that bring emotional wellness programming to students, rather than waiting and hoping students will seek it out on their own. First-year experience programs can provide such early outreach and help short-circuit the growing mental health crisis on university campuses today by equipping students with self-regulatory skills that they can use initially to facilitate their transition to higher education and use continually throughout their college experience to strengthen their academic performance and persistence to graduation. If there is a silver lining in the COVID-19 cloud, it may be that it has raised awareness of the need to take a more holistic approach to students' college preparedness, including their emotional preparedness. A substantial and growing body of research points to the efficacy of three particular tools for enhancing students' emotional wellbeing and their psychosocial capacity to thrive in college: (1) positive psychology, (2) mindfulness, and (3) self -compassion. This chapter examines how these three tools may be combined and delivered in a proactive, systemic manner that exerts synergistic impact on student success. Introduction Compared to their parents' generation, college students today are 50 percent more likely to report feeling overwhelmed (Twenge, 2014). More than half of them report experiencing emotional distress (ACHA-NCHA, 2017) and their rate of emotional distress is trending upward (Hibbs & Rostain, 2019). Compounding students' mental health challenges is the COVID-19 crisis. A study conducted by the Centers for Disease Controls and Prevention revealed that during the pandemic, 46% of those between the ages of 18 and 24 reported mental health disorders; this percentage exceeded that of any other age group (Czeisler, Lane, Petrosky et al. , 2020). National surveys of college students, in particular, indicate the pandemic has elevated their stress level (Active Minds, 2020), lowered their access to social support, and increased their sense of social isolation (PLOS One, 2019). The adverse emotional impact of COVID-19 is likely to persist for some time to come due to a well- founded psychological principle called "negativity dominance"—the tendency for negative experiences to have more intense and lasting emotional impact than positive experiences (Rozin & Royzman, 2001), which slows down the belief that things are getting better when they actually are (O'Brien, 2020). Given the increasing incidence of college students experiencing emotional health issues (Raimondi, 2019)— which reached a level of a public health concern even before COVID-19 pandemic (Eisenberg et al., 2007; Glass, 2016)—now may be is the time for universities to adopt a more comprehensive view of college preparedness that includes students' "emotional preparedness." and the time to start taking a more proactive approach to promoting students' emotional wellness programs during their first-year of college. As Rostain and Hibbs (2019) point out, "There is no Advanced Placement class for emotional readiness, but research has shown that it is the best predictor of whether a student will adjust successfully to college life" (p. C2). Research points to a positive relationship positive relationship between college students' emotional wellness and their persistence to graduation (Choy, 2002). The importance of students' psychological well-being for student retention and college completion was highlighted by the results of a large-scale, meta-analysis of multiple studies in which its authors concluded that the relationship between students' psychosocial adjustment on college retention is so Page 51 of 78 Positive Psychology Agenda Item # 09 Feb 2022 strong and independent of academic preparedness that, given the growth of mental health challenges experienced by today's college students, universities should consider "almost all first-year students to be underprepared" (Permzadian & Crede, 2015, p. 40). Despite the fact that more students experiencing emotional challenges, studies show that many of them still do not utilize campus counseling centers, largely due to lingering stigmas associated with seeking help for mental health issues (Eisenberg, Hunt, & Speer, 2012). Students from minority racial and ethnic groups, in particular, exhibit low rates of help -seeking for emotional adjustment issues (Cheng, Kwan, & Sevig, 2013). This is an especially disturbing finding because a disproportionate percentage of racial and ethnic minority students are first -generation college students who are often saddled with additional stressors, such as lower levels of academic preparedness, less college knowledge and social capital, and limited fiscal resources. The added effort that aspiring minority students must exert to cope with these additional stressors, and the resulting emotional toll it takes on their mental health, has been referred to as "John Henryism" (Hamblin, 2017)—named after John Henry Martin, a steel -driving African American folk hero who worked so hard to successfully complete with a steam - powered machine that he died from the stress he experienced in the process (Tracy, 2008). These findings strongly suggest that universities' traditional use of "passive programming," which relies on individual students to make self -initiated contact with support programs—such as seeking out a campus counselor for help after they being experiencing mental health issues—needs to be augmented by campus -initiated outreach programs that reach out to students and bring emotional wellness support to students before they eventuate in mental health crises. This may be particularly true for at -risk students who lack the assertiveness or cultural proclivity to seek such help on their own. Since research shows that students experiencing mental health issues are twice as likely to withdraw from college (National Academies of Sciences, Engineering, and Medicine, 2017), early outreach would not only serve as preventative measure to offset mental health crises, it would also serve as a retention strategy for promoting the persistence of students at risk for attrition. In addition to helping students who may be at risk for attrition, emotional -wellness outreach programs should benefit students who are surviving in college but not thriving in college (Schreiner, 2015)—that is, students in the "murky middle" who may not be on the precipice of a mental health crisis but are languishing, not flourishing in college and not functioning at an optimal level. If there is a silver lining in the recent COVID cloud, its psychosocial impact on students seems to be have raised universities' awareness of the need to take a more assertive and proactive approach to preserving students' their mental health and promoting their emotional well-being. In a national survey conducted by the American Council of Education, 70% of college and university presidents reported that students' mental health is now one of their "top concerns" (Chessman, Vivil, & Soler, 2020). A substantial and growing body of research points to the efficacy of three particular tools for enhancing college students' mental health and emotional wellness: (1) positive psychology, (2) mindfulness, and (3) self -compassion. This chapter examine how these three tools may be combined and delivered proactively and systemically to exert a synergistic effect on student success. The overarching aim of positive psychology is to enhance the growth and development of the "whole person" (Miller, 2015). The field was born in 1998 when then president of the American Psychological Association, Martin Seligman, called for a new direction in psychology that would focus on "not just fixing what is broken [but] nurturing what is best within us" (Seligman, quoted in Compton & Hoffman, 2020, p. 1). Whereas psychotherapy treats and reduces negative emotions, positive psychology nurtures and promotes "contentment with the past, happiness in the present, and hope for the future" (Positive Page 52 of 78 Agenda Item # 09 Feb 2022 Psychology Center, 2020). Minimizing or eliminating emotional suffering does not automatically translate into enhancing or maximizing emotional wellness (Duckworth, Steen, & Seligman, 2005). According to Seligman (2011), "The gold standard for measuring well-being is flourishing, and the goal of positive psychology is to increase flourishing" (p. 13). Flourishing is defined as experiencing high emotional well-being and low mental illness. In contrast, experiencing low emotional well-being and low mental illness is defined as languishing, whereas experiencing low emotional well-being and high mental illness is defined as struggling (Keyes & Lopez, 2002). Research shows that optimal emotional wellness is achieved not only by maintaining awareness of, and coping effectively with negative emotions, but also by intentionally experiencing and savoring positive emotions (Adler & Hershfield, 2012; Quoidbach et al., 2014; Cross et al., 2018)—such as: hope, optimism, contentment, vitality, joy, happiness, gratitude, self -acceptance, strength recognition, and sense of accomplishment (Compton & Hoffman, 2020). Thus, mental health is achieved by alleviating negative emotions and cultivating positive emotions (Ivetzan et al., 2015; Kashdan & Biswas-Diener, 2014), and the key to flourishing is to experience a higher ratio of positive emotions relative to negative emotions (Fredrickson, 2013). Comprehensive reviews of research reveal that experiencing positive emotions is associated not only with improved mental health, but also with higher levels of physical health, including greater resistance to disease (resulting from improved immune system