Proceedings of a Workshop
Multisector Community Health Partnerships: Potential Opportunities and Challenges
Proceedings of a Workshop—in Brief
On December 8, 2016, the Roundtable on Population Health Improvement held a 1-day public workshop at the James Irvine Conference Center of the Kaiser East Bay Community Foundation in Oakland, California. At this workshop, participants explored multisector community health partnerships that aim to address inequities and improve the health and well-being of communities. Individual participants discussed different strategies used by community partnerships to engage residents in community health initiatives. This Proceedings of a Workshop—in Brief is intended to highlight topics that individual speakers identified as opportunities and challenges to engaging a range of residents and other stakeholders in community-driven social change. A full proceedings of this workshop will also be released.
George Flores of The California Endowment welcomed the audience by asking people to reflect on what they were feeling about equity as they looked forward to 2017, particularly in the context of a very challenging and polarizing political climate. Flores noted that in a nation that is legally committed to equal opportunity for all, regardless of race, religion, national origin, or gender, it was troubling that the United States also produces and supports so many inequities. Flores emphasized that equality of opportunity can only be achieved if there is true equity and fairness in the society.
ACKNOWLEDGING HISTORY AND THE PRODUCTION OF INEQUITIES
Launched by The California Endowment in 2010, the goal of Building Healthy Communities (BHC), is to improve community health status by addressing determinants of health rather than spending on health care. Anthony Iton, senior vice president for healthy communities at The California Endowment, described how the foundation is investing $1 billion in 14 low-income communities in California over 10 years. BHC’s strategy involves capacity building, narrative change, partnerships, and policy advocacy to produce health equity and measurable results.
Iton reminded the audience that community inequities are the product of historical social forces and ideology. As an example, Iton read a quotation from President Abraham Lincoln, who believed that a “physical difference between the white and black races” would “forever forbid the two races living together on terms of social and political equality” (The New York Times, 1860). Iton also shared a quotation from the famous Dred Scott decision of the U.S. Supreme Court upholding separate and unequal treatment under the law and comments by Supreme Court Justice Antonin Scalia about the educability of African Americans at The University of Texas.1
Taken together, these exclusionary practices and narratives that assign different race-based values to human beings inform the current structural inequities and practices in communities today. Iton said we are afraid to talk about racism, “particularly in academic circles,” but “if you don’t talk about racism, don’t talk about classism, if you don’t talk about sexism and talk about strategies to develop a practice that’s antiracist,” it will be difficult to collaborate with
others for community social change. Iton went on to say that the BHC approach is to undo exclusionary narratives of who matters and who is American and instead to create and reweave a social compact focused on creating “real social, political, and economic power in a critical mass of people living in these communities.”
DISMANTLING STRUCTURAL RACISM
Andrea Manzo, a hub manager for BHC in East Salinas, California, emphasized that the “legacy of racism in this country and particularly the damage that institutional and structural racism have had in communities of color such as Salinas” are central to the work that she and her partners do to dismantle structural racism through Healing-Informed Governing for Racial Equity in Salinas, California.2 Manzo shared her approach to dismantling systems of power, which is to acquire the power necessary to change the system itself. In their work to build power for people of color in Salinas, Manzo and her partners ground their work in a healing-informed approach that emphasizes capacity building and making connections with people across sectors. Manzo emphasized that part of capacity building is using a shared language so that residents know how to talk to government officials in order to influence them to take action in support of healthy communities. The value of building relationships, said Manzo, is that they provide an opportunity for people who normally distrust the government to understand their own value. Residents learn how to analyze structural problems and learn that they can push leaders to change their policies over time to improve health.
CHANGING COMMUNITY NARRATIVES AND BUILDING THE CAPACITY OF LEADERSHIP TO BE RESPONSIVE
A common narrative of Salinas, said Manzo, focuses on violence, particularly gang violence. One way to counter that narrative is to develop a structural analysis that “demonstrates that violence is a symptom versus the problem.” Changing the narrative means shifting the way people talk about their community and focusing on the strengths, resilience, and hard work of the community’s residents. It means seeing youth as assets and leaders rather than liabilities, as they are commonly portrayed in the mainstream media, said Manzo. It also means reaching out across sectors to people who may accept the narratives about gang violence and working together to create solutions to the root causes of violence, such as lack of affordable housing, prevalence of low-wage jobs, and lack of education and vocational opportunities. In Salinas, Manzo and her colleagues hosted a Healing-Informed Governing for Racial Equity training with city staff and community leaders. This training allowed participants to learn about and explore inequities as a way to build relationships based on trust. It also allowed Manzo and her collaborators to engage government leaders in changing the way they look at problems and find solutions.
