Tag Archives: community engagement

Public Health in Action – Linked Up/In

links-of-the-chain-517550_960_720

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” –Margaret Mead

Margaret Mead’s quote eloquently describes what I see on a regular basis living and working in Durham, North Carolina. Since moving south from Washington, D.C. two years ago, I’m consistently humbled and inspired to hear what various groups are doing to improve the local community.

I recently attended a meeting hosted by the North Carolina Chapter of the B Corporation and heard a brief presentation from local B Corp Seth Gross, owner of Durham-based brewpub, Bull City Burger. In his remarks, he described how he opened Bull City Burger in 2011 and noticed a significant turnover in staff he had during his first year. After thoughtful consideration, he decided to focus more time, effort and resources on creating a work environment that was conducive to staff retention and a greater community impact. Bull City Burger was one of the, if not the, first restaurant to become certified as a B Corp in 2014. His leadership, willingness to share his story and advice to other restaurateurs and business owners have inspired countless others. North Carolina boasts 37 certified B Corps throughout the state.

Seth’s story with Bull City Burger is just one story among so many others that reflect the city’s level of community engagement.

My interview with Rob Shields, below, takes a deeper dive into the non-profit organization ReCity and its role in “rewriting the story” of Durham.

*********

“Durham incubator works to aid youth employment” local ABC news clip: http://abc11.com/video/embed/?pid=1722793

Rob Shields, Executive Director of ReCity

Me: How did you end up doing the work that you’re currently doing?  Describe your journey to your current role as Executive Director of ReCity.  Describe why you’re passionate about addressing youth disconnection…why others should care about the work you’re doing.

Rob Shields: I’ve been in the youth development space for my whole career – sports coach to a campus-based youth ministry Fellowship of Christian Athletes (FCA) to my current role as Executive Director at ReCity – and although my roles have differed, my professional interests have been in serving youth.

Through the years, I became more aware of division within communities. It really opened my eyes to the reality that communities of color experienced in daily life. The gap between rich and poor was huge and I became discontent with structures and systems that reinforced widening of that gap. From there I wanted to focus on community development and envisioned a thriving community where all individuals had opportunities to succeed. And that’s what attracted me to this role at ReCity. I wondered if this model could this be the solution to magnify programs that were already working and facilitate connections to foster collaboration between those programs. We aren’t trying to compete or reinvent the wheel, but our driving force is how best to serve the community.

I have a strong conviction and belief that talent is equally distributed but opportunity isn’t. And this bothers me. Everyone has dignity and we all have God-given skills and abilities and I want to be part of a city that has opportunities for all to find their way. The gap between rich and poor is too wide and ReCity would ideally play a role in creating the city as it should be.

Me: What inspires you on a daily basis, especially when things get hard?

RS: I draw a lot of inspiration from my Christian faith. My belief in serving a god that is redemptive and restorative in nature. I’m inspired to follow in his example of being involved in work that restores and I feel called to do so. My wife and kids are another source of inspiration and perspective. The startup world is tough and it’s so easy to lose one’s identity in work. My family provides me a constant reminder that I have other priorities that I’m responsible for. They bring balance by slowing me down to a marathon pace when I’m normally sprinting.

Me: Can you tell us more about ReCity and your vision for the next 5 or 10 years?

RS: ReCity is a co-working space for nonprofits and mission-driven organizations committed to restoring opportunities for disconnected youth and their families in Durham. Our space empowers our partner organizations to work alongside each other to close the opportunity gaps in our community through strengthening collaboration and pooling resources as well as social capital to achieve collective impact.

In five years we envision ReCity playing a role in rallying the city to act collectively to address social issues like youth disconnection. And since youth disconnection is a complex mix of underlying core social issues, a focus on youth disconnection specifically would simultaneously address disparities and injustices in other areas like education, housing, and transportation among others. We hope to provide a path to stable employment to 1,000 youth by our third year.

In 10 years, I can see our model as a template to address any complex social issue in any city. The beauty in our model is its simplicity. Living out shared values together in a shared space can accelerate the collaboration needed to solve complex problems plaguing cities nationwide. At the core, these issues are not unique to Durham and we hope that others can find value in what we’re doing.

