The Health and Community Development Convening brought together leaders from various sectors and issue areas to discuss community health inequities and how to effectively engage hospital and health-based institutions to provide community anchor intervention in undeserved neighborhoods. The convening was held in two cities, Baltimore, Maryland, and Wilmington, Delaware, to identify issues specific to the cities. Attendees included a wide range of nonprofits, community organizations, social services providers, local governments, community development corporations (CDCs) and community development financial institutions (CDFIS).
Convening Sponsors
The main sponsors for the convening were NCRC, PHI, MCRC and CACHE.
The National Community Reinvestment Coalition (NCRC) was created by national, regional and local organizations to help build capital for undeserved communities. The organization’s mission is to create a just economy by advocating for fairness and the end of discrimination in lending, housing and business.
The Public Health Institute (PHI) is focused on improving health and wellness through research, partnership collaboration and improving health policy. PHI uses innovative ideas and programs to fight disease, utilize technology to improve healthcare services and galvanize community leaders for change. A branch of PHI, Center to Advance Community Health and Equity (CACHE), aligns community resources for health and equity.
The Maryland Consumer Rights Coalition (MCRC) has created policy and programs for communities in Baltimore City, Baltimore County and Prince George's County. The organization has passed pro-consumer legislation, garnered task forces to guide policy and cultivated earned media.
Mission of the Convening
The purpose of the Wilmington and Baltimore convening was to galvanize community leaders to identify and address city inequities for better resource alignment and distribution.
Topics Identified and Discussed
"Social determinants" are the surroundings which impact and influence an individual’s and community's health and socioeconomic circumstances. Social determinants surpass medical issues by looking at the non-medical, social components that also affect patients’ well-being, such as the environment where we grow up, where we live, work, play and age. (1)
"Health equity" is focused on achieving community health by examining the various components of neighborhoods, such as level of engaged institutions, resources, funding and opportunity, which impact socioeconomic disparities, healthcare and community development. (2)
"Community stress" is created through collective hardships and inequities which impact an individual’s health and well-being. (3) Trauma and "toxic stress," brought on by communal events or experiences, can impact the health and well-being of the community. A type of experience which can create community trauma may be a natural disaster and an example of toxic stress could be a mass shooting. (4)
Wilmington
Issues most prevalent in Wilmington were social determinants of health and mental health resources like trauma-informed approaches.
Wilmington and Kent County had the highest rate of mental health illness in the state in 2015, which is above both the state and national average. The rate of mental health illnesses in these communities is 22%, while the national rate is about 18.5% and the state rate is 17%. (5)
The attendees goals are to affirm change and implement initiatives. One of the goals is to create a universal scale for organizations, governments and other institutions to have a common point of reference to assess effectiveness and community need.
The second call-to-action is to establish long-term goals over a one-year and five-year basis. The one-year plan is to establish dialogue among leaders on critical issues and the five-year plan is meant to ultimately reduce gun violence and improve emotional well-being and increase maternal health in Wilmington. The last goal is to identify the gaps in current initiatives being carried out by other institutions and find methods to fill in the existing disparities.
Baltimore
Some of the issues deliberated in Baltimore included assisting traumatized students by ensuring quality education and safe neighborhoods, reducing economic stress (such as affordable housing, lack of employment opportunities and healthy food insecurity) and ending the stigmatization of poverty.
Mental health and wellness in Baltimore is a rising issue affecting many people in the city. Baltimore has about 609,000 people, of which 175,000 have some kind of mental health condition. About 25% of minors, from the range of 13-18 years old, have mental health concerns. (6)
Baltimore participants collaborated on issue framing and next steps toward moving forward on incorporating health based institutions into communities.
In order to enhance capacity in healthy communities programming, participants agreed that stakeholders need shared data among organizations, hospitals and health systems. Additionally, stakeholder leadership must be engaged with local government. In these discussions, critical challenges, such as social justice, homelessness and poverty stigmatization, should be reframed to find a practical balance and collaboration on the issues. Liaisons should be identified among the stakeholders in order to ensure active engagement and representation.
Common Concerns Between Both Communities
There were overarching themes and topics at the convening. Mental health resources and community stress were among the top issues addressed in Wilmington and Baltimore. Affordable housing and effective local initiatives were also discussed as high priority issues to both communities.
Take Away From the Convening
There were three major takeaways from the convening: an increase in grassroots activism; dialogue and rhetoric between leaders and community members and get the proper funding for projects.
Opportunities and Challenges Moving Forward
The work performed by organizations and other entities should have an intentional racial lens on data collection and ensure racial equity inclusion in their work. By incorporating racial equity and inclusion, organizational initiatives and data will become more empowering and provide a better understanding of communities.
Organizations need to create closer relationships between community members and leaders to bridge the gap between community engagement and trust. The establishment of trust would strengthen prosperity and ensure community buy-in and input. A more inclusive and trust-based foundation is necessary in bringing attention to groups which are in need of greater help. Communal health would also become more effective with initiative implementation and would further develop community engagement infrastructure.
Advocacy groups, organizations and other entities working within this space of change need to develop a better measuring scale to track community results. By having a universal scale of measurement, organizations could better hold each other and other community partners accountable.
Discharged patients need to have better social service options and provisions post-hospital treatment which include temporary housing for future permanent housing solutions.
To watch NCRC's webinar on Healthy Communities, click here.
Citations:
(1) Sammantha Artiga and Elizabeth Hinton. Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity. KFF. (2018). https://www.kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/.
(2) Health Equity. NCRC. https://ncrc.org/health/.
(3) Stephen R. Couch and Charlton J. Coles. Community Stress, Psychosocial Hazards, and EPA Decision-Making in Communities Impacted by Chronic Technological Disasters. NCBI. (2011). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222505/.
(4) Fostering Community Wellness: Addressing Toxic Stress and Adverse Community Events. SAMHSA. https://www.samhsa.gov/sites/default/files/programs_campaigns/wellness_initiative/toxic-stress-fact-sheet.pdf
(5) State Health Needs Assessment. The Delaware Public Health Institute. (2017). https://dhss.delaware.gov/dhss/dph/files/shna.pdf.
(6) Sumeet Manhas. The Deterirorating State of Mental Health in Baltimore: Is There a Solution? Post Examiner. (2019). https://baltimorepostexaminer.com/the-deteriorating-state-of-mental-health-in-baltimore-is-there-a-solution/2019/02/09.
(7) Alignment Overview Wilmington, DE - New Castle County. PHI and CACHE. (2018).