Manzo emphasized that due to the power differences between community members and leaders, BHC collaborators focus on building the capacity of government leaders to engage communities differently. Manzo offered the example of the city’s Department of Public Works investing more in parks after skaters asked for basic amenities, a water fountain, and lights. Manzo noted that collaboration is not about “who screams the loudest” but more about who has been historically excluded and has greater needs. As young leaders, these skaters helped to reframe the negative narrative of youth in Salinas as they advocated for better parks and encouraged more investment and ultimately an improvement in the quality of life for all residents. The goal of BHC’s work in Salinas, said Manzo, “is to liberate us from this legacy of racism and oppression and to give the opportunity for people to actually have a chance to be healthier because as it stands now, the odds are not in their favor. And in order to do this we need to continue organizing and building power to keep our systems accountable to combating structural racism.” During the discussion, Manzo mentioned that before The California Endowment and BHC, no organizations were grounded in and invested in residents with the knowledge and experience to come up with community solutions that work.
ACTIVATING THE COMMUNITY FROM WITHIN
In Algoma, Wisconsin, there has also been success at bridging differences for meaningful conversations and activating change. Teal VanLanen, a community activator for the Algoma school district and the Healthy Children Team lead for Live Algoma, introduced her community by saying that it is 95 percent white, 25 percent of the student body has disabilities, 55 percent of the students live in poverty, and more than 50 percent of the population is 55 or older. Live Algoma is 1 of the 24 communities involved in the 100 Million Healthier Lives Spreading Community Accelerators Through Learning and Evaluation (SCALE) initiative to create communities of solutions with the support of the Robert Wood Johnson Foundation, said panel moderator Soma Stout of the Institute for Healthcare Improvement.
When residents in Algoma started to build their community capacity they had critical conversations with different community members, including the mayor and youth, about some of the challenges in their community, said VanLanen. By
listening to what matters to the youth, the adults were “activated” and became change agents in the community. During the discussion, VanLanen added that using the SCALE framework3 and leading from within require individuals to talk about and acknowledge their own implicit biases when they come to the table. Because of the power differences among residents in communities, it is necessary to help some people to build their capacity and language. Connecting to themes from Manzo’s presentation, VanLanen said this means building the capacity of key stakeholders and community members with lived experiences to have a conversation with each other.
VanLanen added that when the community holds critical conversations in Algoma, even in the classrooms, there are conversations about equity, who is not thriving, and who is not at the table. Pete Knox, the chief innovation and learning officer for Live Algoma and the executive vice president for Bellin Health, noted that from a systems perspective, Algoma is composed of interdependent parts of employers, children, individuals, and community. At the center of this system of overlapping parts are the commons or community assets that need to be built, nurtured, and protected by everyone in the community system. Each of the community (system) components has an activation team of community members representing different sectors, said VanLanen. For example, the Healthy Children Team includes a member of law enforcement, a social worker, a private school teacher, a public school principal, and a Latino mother. From this collective of different perspectives, members are able to work toward a “true shared vision” for the community.
During the discussion, Knox pointed out that Algoma residents see co-creation, critical conversations, and scale as part of growing a grassroots social movement. Though other communities may use different language, they have similar aims to achieve community-driven social change.