functioning) and a longer lifespan (Boehm, 2018; Fredrickson, 2013; Lyubomirsky, King, & Diener, 2005; Richman et al., 2005). In addition, it has been found that experiencing positive emotions has psychosocial benefits, such as: more satisfying interpersonal relationships, more frequent acts of altruism, stronger sense of self -agency or self-efficacy, more successful striving toward the achievement of personal goals, greater job satisfaction, and greater likelihood of career success (Diener et al., 2017; Diener & Chan, 2011; Klug & Maier, 2015; Welzer & Inglehart, 2010; Youseff & Luthans, 2011). The practical implication of positive psychology research for promoting student success is captured succinctly by Shushok and Hulme (2006): "The promotion of success begins with the study of success" (p. 6). Applying the principles of positive psychology to the study of student success would involve measuring student success more holistically, including assessment of positive emotional, psychosocial, and motivational processes that contribute students' level of in the college experience (Louis, 2015; Schreiner, 2015). Higher education scholars argue that infusing the principles of positive psychology into the college curriculum, such as a first-year experience course, may be the most effective and efficient way to equip the student body with the non -cognitive (holistic) attributes needed to fully engage in college and ultimately thrive in college (Fineburg, 2004; Schreiner, 2015). Supporting this argument is a study that examined the impact of positive psychology and emotional wellness content by infusing it into a section of first-year experience course and compared student outcomes in that section with outcomes of students in another section that did not include this infused content. When the two groups were assessed at the end of their first year in college, results revealed that students who participated in the section with positive psychology content exhibited better emotional management skills and higher retention rates (Schutte and Malouff (2002). In another study of nearly 4,000 first-year college students, it was found that their level of positive emotion of optimism and hope was a more accurately predictor of their first-year grades than either their SAT score or high school grade -point average (Snyder et al., 1991). Positive emotions enhance academic performance because unlike negative emotions—which have been found to narrow one's range of thinking and create tunnel vision (Frijda, 1986; Lazarus, 1991), positive emotions do just the opposite—they open -up a wider range of effective cognitive strategies and problem -solving options strategies (Fredrickson, 1998, 2001). Studies also show that students with higher levels of emotional well-being and optimism report enjoying college more (Carver et al., 2009; Diener, 2000) and higher levels of satisfaction with the college experience (Schreiner et al., 2009b). These findings have implications for student retention Page 53 of 78 Agenda Item # 09 Feb 2022 because college satisfaction and student retention are strongly correlated, so much so that student satisfaction with college has been identified as a "primary predictor" of college persistence (Noel & Levitz, 1995). Positive psychology's emphasis on the benefits of developing awareness and cultivating personal strengths is supported by research on college students who have participated in strengths training programs, which reveal that these students exhibit higher levels of academic self-efficacy (Louis, 2015), academic engagement and academic performance (Cantwell, 2005; Williamson, 2002), and are better able to leverage their personal strengths to build on past successes (Bowers & Lopez, 2010). Similar findings supporting strength recognition -and -development education for college students were reported in a study of over 600 students enrolled in a first-year seminar course that included six one- hour class sessions focusing on strength awareness and development. Students who completed the course demonstrated significant pre/post-course gains in awareness of their own strengths (and the strengths of others) as well as greater self -acceptance, optimism, self-confidence, goal-directedness, and realistic self -expectations (Anderson, Schreiner, & Shahbaz in Magyar -Moe, 2015). Comparable results were obtained in a qualitative study of a strengths -based, first-year seminar for academically underprepared college students which revealed that upon completion of the course, these students reported higher levels of academic motivation, deeper understanding of how to apply personal strengths to meet academic challenges, and greater capacity for social networking (Estevez, 2005). Taken together, the confluence of these findings strongly suggests that positive psychology has the potential to realize important outcomes, including students' mental health and emotional wellness, college retention, and academic achievement. Scholars in the fields of student development and student retention have long argued for inclusion of positive psychology practices in new -student orientation programs (Louis & Schreiner, 2012) and student leadership programs (Schreiner et al., 2009a). There are numerous practical exercises that students can engage in to implement the principles of positive psychology, one of which is illustrated in the Application Activities section of this chapter. Additional positive psychology exercises can be found at the websites listed in the Resources section. Mindfulness Mindfulness has been defined as purposeful, nonjudgmental attentiveness to the present moment—a "state of receptive awareness of our open minds to whatever arises as it arises" (Siegel, 2007, pp. 160- 161). A growing body of controlled studies supports the effectiveness of mindfulness -based training for managing stress, maintaining mental health, and promoting subjective well-being (Hanley, Warner, & Garland, 2015; Kadziolka, Di Pierdomenico, & Miller, 2016; Keng, Smoski, & Robins, 2011). This body of evidence includes research on young adults (Rogers & Maytan, 2012) and first-year college students— for whom mindfulness practice has been found to facilitate college adjustment (Ramler et al., 2016)— even after controlling for such variables as self-efficacy and social support (Klainin-Yobas et al., 2016; Mettler, Carsley, Joly, & Heath, 2019). College students who have been exposed to mindfulness training also report that it "helps them 'get more out of' their academic work because they learn how to 'bring the mind back' when a professor is lecturing or other students are talking" (Grace, 2011, p. 241). Stress Management In a series of separate studies, each using a different research methodology, it was found that college students with higher levels of mindfulness: (a) experience lower levels of anxiety in response to academic stressors and (b) use less defensive, more effective coping strategies (Weinstein, Brown & Ryan, 2009). Research also reveals a relationship between increased mindfulness and increased emotional clarity—the ability to differentiate emotions (Hill & Updegraff, 2012). Increased emotional clarity, in turn, improves one's ability to respond specifically and effectively to different emotions (Arch Page 54 of 78 Agenda Item # 09 Feb 2022 & Landy, 2015). In addition, mindfulness is associated with enhanced integrated emotional regulation, that is: (a) deeper awareness of personal feelings, (b) sharper insight into how one's feelings are influenced by the way in which those events are interpreted, and (c) greater control of whether to express one's feeling and how to express them (Deci et al., 2015). Improved emotional regulation related to mindfulness training includes better regulation of one's positive emotions—such as joy and happiness, as well as regulation of negative emotions that a person may have lost touch with or is unwilling to acknowledge—such as grief, anger and fear (Kabat-Zinn, 1994). It has been found that when people experience anxiety, those with higher levels of mindfulness are more aware of what is specifically triggering their anxiety and how that emotion is affecting them cognitively, physically, and behaviorally (Tart, 1994). For instance, after completing a course that included mindfulness training exercises, one college students reported that improving mindfulness "allowed me to see the pattern of my own thoughts ... I now have a greater understanding of where my anxieties came from and how to control them. This gives me confidence as a student" (Grace, 2011, p. 343). College students trained in mindful breathing have also been found to experience fewer repetitive thoughts and less intense negative reactions to those thoughts (Feldman, Greeson, & Senville, 2010). This finding suggests that one way in which mindfulness reduces stress is by reducing rumination— mind wandering and worrisome thinking (Carmody, 2015; Trapnell & Campbell, 1999)—which can intensify and prolong a person's initial response to stressful events (Watkins, 2015) and lead to higher levels of anxiety, depression, boredom, and other negative emotional states (Arch & Landy, 2015; Kane et al., 2007). In fact, the association between mind wandering and negative emotions is causal—that is, mind wandering is not a product of unhappiness, it produces unhappiness. People who engage in less mind wandering during positive emotional experiences, and remain more aware of the pleasant emotions they are currently experiencing, report feeling happier (Killingsworth & Gilbert, 2010). Studies also show that individuals who are more mindful are more accepting of their emotional