Exploring Equity in Multisector Community Health Partnerships Proceedings of a Workshop (2018) / Chapter Skim
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3 Improving Health Through Equitable Transformative Community Change
3 Improving Health Through Equitable Transformative Community Change
Pages 27-48
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From page 27... ...
.1 Teal VanLanen, a community activator for the Algoma School District, and Pete Knox, the executive vice president and chief innovation and learning officer at Bellin Health, then spoke about the Live Algoma2 project in northeastern Wisconsin. Following the presentations (highlights provided in Box 3-1)
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From page 28... ...
. • Community transformation requires understanding how the stories of commu nity residents with lived experiences and their insights about how the system works can be combined with the capacities of those who have more formal positions of power in these communities (Stout)
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From page 29... ...
"We call 100 Million Healthier Lives an unprecedented collaboration of change agents who are pursuing an unprecedented result of 100 million people living healthier lives by 2020," Stout said. "The way we are going to do that is not to go out and change them, it is actually by changing us, by transforming the way we think and act as people who are in communities and in systems of power, to transform the way we think and act to create health, well-being, and equity." Getting to that place, Stout said, will require unprecedented collaboration, the courage to ask questions about what is happening in a community, the courage to "fail forward,"6 and understanding that in coming together communities might create solutions and intentionally transform the systems that are creating inequity.
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From page 30... ...
. 9 This section is the rapporteurs' synopsis of the presentation by Jennifer Lacson Varano, the manager of community benefit and emergency management at Dignity Health Saint Francis Memorial Hospital, and Will Douglas, the manager of community impact for the Saint Francis Memorial Hospital Foundation, and the statements have not been endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 31... ...
Located just north of the Tenderloin, Saint Francis Memorial Hospital is a mission-driven, nonprofit organization that has served the Tenderloin and San Francisco for more than 100 years. "We have one of the busiest emergency departments, and we have invested a lot of time and money in our Charity Care program, as well as in building and strengthening relationships in the community to inform and design our Community Benefit program," Varano said.
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From page 32... ...
"We continue to learn how to do this with our community by co-creating with residents, using the framework of collective impact, convening stakeholders and residents to build consensus around issues and identify new ones, as well as solutions that resonate with the residents that are on the ground," Varano said. Participating in the 100 Million Healthier Lives initiative, she said, has helped the program learn how to integrate improvement science10 and the "Plan, Do, Study, Act" cycle into its everyday work to continue to stay focused and continuously adapt.
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From page 33... ...
With a sustained investment over the past 2 years, Tenderloin Safe Passage has become a safety project adopted by the Tenderloin Community Benefit District that stations 20 corner captains, the majority of whom are residents of the community, for 1.5 hours daily on 7 of the highest-need corners, creating a safe corridor for an average of 650 schoolchildren per week. Starting with Boeddeker Park and Tenderloin Safe Passage, TLHIP has been able to bring a variety of community organizations to the table, and the neighborhood is starting to see more positive changes occurring, 11 For more on bright spots, see http://www.100mlives.org/approach-priorities/ pioid-re o sources/?
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TLHIP also provided a grant to local artists to create a mural in Boeddeker Park to make it an even more appealing place for community activities. Working together, the backbone team of TLHIP -- i.e., the Saint rancis F Foundation, Saint Francis Memorial Hospital Community Benefit, and a multisector community advisory committee -- defined a common agenda that enables those organizations that serve the community daily through direct service to focus on strategic areas of need.
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From page 35... ...
. 14 This section is the rapporteurs' synopsis of the presentation by Teal VanLanen, a com munity activator for the Algoma School District, and Pete Knox, the executive vice president and chief innovation and learning officer at Bellin Health, and the statements have not been endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 36... ...
He has developed a nationally recognized framework for building community that he and his colleagues at Bellin Health have applied to inner-city schools and elsewhere and that serves as the basis of the Live Algoma program.15 Knox's goal is to use this framework to build a common language to tell stories about building communities wherever that happens. 15 For more information, go to http://livealgoma.org (accessed May 25, 2017)
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From page 37... ...