ROOTING WORK AND SOLUTIONS IN LIVED EXPERIENCE
Several participants, including Kanwarpal Dhaliwal, Will Douglas, Manzo, Stout, and VanLanen mentioned the significance of investing in and understanding the stories and knowledge of people with lived experience who are crucial to identifying solutions that will work for the community. Dhaliwal is a co-founder and community health director for the RYSE Center (part of BHC) in Richmond, California. RYSE emerged from young people organizing in 2000 to change the conditions of violence in their community for future generations. RYSE takes an intersectional approach to health and justice by serving as an antioppression organization that focuses on public health, racial justice, queer justice, and gender justice through a multitude of services and programs across community health, education, youth justice, media, arts, and culture. Similar to how Manzo described the narratives about gang violence in Salinas, Richmond is often characterized as a dangerous city. Dhaliwal noted that part of RYSE’s work focuses on identifying interpersonal violence as a symptom of structural violence and the “dehumanization and subjugation” to which communities such as Richmond’s are subjected. Dhaliwal and her colleagues also work to identify the structures and relationships that need to be changed to create the conditions of health, healing, justice, equity, and liberation for youth in their communities.
It is important to root the work of RYSE in “lived experience and the process of understanding the structural forces” affecting communities in Richmond, said Dhaliwal. She emphasized that focusing solely on behaviors risks replicating systems of oppression, inequity, and dehumanization. Dhaliwal said RYSE’s work, such as its hospital-connected violence intervention program, is designed to ensure the needs, priorities, and interests of young people of color are understood and invested in. By way of example, Dhaliwal described how after they get consent, RYSE staff meet with youth at the hospital (which is 24 miles from Richmond) who have been shot, stabbed, or assaulted and advocate on their behalf to ensure they get the help they need.
REFRAMING RELATIONSHIPS AS RESOURCES: USING DATA TO DRIVE COMMUNITY CHANGE
Data are recognized by Dhaliwal and her colleagues as a potential resource to change relationships, structures, and systems. RYSE uses data from the local public health department, foundations, investors, and other sources to inform their community actions and strategies. In partnership with the School of Public Health at the University of California, Berkeley, RYSE conducted a Listening Campaign in which they talked to more than 500 young people about their experiences of violence, trauma, coping, and healing with the intent of taking what they learned to change systems. Through this institutional relationship, which Dhaliwal emphasized was a resource in itself, Berkeley provided consultation on the study design, coding the interview data, and analysis with an understanding that the Berkeley team played a support role in the partnership, as RYSE led the advocacy and use of the data to create systems change.
As they were receiving the data and findings, Dhaliwal and her colleagues brought together stakeholders, including other community benefit organizations, groups who are part of the Healthy Richmond Community, and public systems, to talk about the emerging findings regarding youth and trauma. The number one coping mechanism youth identified to deal
with trauma and distress was smoking marijuana, said Dhaliwal. RYSE is the only harm reduction agency in Richmond, she added. If RYSE took a behavioral intervention approach, they would need to start funding cessation programs. However, because their responsibility is to young people, said Dhaliwal, this finding means that they need to meet youth where they are and develop different strategies. They are now working with some of their partners to try to remove some of the zero-tolerance drug zone clauses from contracts in order to serve these youth through the mental health system.
LISTENING, BEING FLEXIBLE, AND CHANGING STRATEGY TO SUPPORT THE COMMUNITY’S NEEDS
Yesenia Castro, a coalition coordinator for the Mid-Columbia Health Advocates for the Columbia Gorge region of Oregon and Washington, works as a community health worker with a primary focus on Latino issues in the community. The current demographics of the area are majority white with 30 to 40 percent Latino, said Castro. In contrast, she said, the schools are 65 percent Latino, approximately 0.1 percent African American, and approximately 1 percent Native American. Castro described how her work transitioned from a focus on being a connector between county decision makers and community residents to helping Latinos become decision makers themselves.
When Castro started her work, she and her team, including other community health workers, went into the community and asked people their needs, and then they went to county decision makers to form partnerships in order to implement policy changes that met the community’s goals. What Castro and others learned is that listening to the stories of the community members was crucial to providing support where it mattered. Some community members wanted to know how to run for the school board, city counselor, or other elected positions, and so that is how the focus of the coalition changed. Staff helped residents to form committees and assisted people in running for office in order to support Latinos in becoming part of the decision-making process and the leadership in the community.
Castro said that the collaboration is “true and genuine” and that decision makers now actively engage with community members around policy change and the way they do business. Equity is “sexy,” said Castro, and everybody wants to be involved in creating it. The biggest success has been that people are collaborating, talking, and listening to one another, and this ongoing conversation has led to a shift in the community’s thinking toward a greater focus on policy as a way to implement lasting change.
