Submitted by presenters
James E. Bloyd, Bonnie Rateree, and Felipe Tendick-Matesanz1
DESCRIPTION OF CROSS-SECTOR MODEL USED
PLACE MATTERS is an initiative of the National Collaborative for Health Equity. Cook County PLACE MATTERS (CCPM) is 1 of 21 teams in the United States, designed to build the capacity of local leaders and communities around the country to identify and address social, economic, and environmental factors that shape health inequities. The vision of CCPM is to build a health equity movement that works to eliminate structural racism and creates the opportunity for all people of Cook County to live healthy lives. The name reflects the phenomenon of “accumulation of negative conditions in certain communities” as a result of “larger social forces and injustices within American society,” according to three of the founders of the initiative—Gail Christopher, Vincent LaFronza, and Natalie Burke.2
CCPM raises awareness about the existence and root causes of health inequities in the Chicago area; works to increase the power of communities where people are sicker and die sooner; and takes action to promote healthy public policy. In order to address its desire to change existing power relations that constrain community change while being aware that it is at
1Reprinted as submitted by the presenters.
2Christopher, G., Lafronza, V., and Burke, N. 2010. Place matters: Building partnerships among communities and local public health departments. In Tackling health inequities through public health practice: Theory to action a project of the National Association of County and City Health Officials (2nd ed., pp. 458-474). New York: Oxford University Press. P. 458.
the same time deeply embedded in those power relations,3 CCPM is guided by leaders from multiple institutions and backgrounds, in order to work toward an ideal of increased democratic control and accountability, while limiting dominance of any one institution. Therefore, the Cook County Department of Public Health does not “control” or make decisions for CCPM, despite providing key staff support for the team.
At a press conference in July 2012 at the release of “PLACE MATTERS for Health in Cook County: Ensuring Opportunities for Good Health for All,” Cook County Board President Toni Preckwinkle thanked the CCPM team for the report and observed that “it is shameful that we live in one of the wealthiest countries in the world and that a person’s life can be cut short by more than a decade because of factors outside her or his control. People living in areas with a median income greater than $53,000 per year have a life expectancy that is almost 14 years longer than people living in areas with a median income below $25,000 per year.”1
Sectors included CCPM focuses on grassroots communities and labor in the food system, in order to reduce poverty and income inequality, which are at the heart of the obesity epidemic according to researchers Adam Drewnowski and Kate Pickett.
Lessons learned from initiative are that the distribution of resources for an equitable distribution of quality social determinants of health (SDH) is highly political; challenging structural racism is key; and the individual behavior and risk factor model of health is the common perspective.
Barriers to establishing the initiative include a lack of understanding of the SDH and policy implications; a dependence on volunteer and in-kind staff.
Accelerating this cross-sector work will require recognition of the value of alliances with social movements of low-wage workers in racialized, gendered workplaces; specific statements and actions from public health leaders at the federal, state, and local levels that support this work; and prioritizing relationship building with residents of neighborhoods affected by unjust and preventable health inequities.
A core element needed for spread is resources and technical assistance at the national level, while features needed to allow for local adaptation include local decision-making on policy and strategy; organizational struc-
3Please see Himmelman, A. T. 2001. On coalitions and the transformation of power relations: Collaborative betterment and collaborative empowerment. American Journal of Community Psychology 29(2):277-284.
ture and leadership fitting the local context; and recognition of the potential of “non-health” sectors initiating new projects.
The partnership of CCPM with south suburban Harvey, Illinois, resident Bonnie Rateree exemplifies CCPM’s commitment to community sector work toward assuring an equal distribution of high-quality education. Ms. Rateree uses urban gardening as a community activity promoting education, organizing and nutrition. Schools in Harvey and nearby suburbs, where a majority of the population are people of color, are challenged to provide adequate financing in the face of a reliance on local property taxes. Illinois ranks worst among the states in this reliance, which has lead to what Ralph Martire at the Center for Tax and Budget Accountability judges to be “structural racism” in which black and Latino children are selected for low-quality education.
CCPM’s partnership with Restaurant Opportunities Centers (ROC) Chicago exemplifies the understanding that food justice includes the struggle for justice by low-wage “back-of-the-house” workers in Chicago’s expanding restaurant industry. According to research by ROC Chicago, income, working conditions and career advancement opportunities are systematically limited and structured along lines of race/ethnicity and gender.
ROC United is the only national nonprofit dedicated to improving wages and working conditions for the country’s more than 10 million restaurant workers. It is a member-based national workers center with more than 10,000 members with local offices in 12 major cities. ROC United’s innovative approach to system change has three major components: research and policy, workplace justice, and promotion of the high road to profitability.
Through participatory-based research guided by strong academic alliances ROC United is able to produce high-quality data outcomes that can guide policy recommendations.
Through strong supportive structures that educate workers on workplace rights as well as allow space for organizing efforts ROC United is able to help workers produce positive changes that improve working conditions at both restaurant unit and corporate levels.
Through industry training programs that promote career ladders for those most disenfranchised, building business alliances for shared prosperity, supporting and promoting the ethical consumer market, and showcasing and developing new business models for shared prosperity ROC United is able to provide a human rights framework and foundation in the restaurant industry.