As part of the effort to entice businesses to move to Algoma, Bellin Health created a new community collaborative insurance product in which one-third of any shared savings accruing from this product will go to support and sustain community work. Creating this new type of insurance represents an attempt to provide a long-term source of dollars to support community building that improves health and well-being.
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From page 38... ...
She also pointed out that the programs growing out of this model are composed of community members. "For example," she said, "in the healthy children team, we have someone from law enforcement, someone from social work, a private school teacher, a public school principal, a Hispanic mother, and two youths at the table." The team is made up of a variety of people, each with a different perspective, who can talk about what it is in the Algoma community that creates a healthy child.
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From page 39... ...
To build momentum capable of activating the community, Live Algoma staff gave activation team members invitations to a celebratory Aim Primary Drivers Secondary Drivers • Identify the transformational leaders • Build the transformational skills • Ignite the passion Develop • Analytics Transformational • Goals Leadership • Dream big. Start small and learn Create Unified • Fail forward Passion, Vision, and • Create innovation to be involved in the change Message Within a • Start conversation within the community Community Building • Build strategic partnerships within and relationships Build Coalition for a across communities at the Collective Impact • Medical system access community • Inclusive to leave no one behind who wants level to to be involved achieve the Build Momentum • Sharing within and across communities triple aim • Health plan solutions • Finish what gets started Activate the Entire • Identify individual and collective passion Community to ignite personal contributions • Shine the light on the bright spots Build • Liberate Comprehensive • Empower people to take action Engine for • Community gives back funding Community Change • Moving the pillars of power • Health and well-being solutions • Utilize a common set of tools • Appropriate resources • Build a makerspace FIGURE 3-3 Building sustainable communities through social change.
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From page 40... ...
"People who lived their entire lives in Algoma did not know who some of the bright spots were." With the community activated, it is then possible to build the comprehensive engine for community change using a variety of tools and resources that will produce the social revolution needed to create a healthy community. VanLanen then discussed the third domain, which is having critical conversations.
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From page 41... ...
Identifying these bright spots and the things that community members are proud of pulls the community together, she explained, and turns challenges into opportunities for improvement. Live Algoma strives to keep community engagement at the center of the change process.
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From page 42... ...
We have to spread it to the younger generation." Stout added that Live Algoma is now sharing its work and successes with five other nearby communities in order to reduce poverty and increase equity. She noted that one lesson 100 Million Healthier Lives has learned is to "think about collective impact as not simply a group of ormal f
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From page 43... ...
Sanne Magnan asked Douglas and Varano if their initial focus on safety brought different partners into the conversation about improving community health outcomes. Douglas replied that the Community enefit B District, which is a body funded through a small tax on businesses in and around the Tenderloin, as well as some of the technology firms that have moved into the area, are now partners and have even taken over the T enderloin Safe Passage Program.
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From page 44... ...
Johnathan Heller of Oakland-based Human Impact Partners noted that the first panel spoke about the need to tackle power, oppression, and racism head on, and he asked how TLHIP was doing that. Varano replied that in September 2016 there were a number of violent acts in the community and for the first time in her experience, city officials approached them immediately to ask how they could help the Tenderloin.
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From page 45... ...
When participants leave this training, their first task is to build a plan of engagement for the different people in their community who need to be on a problem-solving team, including system leaders, community connectors, and the community members with lived experiences. She commented that this is not a static process, but one that keeps building on who is in the room and how their perspectives help create solutions.
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From page 46... ...
Stout agreed with this second theme and said that 100 Million Healthier Lives has a metric for that. In fact, she said, the program does not define the outcomes by which it will judge a community to be successful.
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From page 47... ...
IMPROVING HEALTH THROUGH TRANSFORMATIVE COMMUNITY CHANGE 47 measurements. VanLanen said that when she first started her work with Live Algoma, her idea was that obesity was the problem that needed to be addressed, but after partnering with community members, it became clear that the community thought the biggest problem was a dream deficit regarding future possibilities, particularly among the community's youth.
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