SUPPORTING DIFFICULT CONVERSATIONS AND USING DATA FOR COLLECTIVE IMPACT
The Tenderloin Health Improvement Project (TLHIP) includes more than 100 public and private partners focused on improving the lives of residents of the Tenderloin neighborhood of San Francisco, California, said Jennifer Lacson Varano, manager of community benefit and emergency management for TLHIP. Varano described the Tenderloin as an ethnically diverse neighborhood that covers roughly 40 square blocks and has a median household income of $27,269. Fifteen percent of families live below the federal poverty level, and there is little open space, a high concentration of establishments that sell alcohol, and a high rate of emergency room visits, she added. However, the Tenderloin is also a neighborhood with more than 100 nonprofits spanning health, housing, arts, youth, senior, and social services. As a SCALE community, TLHIP works with multisector partners in the community to disrupt organizational silos and to co-create solutions with residents.
By using a collective impact approach, explained Will Douglas, manager for community impact for TLHIP, the TLHIP team acts as the backbone and supports community members as they co-create a common agenda for community change. TLHIP assists residents with data collection, evaluation, and consultations. It also provides space to hold community meetings where the staff has facilitated difficult conversations about topics such as injection drug use, community safety, and community improvements. As an example, Douglas mentioned that people from public health tend to have a very strong harm reduction philosophy, so it was challenging to facilitate conversations about injection drug use with active drug users, business representatives, and staff from the public health department. Douglas added that it took these stakeholders about 2 years of conversations to find some common ground on this issue. This exemplifies what many speakers (Dhaliwal, Manzo, VanLanen, Varano) emphasized as the most effective technique, which is to meet people where they are.
During the discussion, Douglas added that, depending on the audience and the best way to communicate with them, the community has conversations about structural racism and who has power in the community. Douglas emphasized that the challenge as a backbone organization and funder is to effectively integrate residents’ voices into the work they do. Thus, “the answer is not to tell the story of the community, but actually let the community tell their own story.”
Similar to Dhaliwal and her colleagues in Richmond, TLHIP in San Francisco uses data to inform its decision making and interventions. Based on a citywide community health needs assessment, in 2014 TLHIP and its partners identified safety as an entry point for working together to improve the health of residents, explained Douglas. Based on the data, TLHIP worked with its partners, including law enforcement and department of health and housing advocates, to select four action zones. Douglas described how the partners focused their interventions in two areas, Boeddeker Park and Tenderloin Safe Passage, in
what were to become bright spots, meaning positive spaces in the community. Boeddeker Park has “historically been one of the most dangerous areas,” said Douglas, and though it was the largest open space in the neighborhood it was underused. Thus, TLHIP funded the Boys and Girls Club to be the master tenant of the park in late 2014. Today, the park is one of the brightest and safest spaces in the neighborhood, he added.
Tenderloin Safe Passage Program is an initiative in which residents work with others in the community to establish safe corridors for children and seniors to walk throughout the Tenderloin neighborhood, said Douglas. For example, the corner captains are resident safety leaders who help kids safely commute from school to aftercare programs. Douglas added that Safe Passage has become a program of the Community Benefit District, which is funded through a small tax on businesses in and around the neighborhood, including tech firms. The Community Benefit District’s ability to speak about cleanliness and safety from the perspective of businesses has been critical to work that is often framed by people who speak the language of public health and nonprofits. Businesses, added Varano, have been great partners in Tenderloin and have been involved in the community.
As TLHIP has progressed with this work, Douglas said, they have evolved their framework for thinking about broad-based safety and creating opportunities for residents to make healthy choices. As TLHIP focuses on additional parks and safe pedestrian passages, the TLHIP team continues to be thoughtful about community engagement and neighborhood voice as being “front and center” of the process. As a SCALE community, TLHIP learned how to create authentic community, said Douglas, by leading from within (coming as one is); leading together (acknowledging that one is not working alone); and leading for outcomes (identifying data and measurement to share critical outcomes).