Me: What role does the community have in addressing social issues like youth disconnection, poverty, unemployment, etc.?

RS: Community leaders are vital in shaping our work. We fully recognize that it’s their community; they are the most invested and are the key stakeholders, which is why we follow their lead when it comes to planning and decision-making. ReCity’s role in addressing youth disconnection in Durham has evolved since our inception because of their unwavering support, input and feedback.

Leaders in the community have the biggest voice in addressing social issues, and since ReCity doesn’t provide direct programs like many non-profits, we have to be very selective in working with organizations that are well-respected in the greater Durham community. These organizations must use appropriate methods when addressing core issues, with a focus on personal and professional development over reinforcing the need for ongoing services. Durham’s population is culturally diverse, therefore the youth we serve are equally diverse. 56% of ReCity partner organizations are minority-led, which is critical for us because one our driving core values as an organization is to reflect the diversity of the community we serve.

Me: What are the current needs in the Raleigh-Durham metro area (or focus in on the city you live in) as they relate to social determinants of health (i.e SES, poverty, access to care, transportation, safety, etc.)?

RS: Affordable housing is a huge concern, which is why I’m excited our network has added partners doing amazing work in this area like Housing for New Hope and Jubilee Home. Providing shelter is only one aspect, but creating paths to social mobility and wealth creation through home-ownership is the key. If we can make progress in raising rates of home-ownership, there’s potential to break generational cycles of systemic injustice and poverty.

Access to regular, reliable transportation is another issue, especially for the youth that our network serves. ReCity has started to consolidate services and resources among our partner organizations and we hope to one day be a “one-stop shop” for every type of resource needed to serve children and families more efficiently and holistically. We also hope innovative partnerships can help improve access to regular, reliable transportation. Private companies already have the vehicles and drivers – it’s a matter of reallocating funds to local transportation companies like Uber or Lyft to serve our target populations. Often times, the highest impact isn’t a result of new programs being created, but from intentionally re-purposing or redirecting the resources that are already in place. And that’s what ReCity is all about.

Advertisements

Public Health in Action – Walking the Walk

wwad

Jonathan Bonnet, MD
Duke Family Medicine, PGY-3

I was fortunate enough to attend the National Physical Activity Plan Congress last week in Washington, DC and was inspired by many of the leaders working in the field of physical fitness and activity.

One program, in particular, really caught my attention.  Walk with a Doc (WWaD) has a simple idea: encourage physical activity in the community by walking alongside physicians.  I think it’s safe to say that the last time each of us had a visit with our doctor, he/she discussed our health behaviors and/or lifestyle, which more than likely included a question or two about how active we have been.  Physicians also typically encourage their patients to get active, eat healthier, cut back on alcohol intake and to stop smoking.  What impressed me the most is the extra step WWaD takes to engage with their patients and local communities.  They encourage their patients to walk alongside them.  By being outside and actually leading by example, I strongly believe that physicians not only connect with their patients on a higher level by building rapport, but it also makes the visit less formal and transactional.  If I were a patient and walked alongside my doctor and we chatted about things other than health and medicine, I would feel that much more comfortable and more willing to share any issues that I was having.  By re-shifting the context in which providers interact with their patients, using this less formal, social setting can have profound results.

I had the pleasure of meeting and interviewing Dr. Jonathan Bonnet for this blog post and I feel privileged to share his story with you all.

Me: Tell us about the path you’ve gone through – college/medicine/residency – and what captured your interest with Walk with a Doc.