experiences (Teper & Inzlicht, 2013) and recover faster from unpleasant emotional events (Broderick, 2005). Struggling with unpleasant emotions tends to intensify their negativity; mindfulness increases acceptance of unpleasant negative emotions and reduces the tendency to struggle against them, and in so doing, reduces their negative impact (Gruber, Mauss, & Tamir, 2011). Physical Health Research on the relationship between mindfulness and physical well-being reveals that higher levels of mindfulness are associated with stronger immune system activity, greater resistance to physical illness, and reduced number of doctor visits (Arch & Craske, 2006; 2010; Black & Slavich, 2016; Brown & Ryan, 2003; Davidson et al., 2003). It has also been found that college females with higher levels of mindfulness experience higher quality sleep and better overall physical health (Murphy et al., 2012). The benefits of mindfulness on physical well-being is highlighted by the fact that more than 250 medical institutions across the country use mindfulness -based stress reduction methods to treat a variety of health conditions, including insomnia, chronic pain, heart disease and cancer (Kingston et al., 2007; Loucks et al., 2015; Matousek & Dobkin, 2010; Ong & Smith, 2017). Elevating Self -Esteem Humans are gifted with the tool of language, but that tool can also be used to conjure up— and get caught up— in internal narratives that involving unfavorable personal comparisons (e.g., "He's smarter than me," or "I'm too fat") that can damage one's self-esteem in any situation at any time (Harris, 2009). Mindfulness can combat such self -deprecatory thinking. According to mindfulness founder, Jon Kabat- Zinn: "Mindful inquiry can heal low self-esteem, for the simple reason that low self -estimation is really a wrong calculation, a misperception of reality. We see only our shortcomings and blow them out of all proportion. At the same time, we take all our good qualities for granted, or fail to acknowledge them" Page 55 of 78 Agenda Item # 09 Feb 2022 (1994, p. 193). Empirical support for Kabat-Zinn's claim comes from research showing that individuals who are more mindful are less likely to respond defensively to self -threatening situations and more likely to exhibit resilience (Niemiec et al. 2010; Perez -Blasco et al., 2015). It has also been found that female college students who participate in mindfulness training become more aware of how their body is reacting to self -evaluative thoughts and are less likely to experience self -evaluative thoughts (Silverstein et al., 2011). Increasing Empathy Research suggests that mindfulness enhances empathy or "interpersonal attunement"—ability to focus on the internal state of another person with kindness and compassion (Siegel, 2012). Higher levels of mindfulness are also associated with higher levels of empathy (Beitel, Ferrer, & Cecero, 2005; Brown, Ryan, & Creswell, 2007). For instance, in as study of pre-med and medical school students who participated in mindfulness training, these students displayed greater empathy toward patients than a control group of students who did not participate in the training (Shapiro, Schwartz, & Bonner, 1998). The need for increased empathy among colleges students is underscored by a meta-analysis of 72 studies involving 14,000 undergraduates conducted over a three -decade period, which revealed that college students' scores on measures of empathy dropped by 40% between the 1980s and 2010 (Konrath, O'Brien, & Hsing, 2011). (The researchers were unsure why empathy dropped so precipitously during this timeframe, but hypothesized it was due to reduced face-to-face contact among young adults resulting from increased use of social media and increased preoccupation with thoughts (and stress) related to their career prospects in a tight job market .) Mindfulness may have the potential to serve as an antidote for this disturbing decline in empathy among college students by helping them divert attention away from self -rumination and opening up more of their attentional capacity to focus on others (Parker et al., 2015). Supporting this hypothesis are studies showing that mindfulness practice increases neurological activity and neuroanatomical growth in parts of the brain known to mediate empathy (Lazar et al., 2005; Luders et al., 2009). Reducing Prejudice Since mindfulness deepens awareness of internal feelings and attitudes, higher levels of mindfulness are more likely to result in greater awareness of implicit biases and prejudices. As the founder of Western mindfulness points out: Our thinking colors all our experience [and] more often than not, our thoughts tend to be less than completely accurate. Usually they are merely uninformed private opinions, reactions and prejudices based on limited knowledge and influenced primarily by our past conditioning. When not recognized as such, our thinking can prevent us from seeing clearly in the present moment. When we commit ourselves to paying attention in an open way, without falling prey to our own likes and dislikes, opinions and prejudices, projections and expectations, new possibilities open up and we have a chance to free ourselves from the straitjacket of unconsciousness" (Kabat-Zinn, 1994, p. 6). This point is supported by research indicating that people with higher levels of mindfulness are less likely to exhibit incongruence between their reported biases and their actual biases—as measured by the Implicit Association Test—a well-established instrument that assesses implicit stereotypes (Brown & Ryan, 2003). Research also shows that individuals high in mindfulness are less likely to make racially - biased judgments about the guilt or innocence of criminal suspects (Niemiec et al., 2010). By helping people distance themselves from their personal viewpoints and emotional reactions, mindfulness facilitates critical thinking, such as the ability to "examine assumptions, discern hidden values, evaluate evidence, and assess conclusions in an objective manner" (Brown, 2015, p. 319). Page 56 of 78 Agenda Item # 09 Feb 2022 The totality of research discussed in this section suggests that mindfulness training has great potential for promoting students' mental and physical health, as well as their social and cognitive development. A sample mindfulness -training exercise is provided among the Application Activities at the end of this chapter. Additional exercises can be accessed at the mindfulness website identified in the Resource Section. Self -Compassion Self -compassion refers to the capacity to forgive, encourage, and motivate oneself when struggling with feelings of personal failure or inadequacy. It is the process of "turning directly toward one's suffering ... and embracing it with feelings of kind, connected presence. As such, it transforms suffering in a way that enhances well-being, resilience, and coping with difficult thoughts and emotions" (Neff & Davidson, 2016, p. 38). As previously discussed, mindfulness focuses on the person's relationship with the experience of being present, whether that experience be positive, negative or neutral. Similarly, mindful self -compassion involves being present, but with a special focus on present feelings of suffering and treating those feelings kindly (Germer, 2009). Without intentional efforts to sooth ourselves, mindfulness alone may not be enough for us to avoid being adversely affected by self -threatening thoughts that trigger anxiety and despondency (Neff, 2011a). Neff and Davidson (2016) point out that, "We often relate to ourselves in a harsh, self-critical manner and routinely say things to ourselves that we would not say to a stranger or, in some cases, even someone we disliked .... We have a tendency to jump immediately into problem solving mode without recognizing the need to provide ourselves comfort for the struggles we're experiencing" (Neff & Davidson, 2016, p. 39 & 40). For instance, when we are feeling inadequate or down, we may need to actively combat those feelings with self -compassionate thoughts, such as: (a) "these feelings are experienced by most people," (b) "difficulties are part of life that everyone goes through," or (c) "there are aspects of myself that I don't like, but I accept them and will try to improve." Self -compassion builds on the mindfulness principles of being present and non -judgmental and positive psychology's focus on experiencing positive emotions, adding that being mindful of our negative emotions and treating them positively with kindness and compassion. Such symbiotic synergy among the three emotional -wellness processes discussed in this chapter is highlighted by research indicating that mindfulness training increases positive feelings toward the self (Hanley, Warner, & Garland, 2015), while at the same time, increases self -compassion (Keng et al., 2012)—particularly if the training explicitly includes experiential and meditative exercises designed to promote self -compassion awareness (Germer & Neff, 2013). It is important to note that self -compassion and self-esteem are not equivalent concept. For example, to promote self -compassion, students would be instructed to "express kindness and understanding of yourself"; whereas, to increase self-esteem, they might be instructed to "describe your positive qualities" (Breines & Chen, 2012). Enhancing self -compassion is not concerned with how we estimate or value ourselves or feeling good about ourselves when we are evaluated negatively by others (Neff & Davidson, 2016). According to self -compassion pioneer, Kristin Neff, there is a major advantage of focusing on self -compassion rather than self-esteem: "The