BUILDING AND TRANSFORMING COMMUNITY THROUGH LEARNING AND SHARING
Being a SCALE community also greatly informs the collaborative work in Algoma. In addition to following the principles of co-creation outlined by Douglas, VanLanen noted that in her role as a community activator she helps with capacity building and assists in identifying tools and resources needed to achieve the community’s goals. VanLanen’s team uses stories and data to communicate with people in the community about what residents need. In this way they can speak to a variety of residents who find different kinds of information compelling. VanLanen added that 33 staff members are learning improvement science 4 and how to scale up initiatives. These processes allow people with different experiences and knowledge to participate in driving community social change.
VanLanen said bright spots are important for identifying what is good about a community and pulling people together. They are also important for reframing challenges as opportunities and meeting people where they are. A common theme across the communities featured at the workshop was the role of youth in informing and leading transformational change. VanLanen shared an example of some high school students who learned CPR and used improvement science to scale up the initiative by teaching CPR to more than 800 people at local businesses, an NFL Green Bay Packers game, and within the Hispanic community. Panel moderator Stout added that it was the 12th graders who were initially trained in CPR. These high school seniors decided it would be a good idea to teach sixth graders improvement science so they would be activated to participate in improving the health and well-being in their community and contribute to the overall sustainability of the initiative.
Building on this success, VanLanen said three of the sixth graders decided they wanted to eliminate food insecurity in their school. By drawing on what they learned from the high school seniors, the sixth graders managed to hold a meeting with 23 key stakeholders in their community to discuss the issue and their proposed solutions. The students’ aim was to get 30 percent of the ugly produce that was discarded by local grocery stores to be donated instead to the school. This program is still going on today with bruised apples and other healthy snacks donated by both local stores to the schools.
Knox added that solution-based thinking is not about solving a problem, but rather about a community dreaming about what it wants to become. Both VanLanen and Varano emphasized the importance of staff coming to the table to listen to residents and other community members and not arrive with assumptions about what the answers are to address community issues.
COMBINING RESOURCES AND TRANSFORMING FRAGMENTATION INTO A COHERENT PLAN FOR ACTION
Action-oriented collaborative leadership is a significant part of what 24:1 is accomplishing in Missouri. Stephanie Co is the special assistant to the president of Beyond Housing, a nonprofit community development organization based in North Saint Louis County, Missouri, that leads the 24:1 initiative. The name 24:1 is derived from the 24 municipalities that make up the Normandy School District. Combined, these small municipalities have a population of about 40,000 people. In part, these
municipalities exist because of structural racism and the historic legacy of restrictive covenants that excluded people of color from living in what used to be all-white suburbs, said Co. As the demographics of the area changed, the people who now live there inherited the political fragmentation of the earlier time. In the midst of the 2008 housing foreclosure crisis as well as the threat of loss of accreditation for the Normandy School District, mayors and other elected leaders started meeting and talking strategy to combine resources in order to solve problems as a collective.
Beyond Housing was initially invited to work on housing issues, said Co. However, as home is what makes a thriving community, collaborators developed a robust community engagement process to form the 24:1 Community Plan to articulate their shared vision to build collectively strong communities, successful children, and engaged families. Because health outcomes are based on where people live, community components in the 24:1 plan include affordable housing, good schools, and wraparound services for early childhood and kindergarten readiness, as well as ensuring people have access to food.
One way 24:1 addresses these myriad issues is to form different coalitions, such as Five by Age Five, which is a group of advocates, organizations, and day care providers that makes sure children have access to opportunities from an early age to prepare them for kindergarten, said Co. Other coalitions focus on issues such as trauma, mental health, and behavioral health; access to food and clothing; and childhood obesity. Co added that improving child wellness is the highest goal for the school district and 24:1.