Jonathan Bonnet: Sports had always been a large part of my life growing up. It wasn’t until undergrad at Ohio State University (OSU), when I fell in love with exercise and physical activity. I ended up majoring in exercise physiology, working in the exercise labs at OSU, and ultimately becoming a personal trainer and interning at Anytime Fitness. The ability to change lives with physical activity inspired me to do more for health and pursue a career in medicine.  As fate would have it, in my first year of medical school at OSU I discovered the national nonprofit  organization, Walk With a Doc (WWaD). Ironically their national headquarters was located in Columbus, OH.  Although the name had initially caught my attention, the people and program inspired me to get more involved and stay involved indefinitely.  I was struck most by the simplicity of the program, as well as the open invitation to the entire community.  The premise was simple: bring doctors and healthcare professionals together and practice what medicine preaches.  I loved the idea of literally ‘walking the walk’ with patients and the community.  The walks are a fun, social event, with the added benefit of everyone getting their daily exercise, too.  After getting involved with the local walks as a medical student, I initiated an Ohio State Walk With a Future Doc program with my peers. My passion for the program as well as my interest in promoting physical activity has continued through residency. With the support of the Duke Community and Family Medicine department, we launched the Duke Family Medicine (WWaD).  Although the walk targets the patients with obesity, it is open to everyone, including the Durham community at large.

Me: What inspires you on a daily basis, especially when things get hard?

JB: I am continuously inspired by the patients I see, my community, the WWaD leadership, and above all else my family and friends. When I see the people around me, with life situations much more challenging than mine, rise up and make the best of their circumstances, I feel truly inspired to help others do the same. I have been incredibly blessed in my life and have a passion to help spread and promote health and happiness to everyone around me.  Seeing family, friends, and loved ones suffer the consequences of largely preventable chronic diseases is devastating.  Research has already shown that lifestyle behaviors – being physically active, eating a healthy diet, not smoking, and maintaining a healthy weight – can prevent 80% of the chronic diseases we face.  This failure to translate what we know into what we do drives me to help make a difference. I firmly believe we can make a difference.  It won’t be easy, but it will absolutely be worth it. Dennis Waitly said “there are two primary choices in life: to accept conditions as they exist or accept the responsibility for changing them.”  I have chosen the latter.

Me: What do you think it will take for our society to view health more seriously?  As in, why is health lower in priority to careers and education and relationships?

JB: In general, health is something that everyone, who has it, takes for granted. It is not until we lose our health, that we realize how precious and valuable it is. I think it is also important to realize that health encompasses more than merely being “not sick” or working out everyday. Health encompasses the physical, mental, social, emotional, and spiritual aspects of life. Health is much more difficult to measure than education, career accomplishments, or relationships.  One of my favorite quotes is that not everything that can be measured, counts, and not everything that counts, can be measured.  Health is a somewhat ambiguous part of life that is difficult to assign value, and it is not something that generally changes overnight.  The gradual loss of health, or what I would prefer to say, lack of vitality, makes it difficult to have a sense of urgency and need to prioritize health when it comes to day-to-day decisions. Eating unhealthy food or not being physically active any single day has minimal effect on long term health. It is the cumulative effect of the day-to-day decisions that promote or impair “health.” Humans are much better at understanding and appreciating short term consequences and that is why health tends to fall lower on the list of priorities for many people.

Changing this societal view on health is tough.  Culture and social norms dictate much of this. People who sacrifice sleep for their jobs are idolized. We tend to measure success by material goods, achievements, awards, and honors, rather than the parts of life that matter most: family, friends, health, etc. It is not something that will change overnight, but it has to start somewhere with someone.  That someone is you, me, and people like David Sabgir, who started WWaD. It doesn’t have to be profound. Simply deciding to embrace the challenge of being the healthiest version of you possible, is an incredible start. If there is demand, government, businesses, and societies will change. It will take an honest conversation with ourselves about what truly is important in life, followed closely by an enthusiasm, passion, and dedication to practicing those values everyday.

Me: What are some things/concepts/ideas/insights you’ve noticed that have helped/hindered health-related outreach and education in communities?  Specifically from a provider perspective.

JB: As a provider, one of the most challenging aspects of care is to really understand the situation and environment a patient is coming from.  It is difficult to do more than graze the surface of what a patient’s living situation and day-to-day life actually looks like in a 15-minute visit. Although it is easy to be idealistic and think everyone can adopt healthy lifestyles, the truth is that the choices we make are subsequent to the choices we have. Frankly, I have patients who do not have healthy options. It is choosing between two bad choices, and that makes it tough.  Oftentimes, it takes multiple office visits and getting to know patients very well before they feel comfortable discussing many of the underpinnings that contribute to their health, or lack of it. Patients are prideful and often times want to “please” their doctor by saying they take their medicine as prescribed and eat healthy, when in reality, the situation may be entirely different.  We know that social determinants of health play a far bigger role than the one-on-one medical care a physician provides, but these are “messy” issues, that do not have quick fixes. Aside from solving world poverty, I think the single best thing we can actually do in health care is to take the time to not talk, but actually listen to our patients and their stories. It is not until we understand our patients values and what drives them, that we are able to facilitate them in making the best decisions for their health.

