04 Mar 2019

A Frustrating Day at a Community Health Improvement Program

A few months ago, I attended a community health annual event associated with one of the many initiatives started by a large organization to bring together groups and begin implementing programs to improve the health of the community.
 
At this particular event after a couple of years of meetings and work, there were a number of presentations by the organization, community groups, the local government and a review of work done to date. It was a Kumbaya moment. Near the end of the day when people were asking questions, a gentleman next to me stood up, he worked in one of the poorest neighborhoods in the city and oversaw a local effort in that community.
He said and I’m paraphrasing.
 
I look at our community and see it has the exact same issues today we had 50 years ago. Nothing has changed, nothing has been done and we look just the same. You tell us to exercise but we have no sidewalks, no parks, the nearest gym is 3 miles away, we have no transportation, no access to healthy foods…
and well you know the rest of the issues he raised. He was clearly frustrated and has every right to be.
At that point a young woman stood up, she runs a yoga program that is one of the initiatives this group has been promoting and touting as a mental health solution for the community.  She responded, again I’m paraphrasing:
We’d be happy to come to your community, don’t worry about transportation we will come to any building, any location, we can train some trainers, we’ll need to get some funding, but we can bring the services to you, you don’t need to come to us. 
She was adamant that she had a solution for this gentleman and his community, while he just quietly sat there listening as she went on and on and on.
So, let’s just cut to the chase. Who really believes that in the top 50 needs of this community, Yoga would be one?
It’s yet another example of people who are not part of the community:

1)   Thinking they know what’s right.

2)   Selecting some apparently cool idea that they would like for themselves for someone else.

3)   Not asking the community what they need and want before starting.

4)   Doing something to check the “I did something box” but not really doing anything meaningful.

5) Selecting a project that will be difficult to scale, that will ultimately impact a small group of people (those who like yoga).

There has got to be a way to get some funds to this community and put in a sidewalk, fix up a park, locate a grocery store, create some safety, improve the schools. At the same time, that this community was (and still is) in need of these basic improvements, the city funded a major road development in another part of town adding bike lanes. Of course, the safety of cyclists is an issue, but this was done in the wealthier part of town. Did their need outweigh the more basic needs this community has?
How do we not get caught up in this approach, which happens more frequently than we’d like?

1)   Ask the community what they need. They know and are more than willing to share. In fact I’m sure most of the people in this community and members of this group know as well; perhaps they just think those issues are not solvable, are too heavy a lift, beyond their scope, who knows? So

2)   Focus on the communities needs like a laser until you find a solution. It may not be in your wheelhouse, may take some time, but with enough focus and the bringing together of the right people solutions can be found.

3) Don’t be afraid to call out stuff thats not working. It’s not a negative. If what you’re doing doesn’t solve the problem, do something else.

4) Look at other funding in your community and move some of that. We all face limited resources. Groups like this need to be a voice for those who are not being heard when decisions are made on funding.

5) Eat the elephant one bite at a time. Perhaps start with fixing one street, part of a park, but all the while think big, think scalable, think of the end results, and incrementally make it better.

To put a nice bow on their approach,  I asked before the meeting if I could discuss H.R. 660, the Community Health Improvement and Leadership Development (CHILD ) Act that we have before Congress (with Bipartisan support) at the event and was told,
No that they did not want to get into Politics. The CHILD ACT would put the funds into the hands of the community themselves overseen by a local board to select their own projects and fund them up. I guess that’s antithetical to their approach in more ways than one.

 

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