FRAMING COMMUNITY RESIDENTS AS ASSETS
Building on themes discussed throughout the day, Castro, Co, and Shelton McElroy each shared brief demonstrations of interactive activities they use in meetings to engage communities in social change. Of note, these speakers represent three of the seven community winners of the 2016 Robert Wood Johnson Foundation Culture of Health Prize. McElroy is a project manager for the United Way of Louisville, Kentucky. His primary area of focus is initiatives that support early childhood development and kindergarten preparation; he also works on service learning projects to beautify the community. The community McElroy and his team work in includes one of the last housing projects in Louisville. McElroy engaged the audience in the room in a provocative activity focused on asset framing and language. To begin, McElroy showed a slide with a common organizational mission statement: “The Center’s mission is to transform lives, schools, and troubled neighborhoods, from the inside out . . . By using a national model of youth violence reduction and high-risk student mentoring program . . . Designed to operate in the most trouble-plagued schools in urban centers with high levels of crime and violence.” McElroy also showed a slide with terms to define “who we are” such as value-generating, trainer, faith-based, provider, research-based, mentor, change agents, stabilizer, educator, and promoter. On the other side, “who they are” used terms such as low-income individuals, underserved, problems of poverty, troubled neighborhoods, priority zip code, high risk, at risk, youth violence. McElroy pointed out that such language frames the community through a deficit lens. He added that he did not hear any deficit framing used by VanLanen or Knox when talking about Algoma: “Is it because 97 percent of the population is white?” asked McElroy. It is difficult to see people as an asset and a deficit at the same time, he said. He then asked everyone in the room to stand up and look directly at another person and tell the other person what was wrong with them. The participants in the room responded with gasps and uncomfortable laughter.
This asset-framing exercise is a way to emphasize, from the perspective of service providers, that there is a need to change the language used when talking about some of the communities being served, said McElroy. For example, instead of using the term “at risk” consider instead “children of promise.” If the conversation is continuously framed around terms like “underserved,” then people tend to be anchored as though they are underserving. Positioning people and communities in that manner creates a space where people have to be “saved” by others, said McElroy. Asset framing is about rejecting narratives that denigrate people, he added.
INVITING PEOPLE TO THE TABLE: BEING ACTIVE AND INCLUSIVE
Co gave the audience a scenario centered on forming a coalition on child health and wellness in a community. At each table, participants answered two questions: (1) Who do you invite to join the coalition? and (2) What are three ways and approaches you will use to share power and ownership in the coalitions? In terms of whom to ask to join, participants’ answers included local hospital, school districts, child care providers, Head Start, public health departments, behavioral health departments, community members, youth, health advocates, faith-based community, homeless shelters, tenant organizations, senior citizen centers, fire departments, community college, grandparents, and policy makers. In terms of approaches to power sharing, individual participants in the group table conversations suggested developing group principles together; creating an equitable and inclusive participatory process from the beginning; ensuring language access for non-English speakers; providing rotating meeting sites; using processes that enable trust; using transparent decision making; and encouraging individual reflection on positional power.
The purpose of the exercise, said Co, was to emphasize the significance of inviting more people with grassroots perspectives to participate in community collaborative initiatives, rather than primarily having “health professionals deciding for the community.” Similar to Live Algoma activation teams, for example, this type of activity means including residents with a range of expertise such as football coaches, food pantry volunteers, boxing gym instructors, and others who will bring different ideas into action. In addition, Co said, 24:1 has subcommittees so that members who may not be comfortable speaking in larger coalition meetings or one-on-one meetings have opportunities to contribute. Co added that the social experience of the meetings is important for coalition building. In addition to providing food and having interactive activities, meetings are important opportunities for individuals to get to know people whom they may not otherwise meet.
In Mid-Columbia coalition meetings, added Castro, child care and a stipend are provided in addition to dinner, because expecting people to participate in evening meetings after working all day means they should receive something in return. Castro explained that meetings also include reports on what happened in the community with a particular action so there is continuous communication. Castro agreed with Co that getting to know people better is essential to building trust among people in coalitions.
During the discussion, McElroy was asked how to make systems leaders comfortable at meetings. He responded that his team has had good experiences bringing many people to the table. McElroy and his collaborators have successfully created spaces for “network nights” when leaders, service providers, practitioners, and community members share a meal. He said bringing people together to sit across from others with a different role in the community has changed “the power dynamic and created a real awesome space” to such an extent that they hold monthly meetings with systems leaders.