Me: What are the current needs in your city as they relate to social determinants of health (ie SES, poverty, access to care, transportation, safety, etc.)?  Social determinants of health are any factors that directly or indirectly affect health.  For example, being homeless could cause stress and malnutrition which could drastically affect one’s health.

JB: As with any community, the social determinants of health play a much larger role in the well being of its members than anything that can be done by a doctor in a single office visit. Access to healthy nutritious food and water, medical care, areas to be physically active, education, shelter, and resources are all critical pieces of health. The Durham community is no different. There are individuals suffering from any and all of the aforementioned components. Obesity is arguably the most pressing health issue this country has ever faced, and social determinants contribute significantly to this. Although it is multifaceted, it has been exciting to be part of a residency program that understands these issues.  At Duke, we started a Walk With a Doc to facilitate physical activity among our patients, staff, and community. Additionally, we brought the Veggie Van program to the Duke Family Medicine Clinic every Thursday afternoon. The Veggie Van offers subsidized fruits and vegetables to the community in an effort to make healthy food affordable and accessible to everyone. We are also collaborating with the Durham Public Health Department to identify and offer other services that are beneficial to the community. None of these interventions alone will solve the problem, but it is our hope that the collective effort will yield meaningful changes in the health of our community.

Public Health in Action – Heather Freeman Believes We All Have Capes

herocape

Heather Freeman, MPH
Founder, Gutsy Girl Club
http://www.GutsyGirlClub.com

As I described on a previous post, the internet is one of the easiest ways to connect with someone else with similar interests and views.  Heather Freeman of the Gutsy Girl Club reached out to me after reading one of my blog interviews.  After checking out her website and understanding the concept of how she was impacting the world around her, I knew that it would be a great addition and offer a unique perspective – empowerment.  Empowerment is essential in sustaining new behaviors and programs long after funding resources have dried out.  Empowerment passes the torch to individuals and allows them to want it for themselves.  It shifts from motivation from extrinsic to intrinsic; it places ownership and accountability back into the individual’s hands.   Her concepts parallel the views Paulo Freire advocated for: an interactive form of education and social justice for everyone.

Now to my questions for Heather!

Me: How did it all start?  Where did you get the idea from?

Heather: The Gutsy Girl Club (GGC) was inspired by my own personal journey and struggle with self-confidence.  At a very young age I had a strong sense for who I was.  I loved to laugh, run, be outdoors, and simply enjoy the world and people around me.  But as I got older that high level of confidence started to crumble and I found myself having a difficult time finding my way.  My parents divorced when I was in 5th grade and my mother, whom I needed the most was caught up in her own swirl of mess, unable to help me navigate through the precarious teen years ahead.  On the inside, I felt my life spinning out of control.  However I didn’t dare show this vulnerability to the outside world.  Instead, I hid my insecurities behind the one thing I was well known for – my smile.  I made my way through the next critical season in my life not letting on of my inner truths & struggles to anyone.

As difficult as this early experience was, I learned from it and slowly found my way back to myself.  With the help of a few key superheroes who showed up in just the right time, I began the journey to reconnect with my confidence.  After spending over 10 years working in health promotions I now help others reconnect with their true confidence through the GGC so they too can experience the joys of taking the lead in their health and wellness.

Me: What inspires you on a daily basis, especially when things get hard?

H: We are all superheroes, sometimes our capes just need a little mending.

