There is growing recognition in the medical field that maintaining good health means more than taking care of yourself and getting regular medical check ups. Healthy living conditions and strong community cohesion foster healthy neighborhoods, while inequality, discrimination, crime, pollution, traffic, isolation, and a sense of powerlessness contribute to disease. It’s difficult to improve people’s overall health without addressing the social, economic and racial issues where they live.
Indeed, you can think of health as a commons in which we all have a stake in maintaining.
In many low-income communities, for instance, residents make more visits to emergency rooms and participate less in preventive health programs. There is less access to health care and wellness services. Fewer people carry health insurance that pays for doctor visits, surgery and medication. Local stores stock less wholesome food and fewer exercise facilities are available. The stress from financial pressures and holding down two or three jobs can makes people more susceptible to disease, accidents and chemical dependency. The close social connections that have been shown to strengthen health are often missing because neighbors move frequently.
“Your zip code affects your health as much as your genetic code,” notes Mary Wheeler, program officer at the Twin Cities office of the Local Initiative Support Corporation, a national organization that helps communities working collaboratively on transformative solutions to their problems.
“The social component of health is as important as the medical component,” Wheeler adds. “When you look at how much we are spending on health care in this country you can see that investing in community health can only help us.”
Through its Building Sustainable Communities program focusing on communities facing economic and social challenges, Twin Cities LISC supports a number of projects that integrate public health with community development, including the following
Cultural Wellness Center
Ruth Hampton Olkon, manager of community programs for Allina Health, says it’s well known that encouraging people to take responsibility for their community’s wellbeing boosts overall health. That’s why Allina has partnered with the Community Wellness Center (CWC) and other organizations on the Backyard Initative--an intensive effort to improve health in seven neighborhoods near Allina’s headquarters on Lake Street in South Minneapolis. In a three-month period last year 4200 community residents (about ten percent of the total population) participated in Backyard Initiative events and groups.
The Cultural Wellness Center (CWC) just off Franklin Avenue in South Minneapolis features an inviting series of rooms, each appointed with cozy chairs and a gallery of African and international art. An assortment of community events happen here, ranging from GLBT zumba classes to gatherings of the Major Taylor bicycle club. Besides Allina, CWC works with Hennepin County Medical Center, the St. Paul Public Schools, the Hope Community and numerous non-profit groups.
CWC hosts study groups, block parties and dinner dialogues for people to explore how to make the neighborhoods healthier, which led to the formation of Citizen Health Action Teams such as Growing in the Backyard, which focuses on gardening and farmers markets; the Rebirthing Community, which creates intergenerational teams to work together on energy projects; and Out in the Backyard, which addresses gay and lesbian health issues in the neighborhood.
A key principle in the Center’s work is that communities must define their own vision of health based on residents’ own experiences. That’s why the Cultural Wellness Center conducted a community health survey to help both community members and professionals better understand the health needs and goals of people living there. Wholeness, connectedness and active living are central themes people identify, notes CWC founder Atum Azzahir,
“One critical measure of health is community, the people who care about us, a kinship network we can turn to help us live more healthy,” she lives says. “We bring people together, which is what community is all about.”
Olkon says, “Groups of residents have come together to work on health issues, developing and implementing projects to make their neighborhood healthier. This promotes social connections and promotes health literacy, giving people the knowledge to make good decisions about their health.”
East Side Family Clinic
The East Side Family Clinic in St. Paul, Minnesota offers medical, dental, mental health, family planning, pre-natal, HIV, diabetes, cancer, social work and preventive health care in this predominantly low-income and immigrant neighborhood. But their services extend beyond the doctor’s office with classes, prevention programs, school clinics, social media, a presence at public events, partnerships with local organizations and participant involvement in medical research.
The clinic showcases another dimension of how combining health programs and community development can bring positive results in challenged communities. “Our approach is to address the whole person, not just the medical patient,” explains Marsha Milgrom, Development Director for the organization. “We emphasize empowering patients to take charge of their own health rather than just fixing them. That motivates people.”
The sparkling new facility serves a large number of Hmong and Latino, Somali and Karen (recent immigrants from Myanmar) patients, and offers both Hmong and Spanish-speaking physicians.
Health outreach and preventive programs as well as doctor’s visits are core to the clinic’s mission, with an emphasis on peer-to-peer support, in which people learn from one another as well as health professionals. Even some research projects at East Side, such as an obesity study, are designed to be participatory, with patients helping set the goals and guide the project. Patients also make up a majority of the organization’s board.
A 5-acre urban farm is sprouting across the street from a large public housing tract in Frogtown, St. Paul’s most diverse neighborhood. Frogtown Farm will boost community health and well-being with gardening classes, demontration plots, a neighborhood farm stand and opportunities to gain skills and employment with commercial food projects like a greenhouse, orchard and beehives. It is part of a new 13-acre public park jointly initiated by the Frogtown Farm organization, the Trust for Public Land and the City of St. Paul.
Frogtown Farm represents a unique opportunity to introduce urban agriculture in the inner city. The focus is on:
*Community education about health and nutrition. Garden plots will highlight favorite crops from Native American, European, Asian, African and Latin American agrarian traditions.
*Public space for social connection and physical activity. The park will include green space for exercise and play along with a grove of tall trees for reflection and relaxation.
*Green business development. Emerging entrepreneurs can find opportunities in sustainable gardening, green technology and food.
A common theme of all three of the these community health projects, well-expressed by Atum Azzahir, is: “You can’t talk about health and not talk about community.”