Some employers are getting involved in community health promotion initiatives to reinforce their own employment-based health improvement goals.

To encourage such efforts, the American Recovery and Reinvestment Act of 2009 established a $1 billion prevention and wellness fund, of which $650 million has been designated for efforts to address chronic disease through evidence-based clinical and community-based prevention and wellness.

In addition, House and Senate health care reform proposals include funding for community transformation grants designed to set up a nationwide infrastructure for active living, such as bike paths, recreation centers and good nutrition, while seeking to eliminate health disparities.

“What we're looking at is, how can we bring the public and private sectors together to build a system that will support healthy choices in the community, in the worksites, in the schools, and align what the different partners are doing and the types of messages that we're putting out to the employee, who is also the community member,” said Sara Palermo, vp of the Mid-America Coalition on Health Care in Kansas City, Mo.

While employers “are spending a lot on health management efforts within the worksite, they've only typically got that employee eight to 10 hours a day, and there's a lot of things they can influence in the community that will make those healthier choices the default option,” Ms. Palermo said.

As part of this effort, the coalition this month is launching Building a Healthier Heartland, a program spearheaded by former Health and Human Services Secretary Michael Leavitt that began as a pilot led by the Midwest Business Group on Health in Chicago. The Kansas City and Chicago health care coalitions plan to merge their HHS-affiliated programs with their ongoing value-based insurance design initiatives with the help of some ARRA grant funding.

“It's a perfect fit for what we're looking to do,” Ms. Palermo said.

Michael Thompson, a principal at PricewaterhouseCoopers L.L.P. in New York, compares mounting national awareness of health promotion and disease prevention to the anti-smoking campaign that began in the 1960s with the U.S. surgeon general's health warning on cigarette packages. That effort eventually led to worksite, community and, in some cases, statewide bans on smoking in public places, he said.

“This represents a recognition that employer wellness programs need to fit into a broader community framework,” Mr. Thompson said. “It really requires a more holistic effort to change the course of society and employers are playing a major role in getting it started, but they can't accomplish it without a lot more support from their communities. We need to have the oars pulling in the same direction.”

Minneapolis-based Target Corp. recently announced innovative partnerships and wellness resources designed to support the company's focus on health and wellness among its employees. Target partnered with RedBrick Health Corp., also in Minneapolis, to pilot a wellness program among its employees while becoming a founding member of the Alliance to Make US Healthiest, a Washington-based coalition of more than 1,000 employers that strives to help U.S. residents become more physically and emotionally healthy.

The alliance evolved from Target's relationship with the Centers for Disease Control and Prevention in Atlanta, said Steve Lafferty, Target's director of benefits.

About 18 months ago, “we started talking to them about health improvement metrics. We wanted to leverage their science,” he said.

For the past year, Gary Earl, senior vp at CIGNA Corp. in Las Vegas, has been speaking to employer groups nationwide about how social and environmental influences can affect employees' health and productivity, drawing from his experience as head of benefits at Caesars Entertainment Inc. in Las Vegas.

For example, he found many employees lived in areas without neighborhood grocery stores, limiting their access to fresh produce. Moreover, they often discouraged their children from playing outside because many of the city's parks were inundated with drug dealers and users.

Mr. Earl's work is part of a larger project spearheaded by CIGNA called Communities of Health, which is guiding community leaders through an evaluation process “so they can determine what the community needs and then collectively determine how to meet those needs.”

“For example, it may start with something as simple as availability of transportation or income levels, overlapping with safety scores in playgrounds, the number of liquor stores, etc.,” Mr. Earl said.

The Partnership for Prevention, a Washington-based group of business, nonprofit and government organizations, was instrumental in getting funding for health promotion added to the proposed federal health reform legislation.

“We have been very engaged in the health reform debate and trying to ensure that prevention is included,” said Dr. Corinne Husten, executive vp and chief policy and program officer of Partnership for Prevention. “Businesses can do a great job within walls...but if the community isn't healthy, it's working against what employers are trying to do,” she said.