The moment my first daughter Bailey was placed in my arms, I experienced a huge shift – an “Ah ha” moment so to speak.  Cradled in my arms, I looked down at her and realized I was in a very powerful position in terms of her survival.  This little girl was helpless and at the most simplest level of being; her life depended upon me.  Regardless of my own experiences as a child, my daughter depended on me to be her superhero.  From this moment forward, I was not only responsible for myself, but I was also responsible for nurturing my daughter’s health until she was ready to be her own superhero.  I also realized that survival wasn’t good enough.  I wanted her to thrive in this world.  I wanted her to have the most magical and extraordinary life.  I wholeheartedly believe every mother has this desire for her newborn child.  I truly believe that we all want a life for our children that is better than our own.  While holding my daughter in my arms, I realized that was my moment of truth.  There have been many moments where this truth has been challenged, but I continue to make the choice to do things differently.  There is not a day that goes by when things don’t get hard, when my work asks me to stretch and go beyond what I think I can give.  It is within these moments that I remember that little girl in my arms and that original moment of truth.  This is what inspires me to help the millions of other little girls out in the world who deserve the same opportunity for an extraordinary life.

Me: What do you think it will take for our society to view health more seriously?  As in, why is health lower in priority to careers and education and relationships?

H: Wow, what a great question. While we typically tend to get caught up in the complexity of the current situation of our society’s health, I believe the answer is quite simple and comes down to a simple choice.  When we choose to say to yes to health we make a mental shift, a shift which precedes a behavioral shift of doing more of the things that support health and wellness.  The choice is available to each of us many, many times each day.  If more people choose to say yes to health more often, then not only does the individual experience greater health in their own life, but it also impacts the people in their life in positive ways.  This creates a ripple effect which indirectly affect communities in which they live and ultimately the greater world.

Me: What are some important insights that the attendees get from your camps?  What are some that you and other staff members observe?

H: The Gutsy Girls Empowerment Camp is one of my favorite programs because evidence shows that by the age of 9 a girl’s self-esteem has peaked.  Which means that during the critical years of emotional development that lie ahead of her, she is at a disadvantage and is less likely to be able to make the smartest choices for her safety, health, and well-being.  The Gutsy Girls Empowerment Camp is all about increasing a girl’s self-esteem and confidence before this critical period hits by seeing her for all that she is and affirming her emerging talents and passions.  One of the biggest insights campers get is ‘hey, they get me here’ and “I am accepted because of who I am.” Girls of the Gutsy Girls Camp don’t have to act perfect, they don’t have to do art that looks like it should be hung in a museum and they don’t have to say the perfect things.  Girls at camp get to be kids, create wildly, and share themselves freely and honestly.  Moms love having a place their daughters can go to for this kind of support.  And through ongoing conversations with moms about the Gutsy Girls Empowerment Camp, I’ve learned that moms want to be a part of the action, too.  That’s why we are bringing the fun to both moms and their daughters through our GGC activities that are starting up this year.  These Club activities will give moms the chance to join in on the fun while at the same time strengthen the bond between her and her gutsy girl.

Me: What are the current needs in your city as they relate to social determinants of health (ie SES, poverty, access to care, transportation, safety, etc.)?  Social determinants of health are any factors that directly or indirectly affect health.  For example, being homeless could cause stress and malnutrition which could drastically affect one’s health.

H: While the GGC is growing to serve a national audience, our home base is in Tolland, CT.  Tolland is a community, which based on the Health Equity Index (a web-based assessment tool developed by the Connecticut Association of Directors of Health) rates average or above average on the social determinants of health (civic involvement, community engagement, economic security, education, employment and housing).  There are however groups of people within this community who for instance do not have equal access to healthcare and who experience transportation and housing issues.

The GGC is committed to building on the strengths of this community by empowering girls of all ages to take charge of their health.  A gutsy girl who believes in her power is able to confidently make healthy choices which not only serve her, but benefit the people around her and the community she lives in.

Engaged in Thought

cenrAugust 23

I was fortunate enough to attend the “Engaging Patients, Families and Communities in all Phases of Translational Research to Improve Health” Conference this past Thursday and Friday because it stimulated some serious thought and discussion amongst attendees, but most importantly myself.  Conferences are usually worthwhile because attendees are typically doing similar work.  An added feature is the sharing of ideas, best practices and stories – the dreaded “networking” – can actually be broken down into genuine conversations about helping each other perform their respective careers better.  Most conferences meet this basic expectation.  But this one was different.  It went above and beyond my expectations for several reasons, which I will describe below.