good feelings of self compassion don't go away when we mess up or things go wrong. In fact, self -compassion steps in precisely where self-esteem lets us down—whenever we fail or feel inadequate" (Neff, 2011a, p. 153). Supporting her point are the findings of a study in which college students were asked to discuss their weaknesses in a mock job interview. Students exhibiting higher levels of self -compassionate experienced fewer feelings of self- consciousness and social anxiety than those with lower levels. In contrast, students with high self- esteem did not report feeling less socially anxious than students with low self-esteem (Neff, 2011a). Page 57 of 78 Agenda Item # 09 Feb 2022 Other studies point to the effectiveness of self -compassion for promoting a variety of positive outcomes, such as those described below. Emotional Wellbeing Meta-analyses of multiple studies reveal a significant correlation between self -compassion and higher overall mental health, lower susceptibility to psychopathology (MacBeth & Gumley, 2012), and fewer transient feelings of stress, anxiety, and depression (Barnard & Curry, 2011; Vam Dam et al., 2011). These findings have been reported for all age groups, and for adolescents and young adults in particular (Bluth & Blanton, 2015; Ferrari et al., 2018). For instance, in one study of college students with symptoms of PTSD following a traumatic event, those with more self -compassion experienced less severe symptoms after the trauma and were better able to face the negative feelings triggered by the traumatic event (Neff, 2011a). Self -compassion training has also been found to reduce chronic academic stress among college students (Kyeong, 2013; Zhang et al., 2016). Even brief self -compassion interventions with college students have alleviated feelings of depression and elevated feelings of optimism, happiness, and self-efficacy (Neff, Rude, & Kirkpatrick, 2007; Shapira & Mongrain, 2010; Smeets et al., 2014). Self -Motivation Studies show that self -compassion is associated with higher levels of self-motivation (Breines & Chen, 2012) and that self -compassion is a more effective motivational strategy for changing one's behavior than self-criticism (Neff, 2003, 2011b). Research comparing people with low and high self -compassion shows that those with higher self -compassion are more oriented toward personal growth, more likely to create specific plans for reaching their goals, and are just as likely to hold high standards for themselves as others; however, when they don't meet those standards, they are less likely to engage in excessive self-criticism. The researcher who conducted reached the following conclusion: "Self -compassion in no way lowers where you set your sites in life. It does however soften how you react when you don't do as well as you hoped, which actually helps you achieve your goals in the long run" (Neff, 2011a, p. 168). This finding is reinforced by a study that found women who were more self -compassionate were likely to set and stick with their goal of adopting a healthier diet (Adams & Leary, 2007). The motivational advantages of self -compassion are supported further by studies indicating that college students with higher levels of self -compassion exhibit lower levels of procrastination (Sirois, 2014) and higher levels of resilience—willingness to try again after experiencing personal setbacks and failures (Neely et al., 2009). Self -compassionate students are also more likely to respond constructively to academic setbacks, maintain self-motivation and a sense of competency, and perceive mistakes as opportunities for potential growth (Neff, Hsieh, & Dejitterat 2005). For instance, in a study of undergraduates who recently failed a midterm exam, self -compassionate students were more likely to view the failure as a growth opportunity rather than as a blow to their self-esteem (Neff, 2011b). Self - compassion training programs have also been found to have positive impact on participants' willingness to expend more effort on learning from past mistakes and changing behavior that could lead to similar mistakes in the future (Neff & Davidson, 2016). Collectively, the foregoing findings strongly suggest that "people who take an accepting approach to personal failure may be more motivated to improve themselves, seemingly paradoxically, precisely because they treat themselves more kindly" (Compton & Hoffman, 2020, p. 321). Social Adjustment & Interpersonal Relations Page 58 of 78 Agenda Item # 09 Feb 2022 Research on undergraduates indicates that those who exhibit higher levels of self -compassion are less likely to report feelings of homesickness during their first term in college (Terry, Leary, & Mehta, 2012) and experience fewer social adjustment issues throughout their time in college (Kyeong, 2013). It has also been found that individuals higher in self -compassion are better able to recognize and feel compassion for the suffering of others, which reduces their feelings of social isolation and increases their sense of belongingness (Neff & Davidson, 2016). For instance, in a study of how people reacted to difficult personal events in their lives, those who responded with higher levels of self -compassion were more likely to take a global perspective on those events—viewing them as experiences they shared with the rest of humanity—which enabled them to feel less personally isolated and have more empathy for others (Leary et al., 2007). Thus, similar to the practice of mindfulness, the practice of self -compassion may have potential for advancing efforts at promoting equity and inclusion. Research on both practices strongly suggests reveals they can increase: (a) awareness of unconscious bias, (b) appreciation of diverse perspectives, and (c) empathy and compassion for others. Concluding Thoughts The need for campuses to adopt emotional wellness programming and deliver it to students in a way that is inescapable, rather than optional, is supported by a report published by in the American Journal of College Health which revealed that the top -three reasons college students give for not seeking support for emotional challenges were: (a) "My problem are not serious enough to warrant assistance (66%), (b) "I don't have enough time" (27%), and (c) "I prefer to manage my problems on my own" (18%) (Czyz et al., 2013). Since research shows that many students experiencing mental health in college issues do not initiate contact with campus counseling centers (Cheng, Kwan, & Sevig, 2013; Eisenberg, Hunt, & Speer, 2012), campuses need to engage in proactive outreach efforts to bring emotional wellness education to students, rather than waiting and hoping that students will seek it out on their own. Infusing emotional wellness into students' first-year experience could provide such early outreach, helping to short-circuit the growing mental health crisis among college students by equipping students with self-regulatory skills they can use initially to facilitate their transition to higher education and use continually throughout their college experience to promote their persistence to graduation. In what ways should campuses deliver emotional wellness education to maximize its positive impact on student success? How educational content is delivered is as important as what content is delivered. The impact of emotional wellness education is optimized when it is delivered: Proactively: "front loaded" early in the college experience (during students' first year)—to address mental health in a manner that is preventative rather than reactive. Waiting until emotional problems are experienced and then reacting to them with treatment may be "too little too late" and fail to intercept emotional challenges before they result in academic underperformance or college attrition. Intrusively: actively brought to students through required course work and co -curricular programs, thus destigmatizing mental health support and ensuring it reaches all students. When student support services are offered as optional, students who are most need of the support are often the ones least likely to exercise that option—because of the stigma attached to help - seeking, particularly help -seeking help for emotional issues. Engagingly: delivered in a manner that actively involves students in the educational process. Students' high level of interest in and engagement with computer technology may be capitalized Page 59 of 78 Agenda Item # 09 Feb 2022 on to deliver emotional wellness content in engaging, interactive visual formats (e.g., "Ted Talks) interspersed with pauses for student reactions and reflections. The expanded use of online education in response to the COVID pandemic could also provide a window of opportunity for delivering emotional wellness tools to first-year students. All the technological adaptations that campuses have made during the pandemic may become more than just short-term "fixes" that end when the pandemic ends. Some of these adaptations may continue to be used as effective, long-term vehicles for delivering educational content in the future. For instance, all the work done to convert informational content from in-person lectures to online delivery formats during COVID may be tweaked to deliver online emotional wellness content, opening more in-person time for student engagement and social integration with respect to the content covered. Mental health- related services that some campuses adopted to help students cope with the stress they were experiencing during COVID could continue to be delivered routinely post-COVID. It has been said that "necessity is the mother of invention." If so, then the inventive educational delivery formats necessitated by COVID may serve as useful tools for delivering ongoing emotional wellness education to students proactively and at scale—the result of which would be improved mental health among college students and higher rates of college completion. Questions for Critical Reflection 1. College students' mental health has become a significant issue on American campuses. Is that the case on your campus as well? 2. Do you believe that greater attention to emotional wellness education will improve the academic success and graduation rates of students at your college or university? If yes, why? If no, why not? 3. Does your campus take a proactive approach to supporting students' mental health during their first year of college? Do you think that bolstering such support would facilitate your first-year students' adjustment to college life and their second -year return rate? 4. What existing curricular offerings or co -curricular programs on your campus are well positioned to serve as avenues through which additional emotional wellness and mental health education may be delivered to students? 