Castro introduced the audience to an example of a movement-building activity rooted in popular education that she and her colleagues use as a way to get people to discuss some of the challenges and barriers to building community health partnerships. The interactive activity involves throwing around the room a cabbage created of leaves of paper as music is played. When the music stops, whoever has the cabbage opens up a leaf and reads aloud one of the challenges and barriers to effective community partnerships. Examples of leaves included insufficient time spent on coordination and facilitation of partners, turnover, funding, and lack of trust.5
During the discussion, Castro and Co both said trust is the biggest factor in successful community engagement. Castro added that a safe and accessible space is also important, particularly for rural communities in the Columbia Gorge region. In answer to a question about community fatigue, Co said their collaborative uses different forms of engagement to elicit community feedback by meeting residents where they are, such as in grocery stores, or by using community street teams to go door-to-door to ask people questions. Castro added that building the agenda together with community members is a way for organizers to demonstrate they are listening. An example is including speakers whom community members have specifically requested. Castro also noted that if there is low attendance at meetings, it is time for organizers to ask why. When people are engaged and find the collaborative meaningful to them, they will let organizers know by showing up, Castro added.
Panel moderator Jomella Watson-Thompson of the University of Kansas added that celebrating accomplishments is also an important way to get through moments of community fatigue, echoing other speakers’ emphasis on celebrating wins and bright spots. Watson-Thompson added that reframing the conversation to make it clear that this is a collective struggle to make the community better also indicates that attendance is in the best interest of the community. McElroy added that it is also important to help people to understand that even if they will not see or benefit from the result of an effort, what they are doing is worthwhile for others, which is similar to how Dhaliwal characterized the emergence of RYSE in Richmond.
McElroy said success is seeing leadership cultivated from within the community and going “into spaces and seeing faces that generally were excluded.” Co noted that resident leaders are important in part because of staff turnover in backbone organizations. Resident leadership can be integrated into the plan for coalition building from the very beginning, Co added. By nurturing this leadership, community members will eventually have more knowledge than some staff and provide continuity. These community resident volunteers could be recognized and charged with doing a lot of the work because they are more likely to stay in the community. Castro also pointed out that community health workers are important because institutional leaders like CEOs have such high turnover that they do not have the same connections as others who were born and raised in the community and plan to stay.
Throughout the day, all the speakers (Castro, Co, Dhaliwal, Douglas, Knox, Manzo, McElroy, VanLanen, and Varano) mentioned that they engage residents by talking about making the community a better place to live. In response to a
question about framing community engagement efforts as being about health, McElroy said, “When you’re in the community you might not use [the term health], but everybody wants better. Everybody wants better for their family. They want better for their neighbors. They want better for their community, and that’s health.” That desire for something better is why there are many opportunities to engage residents in multisector partnerships to equitably improve community health and well-being.♦♦♦
The New York Times. 1860. Mr. Lincoln and Negro equality. The New York Times. December 28. http://www.nytimes.com/1860/12/28/news/mr-lincoln-and-negro-equality.html?pagewanted=all (accessed February 28, 2017).
DISCLAIMER: This Proceedings of a Workshop—in Brief was prepared by Darla Thompson as a factual summary of what occurred at the meeting. The statements made are those of the rapporteur or individual meeting participants and do not necessarily represent the views of all meeting participants, the planning committee, or the National Academies of Sciences, Engineering, and Medicine.
The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop—in Brief rests with the rapporteur and the institution.
REVIEWERS: To ensure that it meets institutional standards for quality and objectivity, this Proceedings of a Workshop—in Brief was reviewed by George Flores, The California Endowment, and Mary Lou Goeke, United Way of Santa Cruz. Lauren Shern, National Academies of Sciences, Engineering, and Medicine, served as the review coordinator.
SPONSORS: This workshop was partially supported by the Aetna Foundation (15-1381), The California Endowment (#20171618), Department of Health and Human Services (HHSP23337054), General Electric, Health Resources and Services Administration (HHSH25034007T), Kaiser Permanente, The Kresge Foundation (R-1512-255471), and Robert Wood Johnson Foundation (#73263).
For additional information regarding the meeting, visit http://nationalacademies.org/hmd/Activities/PublicHealth/PopulationHealthImprovementRT/2016-DEC-08.aspx.
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2017. Multisector community health partnerships: Potential opportunities and challenges: Proceedings of a workshop—in brief. Washington, DC: The National Academies Press. https://doi.org/: 10.17226/24784.
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Copyright 2017 by the National Academy of Sciences. All rights reserved.