First, the size of this conference was extremely manageable.  Roughly 200 attendees registered to attend and all but a dozen or so made it to Bethesda to hear keynote speaker Dr. Chris Austin kick off Thursday with laughter and thought-provoking questions.  Out of the 180+ that attended, I can safely and confidently say that I was able to engage with 20 of them in meaningful conversation regarding potential opportunities to collaborate in the near future.  Contrast that with a larger conference, say APHA’s annual conference of a massive 30,000+ attendees, and it’s no wonder why attendees stay within their subsections and specialties.  This conference provided me with ample opportunities to engage with and learn from professionals doing completely different work.  And that to me was particularly valuable.

I touched on it earlier, but I was very impressed with the wide range of experts in the field of public health and community-based research.  One group showcased their work to improve health outcomes in Amish communities and another described relaying crucial health communication messages via text messages in rural health clinics at various sites in Kenya.  Talk about learning opportunities!  And this is my favorite way to learn – seeing problems being solved in the field as they relate to the realities of life and then interacting with the investigators to learn how these interventions could be replicated to improve health in other populations.

Lastly, the agenda was designed to introduce ideas via speaker presentations then move into smaller breakout groups to tackle more specific questions.  One specific breakout session that I attended dealt with the ethical implications of community-based research.  Here were a few questions that were left in my mind to sort out post-conference as I continue working at the community level:

*As researchers, what value can we provide back to communities in exchange for critical research data?  

*How can we make the relationship more mutually beneficial?

*What if the research results did not shed the community in a particularly positive way – think of the negative implications that could arise if the media reported on those same results

*The idea of research and the value of official academic research compared to “findings” or “observations” seen in communities…is one necessarily better than the other?

For the reasons aforementioned, I personally thought this conference was very valuable to my work as a public health professional.  But, similarly, it also leads me to think that much more work needs to be done outside of our own “public health bubble.”  Dr. Austin of the National Center for Advancing Translational Sciences at the National Institutes of Health illustrated this with a simple, yet extremely profound anecdote.  He described meeting with members of Congress recently and one of the members asked him about his work in linguistics.  Apparently that member read translational sciences in the title of his division and assumed it was translating language rather than public health science.  Viewing this from a public health lens, I would shake my head and laugh.  But viewing this outside our “public health bubble,” I probably would have said the same thing or asked, what does this really mean?  Even in my own experiences when trying to explain what public health is to people from all walks of life, to put it simply, it is a complex conversation to have.  Which is why I strongly believe that we as public health professionals need to do a better job at relating to and forgiving others for not understanding ideas and concepts from our perspective.  One example of this is public health funding.  Public health funding was increased under the support of President Obama and written into the Affordable Care Act back in 2010.  Shortly thereafter, resulting from the many tumultuous battles to reduce federal debt and annual federal budgets, public health funding was the first on the chopping block.  Many members chose to redistribute funds previously appropriated for public health work to budgets of the Department of Health and Human Services.  The same funds which were originally set aside to boost prevention efforts in communities nationwide.  This left public health professionals – including myself – outraged.  Why can’t the appropriations for the Department of Defense be on the chopping block instead?

But now it all makes sense.  The dots are finally connecting because of that anecdote Dr. Austin shared.  One of the main reasons that the field public health has trouble getting traction with funding streams is that the greater public – whose health we ironically serve to improve – doesn’t really know what we do.  And when a member of Congress sees a significant budget devoted to what appeared to them as “translating language,” then our efforts will always be reactive in nature – why are you taking from our much needed annual appropriation?  Therefore we must strive to espouse one of the basic principles of public health: take action for a proactive solution to funding – “Dear members of Congress, this is why we need what we are asking for.”

Until we get to that point, we’re still downstream on that river asking why there are so many people falling in.

I know we can do better and I am confident that we will.

“Anybody can become angry – that is easy, but to be angry with the right person and to the right degree and at the right time and for the right purpose, and in the right way – that is not within everybody’s power and is not easy.” — Aristotle