5. Are there any practices associated with positive psychology, mindfulness and/or self -compassion discussed in this chapter that strike you as having particularly strong potential for promoting the success of the students you serve? Application Activities Positive Events Journal A"positive events journal" is a written record of: (a) good things that happen to us, (b) things we're grateful for, and (c) accomplishments we've achieved. When students keep a positive journal, their entries leave them with an uplifting visible productthey can view and review anytime theyare feeling down or overwhelmed. Students may be assigned or encouraged to keep a positive events journal in response to prompts that ask them to identify: Page 60 of 78 Agenda Item # 09 Feb 2022 • Personal strengths, along with an explanation of how each of the strengths identified has helped or can help them reach their goals. • Accomplishments or achievements in their life and what attributes enabled them to do so. • Mistakes made they learned from and have contributed to their personal growth. • Things they're grateful for and why they're grateful for them. (For additional positive psychology exercises, see the links listed in the Resources section.) Developing Mindfulness through Mindful Breathing Exercises Mindfulness exercises involve practice maintaining awareness of something and bringing our awareness back to that thing when our mind begins to wander from it. One way to become more mindful is to practice becoming more "bodyful" (Kabat-Zinn, 1994)—that is, using awareness of our body to anchor or center ourselves in the present moment and block out distractions from external stimuli or internal thoughts (Tart, 1994). One of the easiest and most portable ways to use awareness of our body to promote mindfulness is by engaging in the practice of mindful breathing. By deliberately redirecting attention to the sensations of our breathing (in and out), we can enhance mindfulness and help break the cycle of negative thoughts by taking our mind off negative thoughts and replace feelings of stress with feelings of calmness. People who use this simple attention breathing -redirection strategy report that is an effective way to reduce tension, particularly at times when they're experiencing negative or distressing thoughts (Kabat-Zinn, 1990). Even short practice in breathing - focused mindfulness has been found to lower feelings of stress and lessen emotional reactivity to stressful stimuli (Arch & Craske, 2006). Students may be encouraged or instructed to practice breathing -focused mindfulness by engaging in the following three simple steps. Step 1. Tune into the feeling of your breath as it enters your body and the feeling of your breath as it exits your body. Don't do anything different or special with your breathing—such as taking deeper breaths—just breathe the way you normally do. Step 2. As you tune into your breath entering and leaving your body, just observe and accept what you're experiencing in the present moment— what thoughts or feelings enter your mind, what images you see, or what sounds you hear—without attempting change them. Step 3. When your awareness drifts away from your breath, which will repeatedly happen (especially when first doing this exercise), notice when it drifts and quickly bring your awareness back to your breathing. Continually bringing awareness back to your breathing serves to strengthen your "attention muscles," enabling you to get better and better at staying focused on your breath and noticing when you're about to become distracted. The effort and energy you exert to pull awareness back to your breathing will not only help prevent attention drift during this breathing exercise, it will also strengthen your ability to maintain attention and block out distractions in other situations. These three steps can be practiced at any time during the day time for as short as five seconds or up to five minutes. Page 61 of 78 Self -Compassion Exercise Agenda Item # 09 Feb 2022 Sources: Gunaratana (2019); Kabat-Zinn ( 1994); Tart (1994). (For additional mindfulness exercises, see the link listed in the Resources section.) Similar to how mindfulness can be practiced by engaging in exercises such as mindful breathing, so too can mindful self -compassion be practiced by engaging in exercises—such as the following four -step activity. Steps: 1. Think about times when a close friend of yours really felt bad or was really struggling in some way. How did you respond your friend in these situations? Write down what you typically said and the tone in which you said it. 2. Think about times when you have felt bad about yourself or were struggling. How do you typically respond in these situations? Write down what you usually say to yourself and the tone in which you say it. 3. Note the differences in your responses to step 1 and step 2. Why do you think you respond in different ways to your own struggles compared to the struggles of a close friend? 4. How things might change in the way you view or treat yourself if you responded to your struggles in the same way you respond to your close friend? Source: Neff (2021) (For additional mindfulness exercises, see the link listed in the Resources section.) Resources Positive Psychology https//www.health.harvard.edu/topics/positive-psychology Identifying Positive Attributes & Personal Values www.viacharacter.org Mindfulness https//www.mindful.org/what-is-mindfulness/ Page 62 of 78 Agenda Item # 09 Feb 2022 Self -Compassion https://self-compassion.org/category/exercises/ Mental & Emotional Wellness Programming for College Students https//www.uthriveeducation.com/ Glossary Intrusive—the process of actively bringing support to students through required course work and co - curricular programs, rather than offering support passively through optional programs and hoping that students seek it out on their own. "John Henryism": the added effort that minority students must exert to cope with additional stressors associated with their minority status and the resulting emotional toll it takes on their mental health, Mindful self -compassion: the process of being present and aware of what we are experiencing, with special attention to present feelings of personal suffering and treating those feelings kindly. Mindfulness: purposeful, nonjudgmental attentiveness to the present moment—a state of receptive awareness of our open minds to whatever arises as it arises. "Passive programming": offering support services to students in a way that relies on them to make self - initiated contact with services (e.g., students initiating contact with personal counselors if they are experiencing mental health issues). Positive Psychology: a branch of psychology that focuses on the growth and development of the whole person, nurturing what is best within the person, and promoting contentment with the past, happiness in the present, and hope for the future. Proactive: the process of "front loading" support during the early stages of the college experience (e.g., first-year experience programs that support students' psychosocial transition to college and address their mental health in a manner that is preventative rather than reactive). Self -compassion: the capacity to forgive, encourage, and motivate oneself when struggling with feelings of personal failure or inadequacy—by turning directly toward one's suffering—embracing it with a connected presence and feelings of kindness that serve to enhance wellness and promote resilience. References Active Minds. (2020.) The impact of COVID-19 on student mental health. Retrieved from activeminds.org/studentsurvey/ Adams, C. E., & Leary, M. R. (2007). Promoting self -compassionate attitudes toward eating among restrictive and guilty eaters. Journal of Social and Clinical Psychology, 26(10), 1120-1144. Page 63 of 78 Agenda Item # 09 Feb 2022 Adler, J., & Hershfield, H. (2012). Mixed emotional experience is associated with and precedes improvements in psychological well-being. PLoS ONE, 7(4). Available at http://people.stern.nyu.ed u/hhershfi/resources/Resea rch/PLoS-O N E -2012 -Ad ler.pdf American College Health Association National College Health Assessment (ACHA- NCHA) (2017). Fall 2017 Reference Group executive summary. Retrieved from http://www.acha- ncha.org/docs/NCHA- II_2017_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf Arch, J. J., & Craske, M. G. (2006). Mechanisms of mindfulness: Emotion regulation of mindfulness: Emotion regulation followed a focused breathing induction. Behaviour Research and Therapy, 44(12), 1849-1858. Arch, J. J., & Craske, M. G. (2010). Laboratory stressors in clinically anxious and non -anxious individuals: The moderating role of mindfulness. Behaviour Research and Therapy, 48(6), 495-505. Arch, J. J., & Landy, L. N. (2015). Emotional benefits of mindfulness.. In D. