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Community Health Improvement Plan

Florida Department of Health in Monroe County

  •  (305) 293-7500


    (305) 809-5629

    Mailing Address

    1100 Simonton Street 

    Key West, FL 



William Brookman, MPH,Community Health Services Director

   Wouldn’t you agree that there is vast diversity among the people who live in this island chain. What is behind the health statistics? Who are the communities and neighborhoods that make up the Florida Keys? These are important questions when we as health professionals attempt to assist our neighbors to lead healthier lives, while we ourselves are striving toward the same healthy goals.

What is a Micro-Community?  

A micro-community is a small group of neighborhoods in the Florida Keys that share a common environment. By that we mean they share the same grocery store, the same group of physicians, the same hospital or clinic, the same restaurants, the same retail stores, clubs and the same governance. People who share the same environment may share common health conditions.

The “census tract” is the smallest portion of larger county, state, and national health statistics. The Florida Department of Health in Monroe County has used this data to determine disease trends in the areas that appear on the facing page. Information supplied from  county death certificates is geo-coded to census tract areas. Therefore, health professionals can see if there are commonalities in causes of death almost at the neighborhood level. We have divided the Florida Keys into 19 tracts and labeled them as micro-communities with names that correspond to the dominant geographical area or feature.  We have excluded mainland Monroe since it has such a small population.

The Ecological Model: A  Respected Public Health Tool

The Institute of Medicine has defined the ecological model as “a model of health that emphasizes the linkages and relationships among multiple factors (or determinants) affecting health.” More simply put, the social and physical environment, along with all their complex components, are major factors that strongly shape the pattern of disease and injury in our micro-communities.

Therefore, the approach of the health institutions in Monroe County charged with improving health for the citizens, must take into account the social and physical environments of the individual micro-communities.  This includes the built environment: access to playgrounds, athletic fields, grocery stores offering healthy foods, a transportation system that allows all access to healthcare, and so forth. People living in Big Pine have a different social and physical environment than people living in Old Town Key West.  West & Central Marathon is different from East Islamorada. The Ecological Model, sometimes called the Socio-Ecological Model of Health, helps health professionals make some sense of all the varying factors affecting health in each location.

How Does the Health Department Prioritize their Community  Health Improvement Process?

Resources are limited and therefore must be focused in the most effectual manner. Each micro-community has a characteristic 5 year disease mortality rate for 5 diseases or conditions of interest noted on the profile pages. These rates are added up and tracts with the highest mortality rate totals are given priority. Despite some sensational claims, this in no way implies that the tracts are “unhealthy”. It is simply a relative measure to prioritize limited resources. Each tract is compared to county and state mortality rates, thus providing the reader with a frame of reference.

PACE-EH: An Opportunity for a Community Voice in Health Matters

The PACE-EH process has a proven track record of success. As the health department facilitates the 13 steps of the process, micro-communities are able to mobilize their neighborhoods to identify common community health concerns, leverage resources, form profitable partnerships, and solve health disparities. Many times this can be done with minimal financial outlay. PACE-EH gives the micro-community a voice.  Community partnerships from health institutions sharing common goals bridges the gap of inactivity. These partnerships give the voice of the community power. And with power comes needed change.

Download the PDF version of our Community Health Improvement Plan 2017

Download the PDF version of our Community Health Improvement Plan 2015

Download the PDF version of our Community Health Improvement Plan 2013