The California Endowment Takes a Community-based Approach to Statewide Health

Monday, October 17, 2016

This is one in a series of profiles highlighting the work of our longtime members to commemorate the 40th anniversary of San Diego Grantmakers' founding in 1976.

When it comes to expanding access to affordable quality healthcare for the underserved, people often talk of increasing the number of reduced-cost community clinics, implementing nutrition programs in at-risk communities, and promoting the benefits of exercise to children.  For the first 10 years of The California Endowment’s 20-year history, this is the type of work they did – to the tune of about $1 billion in grants throughout the state. 

Then in 2006, the organization decided to take a long, hard look at whether these methods were really promoting fundamental improvements in the health status of all Californians. What they discovered led them to revolutionize their approach. 

“All of our grantmaking was done around issues that people traditionally identify as being health-focused or healthcare related,” says California Endowment Senior Program Manager Steve Eldred. “In order to really affect change, we needed to look at more sustainable actions. We had been making a lot of grants, but they were usually addressing the same problems through very similar strategies.  We were not seeing many systemic, everlasting results.” 

Building Healthy Communities…

The Endowment knew that to really transform the state of healthcare in California, it needed to dismantle many of the barriers to healthy living that people face, and look for ways to support and encourage healthy behaviors. With this reality in mind, they started to think about how they could change the conditions in which people live. This shift in thinking led to the Building Healthy Communities strategy that, for the last decade, has driven The Endowment’s mission. 

Building Healthy Communities emerged after an 18-month community planning process to become a 10-year strategy that will take them through 2021. They chose to focus their efforts on 14 communities throughout the state, addressing the major concerns in each area that were preventing community members from living up to their healthiest potential. In San Diego, this chosen neighborhood is City Heights. 

…By Empowering Residents

In order to take a deep dive into the health needs of City Heights, The California Endowment partnered with Mid-City CAN (Community Action Network), a nonprofit organization that mobilizes and engages residents of San Diego’s mid-city neighborhoods, to be the hub for its work in San Diego for the last six years. With The Endowment’s support, Mid-City CAN identified the issues affecting City Heights and developed specific campaigns aimed at solving them. Then they formed “momentum teams” of 30-40 residents, nonprofit organizations, and other stakeholders that were tasked with implementing these campaigns and tackling the arising challenges. 

One proven way to create a sustainably healthy and productive community is through helping children live free of violence, and “restorative justice” is one such approach to this.

Restorative justice aims to curb juvenile criminal behavior by offering young offenders the opportunity to come together with their victims, talk through the negative impact of their choices, and discuss restitution. This is done in lieu of putting them in a juvenile detention center or other punitive measures. 

Mid-City CAN’s “peace promotion” momentum team took a look at the factors affecting at-risk juveniles, such as family conditions. They also assessed what local resources were already in place to help.  In 2010, the momentum team approached the district attorney, chief probation officer, public defender, and presiding judge of the juvenile court, and successfully made the case for their restorative justice solution.

Other momentum teams address such issues as school attendance, food justice, transportation, the environment and, of course, access to healthcare. There is also a youth council team that works on issues important to young residents. One of the successes of this group was securing two local skate parks in City Heights. 

Because City Heights is recognized as one of the most racially and ethnically diverse communities in the country, the momentum teams also focus on services that address various cultural, language and religious needs through partnerships with residents, the school system, and other local entities. 

“Forty-two percent of all residents in City Heights are foreign-born and nearly 60 percent of students are classified as English language learners, with more than 35 languages and nearly 100 dialects spoken in City Heights schools,” says Steve. “In order to reach this population, we needed to rise to meet this challenge and create more cultural awareness in our programs.”

A Model of Success

Some of the successes of this momentum team approach include making the local farmers market one of the first in the nation to accept food stamps; expanding access to bus passes for students dependent on public transportation to get to school; and increasing the number of healthy, locally grown options in school meals.

It has also resulted in systemic changes in the region, according to Steve. “We are altering the perception of City Heights as a dangerous place, with residents and outsiders embracing the good things about this community,” he says. “Our restorative justice practices have been adopted by the schools at a district level and are really influencing the system. This includes how people view the issue of healthcare improvement in the community and the resources that are allocated to fulfill this need.” 

The approach has also caught on in other areas of The California Endowment’s Building Healthy Communities initiative. In fact, The Endowment has provided funding for Mid-City CAN to train other communities on how to use momentum teams to achieve their own objectives. 

With five years of its 10-year Building Healthy Communities strategy left to replicate these types of efforts, there’s a lot of opportunity to achieve similar results throughout the state. “This is where we’ll see the lasting impact we have been working for,” says Steve.

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