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 208-224). New York, NY: The Guilford Press. Barnard, L. K., & Curry, J. F. (2011). Self -compassion: Conceptualizations, correlates, and interventions. Review of General Psychology, 5(4), 289-303. Beitel, M., Ferrer, E., & Cecero, J. J. (2005). Psychological mindfulness and awareness of self and others. Journal of Clinical Psychology, 61, 739-750. Black, D. S., & Slavich, G. M. (2016). Mindfulness meditation and the immune system: A systematic review of randomized controlled trials. Annals of the New York Academic Sciences, 1373, 13-24. Bluth, K., & Blanton, P. W. (2015). The influence of self -compassion on emotional well-being among elderly and older adolescent males and females. Journal of Positive Psychology, 10, 219-230. Boehm, J. K. (2018). Living healthier and longer lives: Subjective well-being's association with better health. In E. Deiner, S. Oishi, & L. Tai (Eds.), Handbook of well-being. Salt Lake City, Utah: DEF. Bowers, K. M., & Lopez, S. J. (2010). Capitalizing on personal strengths in college. Journal of College and Character, 11(1), 1-11. Breines, J. G., & Chen, S. (2012). Self -compassion increases self-improvement motivation. Personality and Social Psychology Bulletin, 38, 1133-1143. Brown, K.W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822-848. Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological Inquiry, 18, 211-237. Cantwell, J. (2005). A comparative analysis of strengths -based versus traditional teaching methods in a freshman public speaking course: Impacts on student learning and engagement. Dissertation Page 64 of 78 Agenda Item # 09 Feb 2022 Abstracts International, 67(02A), 478-700. (UMI No. AAT3207574) Carmody, J. (2015). Reconceptualizing mindfulness: The psychological principles of attending in mindfulness practice and their role in well-being. In D. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 62-78). New York, NY: The Guilford Press. Carver, C. S., Scheier, M. F., Miller, C. J., & Fulford, D. (2009). Optimism. In S. J. Lopez & C. R. Snyder (Eds.), Oxford Handbook of Positive Psychology, 2"d ed. (pp. 303-312). Oxford, England: Oxford University Press. Cheng, H., Kwan, K. K., & Sevig, T. (2013). Racial and ethnic minority college students' stigma associated with seeking psychological help: Examining psychocultural correlates. Journal of College Counseling Psychology, 60(1), 98-111. Chessman, H. M. Vivil, D., & Soler, M. C. (2020). Mental health task forces in higher education. Washington, DC: American Council on Education. Choy, S. (2002). Findings from the condition of education 2002: Nontraditional undergraduates.US Department of Education, National Center for Education Statistics. NCES 2002-012. Retrieved from https://ncs.ed.gov/pubs2002-2002012.pdf Compton, W. C., & Hoffmann, E. (2020). Positive psychology: The science of happiness and flourishing (3rd ed.). Thousand Oaks, CA: Sage. Cross, M. P., Hofschneider, L., Grimm, M., & Pressman, S. (2018). Subjective well-being and physical health. In E. Diener, S. Oishi, & L. Tau (Eds.), Handbook of well-being. Salt Lake City, UT: DEF Publishers. Retrieved from https://www.nobascholar.com/chapers/64/download.pdf Czeisler, M. E., Lane, R. 1., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., Weaver, M. D., Robbins, R., Facer -Childs, E. R., Barger, L. K., Czeisler, C. A., Howard, M. E., & Rajaratnam, S. M. W. (2020). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic - United States, June 24- 30, 2020. MMWR. Morbidity and Mortality Weekly Report, 69(32), 1049-1057. 10.15585/mmwr.mm6932a1 - PMC - PubMed Czyz, E. K., Horwitz, A. G, Eisenberg, D., Kramer, A., & King, C. A. (2013). Self-reported barriers to professional help seeking among college students at elevated risk for suicide. Journal of American College Health, 61(7), 398-406. Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santrelli, S. F., et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564-570. Deci, E. L., Ryan, R. M., Schultz, P. P., & Niemiec, C. P. (2015). Being aware and functioning fully: Mindfulness and interest taking within self-determination theory. In D. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 112-129). New York, NY: The Guilford Press. Page 65 of 78 Agenda Item # 09 Feb 2022 Diener, E. (2000). Subjective well-being: The science of happiness and a proposal for a national index. American Psychologist, 55, 34-43. Diener, E. & Chan, M. (2011). Happy people live loner: Subjective well-being contributes to health and longevity. Applied Psychology: Health and Well -Being, 3, 1-43. Diener, E., Pressman, S., Hunter, J., & Delgadilio-Chase, D. (2017). If, why, and when subjective well- being influences health, and future needed research. Applied Psychology: Health and Well -Being, 9, 133-167. Duckworth, A. L., Steen, T. A., & Seligman, M. E. (2005). Positive psychology in clinical practice. Annual Review of Clinical Psychology, 1, 629-651. Eisenberg, D., Hunt, J., & Speer, N. (2012). Help seeking for mental health on college campuses: Review of evidence and next steps for research and practice. Harvard Review of Psychiatry, 20(4), 222-132. Estevez, E. F. (2005). The role of strengths -based case management strategies in the promotion of social capital and academic success of underprepared students. Dissertation Abstracts International, 66(08A), 2852-2975. (UMI No. AAT3185052) Feldman, G., Greeson, J., & Senville, J. (2010). Differential effects of mindfulness breathing, progressive muscle relaxation, and loving -kindness meditation on decentering and negative reactions to repetitive thoughts. Behaviour Research and Therapy, 48, 1002-1011. Ferrari , M., Yap, K., Scott, N., Einstein, D. A., & Ciarrochi, J. (2018). Self -compassion moderates the perfectionism and depression link in both adolescence and adulthood. PLOS One, 13, e0192022. Available at https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0192022 Fineburg, A. C. (2004). Introducing positive psychology to the introductory psychology student. In P. A. Linley & S. Joseph (Eds.), Positive psychology in practice (pp. 197-209). Hoboken, NJ: John Wiley and Sons. Fredrickson B. L. (1998). What good are positive emotions? Review of General Psychology, 2, 300-319. Fredrickson B. L. (2001). The role of positive emotions in positive psychology: The broaden -and -build theory of positive emotions. American Psychologist, 56(3), 218-226. Fredrickson, B. L. (2013). Love 2.0: Creating happiness and health in moments of connection. New York, NY: Penguin. Frijda, N. H. (1986). The emotions. England: Cambridge University Press. Germer, C. K. (2009). The mindful path to self -compassion. New York: Guilford Press. Germer, C., & Neff, K. (2013). The Mindful Self -Compassion training program. In T. Singer & M. Bolz, Compassion: Bridging theory and practice: A multimedia book (pp. 365-396). Leipzig, Germany: Max - Planck Institute. Page 66 of 78 Agenda Item # 09 Feb 2022 Glass, G. D. (2016). Introducing psychotherapy for the collective: A paradigm shift for college mental health. Change: The Magazine for Higher Learning, 48(6), 16-23. Grace, F. (2011). Meditation in the classroom: What do the students say they learn? In H. Simmer -Brown & F. Grace (Eds.), Meditation and the classroom (pp. 237-249). Albany, NY: State University of New York Press. Gruber, J., Mauss, 1., & Amir, M. (2011). A dark side of happiness? How, when, and why happiness is not always good. Perspectives on Psychological Science, 6, 223-233. Gunaratana, B. H. (2019). Mindfulness in plain English. Somerville, MA: Wisdom Publications. Hamblin, J. (2017, January 27). Why succeeding against the odds can make you sick. The New York Times. Retrieved from https://www.nytimes.com/2017/01/27/opinion/sunday/why-succeeding- against-the- odds-can-make-you-sick.html Hanley, A., Warner, A., & Garland, E. L. (2015). Associations between mindfulness, psychological well- being and subjective well-being with respect to contemplative practice. Journal of Happiness Studies, 16(6), 1243-1436. doi: 1007/s10902-014-9569-5 Harris, R. (2009). ACT made simple: An easy -to -read primer on acceptance and commitment therapy. Oakland, CA: New Harbinger Publications. Hibbs, B. J., & Rostain, A. (2019). The stressed years of their lives: Helping your kid survive and thrive during their college years. New York: St. Martin's Press. Hill, C. L. M., & Updegraff, J. A. (2012). Mindfulness and its relationship to emotion regulation. Emotion, 12(1), 81-90. Ivetzan, 1., Lomas, T., Hefferon, K., & Worth, P. (2015). Second wave positive psychology: Embracing the dark side of life. New York, NY: Routledge. Kabat-Zinn, J. (1994). Wherever you go there you are: Mindfulness meditation in everyday life. New York, NY: Hatchette. Kadziolka, M. J., Di Pierdomenico, E. A., Miller, C. J. (2016). Trait -like mindfulness promotes healthy self- regulation of stress. Mindfulness, 7, 236-245. DOI: 10.1007/S12671-015-0437-0 Kane, M. J., Brown, L. H., McVay, J. C., Silvia, P. J., Myin-Germeyes, 1., & Kwapil, T. R. (2007). For whom the mind wanders, and when. Psychological Science, 18(7), 614-621. Kashdan, T. B., & Biswas-Diener, R. (2014). The upside of your dark side: Why being your whole self --not just your "good" self --drives success and fulfillment. New York, NY: Avery. Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychological Review, 31, 1041-1056. http://dx.doi.org/10.1016/j.cpr.2011.04.006 Page 67 of 78 Agenda Item # 09 Feb 2022 Keng, S., Smoski, M. J., Robins, C. J., Ekblad, A. G., & Brantley, J. G. (2012). Mechanisms of change in mindfulness -based stress reduction: Self -compassion and mindfulness as mediators of intervention outcomes. Journal of Cognitive Psychology, 26(3), 270-280. Keyes, C. L. M., & Lopez, S. J. (2002). Toward a science of mental health: Positive directions in diagnosis and interventions. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 45-59). London: England: Oxford University Press. Killingsworth, M. A., & Gilbert, D. T. (2010). A wandering mind is an unhappy mind. Science, 330, 932. Kingston, T., Chadick, P., Meron, D., & Skinner, T. (2007). A pilot randomized control trial investigating the effect of mindfulness practice on pain tolerance, psychological well-being, and physiological activity. Journal of Psychosomatic Research, 62, 297-300. Klainin-Yobas, P., Ng, S. H., Stephen, P. D. M., & Lau, Y. (2016). Patient Education and Counseling, 99(4), 512-521. doi: 10.1016/j.pec.2015.10.020 Klug, H. J., & Maier, G. W. (2015). Linking goal progress and subjective well-being: A meta-analysis. Journal of Happiness Studies, 16(1), 37-65. Konrath, S. H., O'Brien, E. H., & Hsing, C. (2011). Changes in dispositional empathy in American college students over time: A meta-analysis. Personality and Social Psychology Review, 15, 180-198. Kyeong, L. W. (2013). Self -compassion as a moderator of the relationship between academic burn -out and psychological health in Korean cyber university students. Personality and Individual Differences, 54(8), 899-902. Lazar, S. W., Kerr, C. E., Wasserman, R. H., Gray, J. R., Greve, D. N., Treadway et al. (2005). Meditation experience is associated with increased cortical thickness. Neuro -Report, 16, 1893-1897. Lazarus, R. S. (1991). Emotion and adaptation. New York, NY: Oxford University Press. Leary, M. R., Tate, E. B., Adams, C. E., Allen, A. B., & Hancock, J. (2007). Self -compassion and reactions to unpleasant self -relevant events: The implications of treating oneself kindly. Journal of Personality and Social Psychology, 92(5),887-904. Loucks, E. B., Schurman-Olivier, Z., Britton, W., Fresco, D. M., Desbordes, G., Brewer, J. A., & Fulwiler, C. (2015). Mindfulness and cardiovascular disease risk: State of the evidence, plausible mechanisms, and theoretical framework. Current Cardiology Reports, 17. doi:10.1007/s11886-015-0668-7 Louis, M. C. (2015). Enhancing intellectual development and academic success in college: Insights and strategies from positive psychology. In J. C. Wade, L. I. Marks, & R. D. Hetzel (Eds.), Positive psychology on the college campus (pp. 99-131). New York, NY: Oxford University Press. Louis, M. C., & Schreiner, L. A. (2012). Helping students thrive: A strengths development model. In L. A.. Schreiner, M. C. Louis, & D. D. Nelson (Eds.), Thriving in transitions: A research -based approach to college student success (pp. 19-40). Columbia, SC: University of South Carolina, National Resource Center for the First -Year Experience and Students in Transition. Page 68 of 78 Agenda Item # 09 Feb 2022 Luders, E., Toga, A. W., Lepore, N., & Glaser, C. (2009).The underlying anatomical correlates of long- term meditation: Larger hippocampal and frontal volumes of gray matter. Neurolmage, 45(3), 672- 678. Lyubomirsky, S., King, L., & Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin, 31(6), 803-855. MacBeth, A., & Gumley, A . (2012). Exploring compassion: A meta-analysis of the association between self -compassion and psychopathology. Clinical Psychology Review, 3, 545-552. Magyar -Moe, J. L. (2015). Positive psychology in the classroom. In J. C. Wade, L. 1. Marks, & R. D. Hetzel (Eds.), Positive psychology on the college campus (pp. 133-166). New York, NY: Oxford University Press. Matousek, R. H., & Dobkin, P. L. (2010). Weathering storms: A cohort study of how participation in a mindfulness -based stress reduction program benefits women after breast cancer treatment. Current Oncology, 17, 62-70. Miller, L. (2015). Positive psychology in college sport and exercise. In J. C. Wade, L. 1. Marks, & R. D. Hetzel (Eds.), Positive psychology on the college campus (pp. 299-317). New York, NY: Oxford University Press. Murphy, M. J., Mermelseten, L. C., Edwards, K. M., & Gidycz, C. A. (2012). Te benefits of dispositional mindfulness in physical health: A longitudinal study of female college students. American Journal of College Health, 60(5), 341-348. National Academies of Sciences, Engineering, and Medicine (2017). Supporting students' college success: The role of assessment of intrapersonal and interpersonal competencies. Washington, DC: The National Academies Press. https://doi.org/10.17226/24697 Neely, M. E., Schallert, D. L., Mohammed, S. S., Roberts, R. M., & Chen, Y. (2009). Self -kindness when facing stress: The role of self -compassion, goal regulation, and support in college students' well- being. Motivation and Emotion, 33, 88-97. Neff, K. (2021). "Self -compassion: How would you treat a friend?" Retrieved from https//:self- compassion.org/exercise-1-treat-friend/ Neff, K. D. (2011a). Self -compassion: The proven power of being kind to yourself. New York, NY: HarperCollins. Neff, K. D. (2011b). Self -compassion, self-esteem, and well-being. Social and Personality Psychology Compass, 5, 1-12. Neff, K.D. (2003). Self -compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85-105. Neff, K., & Davidson, & 0. (2016). Self -compassion: Embracing suffering with kindness. In 1. lvtzan & T. Page 69 of 78 Agenda Item # 09 Feb 2022 Lomas (Eds.), Mindfulness in positive psychology: The science of meditation and wellbeing (pp. 37-50). London, UK: Rutledge. Neff, K. D., Hsieh, Y. , & Dejitterat, K. (2005). Self -compassion, achievement goals, and coping with academic failure. Self and Identity, 4(3), 263-287. Neff, K. D., Rude, S. S., & Kirkpatrick, K. L. (2007). An examination of self -compassion in relation to positive psychological functioning and personality traits. Journal of Research in Personality, 41, 908- 916. Niemiec, C. P., Brown, K. W., Kasdan, T. B., Cozzolino, P. J., Breen, W. E., Levesque -Bristol, C., et al. (2010). Being present in the face of existential threat: The role of trait mindfulness in reducing defensive responses to mortality salience. Journal of Personality and Social Psychology, 99(2), 344- 365. Noel, L. & Levitz, R. (1995). New strategies for difficult times. Recruitment & Retention in Higher Education, 9(7), pp. 4-7. O'Brien, E. (2020). "There's a psychological reason we won't return to normal right away after society reopens." Los Angeles Times. Retrieved from https://www.latimes.com/opinion/story/2020-06- 01/coronavirus-consumer-psychology-negativity-dominance Ong, J. C., & Smith, C. E. (2017). Using mindfulness for the treatment of insomnia. Behavioral Therapy, 3, 57-65. Parker, S. C., Nelson, B. W., Epel, E. S., & Siegel, D. J. (2015). The science of presence: A central mediator of the interpersonal benefits of mindfulness.. In D. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 225-244). New York, NY: The Guilford Press. Perez -Blasco, J., Sales, A., Melendez, J. C., & Mayordomo, T. (2015). The effects of mindfulness and self - compassion on improving the capacity to adapt to stress situations in elderly people living in the community. Clinical Gerontoogist, 59, 90-103. Permzadian, V., & Crede, M. (2016). Do first-year seminars improve college grades and retention? A quantitative review of their overall effectiveness and an examination of moderators of effectiveness. Review of Educational Research, 86(1), 277-316. PLOS One. (2019.) Health risks associated with social isolation in general and in young, middle and old age. Retrieved from ncbi.nlm.nih.gov/pmc/articles/PMC6638933/ Positive Psychology Center (2020). Retrieved from the University of Pennsylvania Positive Psychology Center website: https://ppc.sas.upenn.edu/ Quoidbach, J., Gruber, J., Mikolajczak, M., Kogan, A., Kotsou, I., & Norton, M. (2014). Emodiversity and the emotional ecosystem. Journal of Experimental Psychology: General, 143, 2057-2066. Raimondi, T. P. (2019). Compassion fatigue in higher education: Lessons from other helping fields. Page 70 of 78 Agenda Item # 09 Feb 2022 Change: The Magazine of Higher Learning, 51(3), 53-58. Ramler, T. R., Tennison, L. R., Lynch, J., & Murphy, P. (2016). Mindfulness and the college transition: The efficacy of an adapted mindfulness -based stress reduction intervention in fostering adjustment among first-year students. Mindfulness, 7, 179-188 Richman, L., Kubansky, L., Maselko, J., Kawachi, I., Choo, P., & Bauer, M. (2005). Positive emotion and health: Going beyond the negative. Health Psychology, 24, 422-429. Rogers, H., & Maytan, M. (2012). Mindfulness for the next generation: Helping emerging adults manage stress and lead healthier lives. New York: Oxford University Press. Rostain, A., & Hibbs, B. (2019, August 24-25). "Is your child emotionally ready for college?" Review. The Wall Street Journal, pp. C1-C2. Rozin, P., & Royzman, E. B. (2001). Negativity bias, negativity dominance, and contagion. Personality and Social Psychology Review, 5 (4), 296-320. Schreiner, L. A. (2015). Positive psychology and higher education: The contribution of positive psychology to student success and institutional effectiveness. In J. C. Wade, L. I. Marks, & R. D. Hetzel (Eds.), Positive psychology on the college campus (pp. 1-25). New York, NY: Oxford University Press. Schreiner, L. A., Pothoven, S., Nelson, D., & McIntosh, E. J. (2009b). College student thriving: Predictors of success and retention. Paper presented at the annual meeting of the Association for the Study of Higher Education. Vancouver, British Columbia. Schutte, N. S., & Malouff, J. M. (2002). Incorporating emotional skills content in a college transition course enhances student retention. Journal of The First -Year Experience, 14(1), 7-21. Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. New York, NY: Free Press. Shapira, L. B., & Mongrain, M. (2010). The benefits of self -compassion and optimism exercises for individuals vulnerable to depression. The Journal of Positive Psychology, 5 (5), 377-389. Shapiro, S. L., Schwartz, G., & Bonner, G. (1998). Effects of mindfulness -based stress reduction on medical and premedical students. Journal of Behavioural Medicine, 21, 581-589. Shushok, F. & Hulme, E. (2006). What's right with you: Helping students find and use their personal strengths. About Campus, 11(4), 2-8. Siegel, D. J. (2007). The mindful brain: Reflection and attunement in the cultivation of well-being. New York: Norton. Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are (2nd ed.). New York: Guilford Press. Silverstein, R. G., Brown, A. -C. H., Roth, H. D., & Britton, W. B. (2011). Effects of mindfulness training on Page 71 of 78 Agenda Item # 09 Feb 2022 body awareness to sexual stimuli: Implications for female sexual dysfunction. Psychosomatic Medicine, 73(9), 817-825. Sirois, F. M. (2014). Procrastination and stress: Exploring the role of self -compassion. Self and Identity, 13, 128-145. Smeets, E., Neff, K., Alberts, H., Alberts, H., & Peters, M. (2014). Meeting suffering with kindness: Effects of a brief self -compassion intervention for female college students. Journal of Clinical Psychology, 20(1), 1-15. Snyder, C. R., Harris, C., Anderson, J. R., Holleran, S. A., Irving, L. M., Sigmon, S. T., et al. (1991). The will and the ways: Development and validation of an individual -differences measure of hope. Journal of Personality and Social Psychology, 60, 570-585. Tart, C. T. (1994). Living the mindful life. Boston, MA: Shambhala Publications. Teper, R., & lnzlicht, M. (2013). Meditation, mindfulness and executive control: The importance of emotional acceptance and brain -based performance monitoring. Social Cognitive and Affective Neuroscience, 8(1), 85-92. Terry, M. L., Leary, M. R., & Mehta, A. (2012). Self -compassion as a buffer against homesickness, depression and dissatisfaction in the transition to college. Self and Identity, 12, 278-290. Tracy, S. C. (2008). John Henry: Roark Bradford's novel and play. Oxford, England: Oxford University Press. Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the five -factor model of personality: Distinguishing rumination from reflection. Journal of Personality and Social Psychology, 76, 284-304. Twenge, J. (2014). Time period and birth cohort differences in depressive symptoms in the U.S., 1982- 2103. Social Indicators Research, 121(2), 437-454. Vam Dam, N. T., Sheppard, S. , C., Forsyth, J. P., & Earleywine, M. (2011). Self -compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders, 25, 123-130. Watkins, E. R. (2015). Mindfulness in the context of processing mode theory. In D. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 90-111). New York, NY: The Guilford Press. Weinstein,N. Brown, K. W., & Ryan, R. M. (2009). A multimethod examination of the effects of mindfulness on stress attribution, coping, and emotional well-being. Journal of Research in Personality, 43, 374-385. Welzer, C., & Inglehart, R. (2010). Agency, values, and well-being: A developmental model. Social Indicators Research, 97, 43-63. Page 72 of 78 Agenda Item # 09 Feb 2022 Williamson, J. S. (2002). Assessing student strengths: Academic performance and persistence of first- time college students at a private church -affiliated college. Unpublished doctoral dissertation, University of Sarasota, New York, NY. Youseff, C., & Luthans, F. (2011). Positive psychological capital in the workplace: Where we are and where we need to go. In K. M. Sheldon, T. B. Kashdan, & M. F. Steger (Eds.), Designing positive psychology: Taking stock and moving forward (pp. 351-364). New York, NY: Oxford University Press. Zhang, Y., Luo, X., Che, X., & Duan, W. (2016). Protective effect of self -compassion to emotional response among students with chronic academic stress. Frontiers in Psychology, 7, 1802. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5118418/ Page 73 of 78 Page 74 of 78 Agenda Item # 09 Feb 2022 Possible Council Topics Draft 1/20/2022 Aging in Place and Senior Programming Air Quality Alcohol Biking and Complete Streets Clean Air and Asthma Community Education Faith Food Insecurity Gardening Guns Health Insurance History Homelessness Meditation and Mindfulness I Mental Health Mentoring Military Neighborhood Identity Opioid & Drug Use Oral Healthcare Pets Philanthropy Physical Activity and Programming Race and Equity Self -compassion Setting Personal Boundaries and Limits Small Businesses Smoking Special Events Suicide Support of Nonprofit Network Volunteerism Workforce Housing Page 75 of 78 Page 76 of 78 Agenda Item # 09 Feb 2022 NOTICE OF MEETING AND INSTRUCTIONS FOR PROVIDING PUBLIC COMMENTS FOR THE MAYOR'S COUNCIL ON HEALTH AND WELL-BEING MEETING BEING HELD ON FEBRUARY 9, 2022 AT 12:00 P.M. IN THE CITY HALL, COMMISSION CHAMBER, 800 SEMINOLE ROAD, ATLANTIC BEACH, FLORIDA 32233 AND VIA ZOOM Notice is hereby given that a meeting of the Mayor's Council on Health and Well -Being will be held at 12:00 pm on February 9, 2022. This meeting will be held in-person and through Communications Media Technology (CMT) - which will allow for both in-person participation and virtual participation. In person participation will be held in Commission Chamber located at 800 Seminole Road, Atlantic Beach, FL 32233. Virtual participation will be held through Zoom. The options and instructions for providing public comments are provided below. Please Note: Two or more members of any board or committee of the City of Atlantic Beach may be in attendance. Live stream of this meeting can be viewed at https://atlanticbeachfl.swagit.com/live at the time of the meeting. The following three (3) options are available for providing public comments. Option 1: Attend and provide comments at the meeting. If you choose this option, please register to speak by completing a speaker form which is located on the table as you enter the Commission Chamber and submitting it to the Recording Clerk prior to the start of the meeting. The time allowed for public comments will be determined by the number of speakers and will be announced at the meeting. When it is your turn to speak, you will be called to the podium. Option 2: Provide written comments/materials - either by email, hand delivery, or drop box. This option allows the public to submit written comments (1) to be read during the meeting or (2) to be entered into record without being read during the meeting. For this option, the following are required. 1. Title your comments: "Written Comments for Mayor's Council on Health and Well -Being Meeting, February 9, 2022." 2. Provide your name (required), address and email address, and 3. If you desire for your written comments to be read into the record during the meeting, please indicate so and limit the size to 300 words. Only written comments of 300 or fewer words will be read into the record during the meeting. All other written comments received by the deadline below will be entered into the meeting record and distributed to the Committee members and appropriate staff before the start of the meeting. 4. Submit your comments to Abrielle Genest no later than Noon on Monday, February 7, 2022 using one of the following methods: • by emailing to agenest@coab.us, • by hand delivering to the Planning Department at City Hall, 800 Seminole Road, Atlantic Beach during business hours, OR • by placing in the Drop Box located at the entrance to City Hall, 800 Seminole Road, Atlantic Beach. Page 77 of 78 Agenda Item # 09 Feb 2022 Option 3: Join by CMT (Zoom) Members of the public who opt to comment during the meeting through Zoom — rather than providing written comments before the meeting -- may do so by registering to provide public comment. To register, please go to https://www.coab.us/506/Meeting-Videos; click on "Register to Provide Public Comment during Mayor's Council on Health and Well -Being via Zoom"; and complete and submit the form by clicking "Register". Registration must be completed at least one hour prior to the start of the meeting to confirm your login credentials. Following completion of the registration form, you will receive a confirmation email with information on how to join the Meeting. Please re -connect at least 10 minutes prior to the start of the meeting to provide public comment. Due to security guidelines, you will not be able to connect after the meeting starts. The time allowed for public comments will be determined by the number of speakers and will be announced at the meeting. When it is your turn to speak, you will be called. The meeting moderator will monitor adherence to these CMT Procedures or Robert's Rules of Order and may mute any persons determined to be in violation. In accordance with the Americans with Disabilities Act, persons needing a special accommodation to participate in this proceeding should contact Donna Bartle, City Clerk, at 247-5809 or at City Hall, 800 Seminole Road, no later than Noon on the Monday prior to the meeting. For assistance, please contact Abrielle Genest at City Hall, 800 Seminole Road, Atlantic Beach, (904) 247-5847 or agenestPcoab.us. Posted by Donna Bartle on Feb. 3, 2022 at 12:15 p.m. Page 78 of 78