Building people power to advance health equity: 3 lessons from community-driven initiatives

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What do early literacy in Del Norte County and Tribal Lands, urban agriculture in Sacramento, reentry efforts in Richmond, and restorative justice in Kern County all have in common? They're each part of a 10-year, $1 billion initiative to advance health equity throughout California. They're also evidence that real change happens when residents have a voice in identifying the top issues facing their communities and are involved in crafting solutions.

The California Endowment launched this comprehensive community initiative, known as Building Healthy Communities (BHC), in 2010 "to advance statewide policy, change the narrative, and transform 14 of California's communities devastated by health inequities into places where all people and neighborhoods thrive."

To better understand the work happening in these locations so that the efforts can be replicated in other places, Berkeley Media Studies Group conducted case studies of four communities that received funding through the grant. During our background research and interviews, we identified several key strategies that helped advocates in each location overcome obstacles and lay the foundation for health:

1. Engage community at every step.

Whether advocates are working to increase literacy rates or end the school-to-prison pipeline, accomplishing major social change requires collaboration. And the strongest partnerships go beyond top-down approaches; instead, they involve community members from a project's inception to its implementation and evaluation.

In Del Norte, for example, efforts to improve school readiness consisted of six co-design stages that actively engaged the community, including families, educators, schools, and early child care providers. Together, the group defined its overarching goal — to have 100 percent of third-graders in Del Norte and Tribal Lands reading at third-grade level by 2023 — and identified specific targets like improving access to quality child care and increasing access to preschool slots. They also developed many projects to reach those targets, such as the Un-homework initiative, which calls for homework policies to eliminate lengthy homework assignments requiring time commitments from parents. Finally, they analyzed results together to see what was and wasn't working.

"It was a transformational experience for everyone," said Geneva Wiki, TCE program manager in Del Norte. "The old model was, 'We know what's best for you.'" But, under the new model, she explained, advocates used empathy-based research methods to gather stories from educators and families to learn about the challenges they were facing in helping children learn to read. "It was getting out of sympathy to empathy: I feel and understand your pain."

Although the details differ, advocates working to create a healthier school environment for students in Kern County reported a similar experience. When education data revealed that the Kern High School District was suspending and expelling its students of color at higher rates than its white students, local organizers collaborated with parents, students, faith leaders, educators, and members of the community to address inequities within the school system.

The group's efforts have resulted in several victories, including a landmark legal settlement that is requiring the Kern High School District to make its data on suspensions and expulsions more transparent; engage the community through twice yearly forums; implement a new data system to track disciplinary issues in real time; change disciplinary policies and practices to be less punitive; and educate teachers, staff, and administrators on implicit bias.

Building community members' leadership for advocacy took time and investment. However, without doing so, advocates would not have gotten the results they did, nor would they now be in a position to monitor the reform process and hold school administrators accountable. Advocates in Kern County stressed that it is important to engage residents throughout the process, noting that they know how to interpret data, provide testimony, and can sit on decision-making bodies where policy is crafted.

2. Elevate authentic voices.

Messengers are often just as important as messages. A prime example of this comes from Richmond, where a coalition of city residents, local law enforcement, and formerly incarcerated residents were able to create a reentry network that owes much of its success to the power of storytelling.

One reentry organization, the Safe Return Project, was launched with the help of a BHC grant and has helped elevate the voices of formerly incarcerated residents so they can advocate for resources and push for policy change. Another group, the Contra Costa Interfaith Supporting Community Organization, has built civic engagement and harnessed the power of authentic voices by hiring formerly incarcerated people to help with research. "The room was always filled with 'experts,' but there were no former prisoners there," said the late Richard Boyd, a community member who was involved with CCISCO. "We came up with the idea of raising money to hire formerly incarcerated inmates to do our research. That was something I'm a firm believer in."

Both of these organizations brought a social justice approach to their work and aimed to empower those who they were trying to serve from the very beginning. Soon, advocates and community members were filling the halls of public hearings to successfully push for policy change. "It's the broader narrative change work that we need to continue to push," said Diane Aranda, program manager for BHC Richmond. "It's about seeing their faces and hearing their voices."

This approach has helped change misconceptions about formerly incarcerated people among key decision-makers in the local criminal justice system and foster a greater public understanding about the need for systemic change.

Meanwhile, advocates in Sacramento who are striving to improve access to healthy food share the same commitment to lifting up the voices of those who are the most affected. There, local organizers drafted ordinances to make it easier for people to grow and sell food from their own yards; however, they knew that to gain the support needed to pass the ordinances, council members would need to hear directly from residents who would benefit from participating in urban agriculture.

To that end, they did community outreach to ensure a large turnout at council meetings. A wide variety of people, including parents, urban farmers, and local nonprofit leaders, showed up and testified.

"Right now, barriers such as zoning restrictions and limited land use hinder our communities' ability to farm and contribute to the local economy," Sue Vang, with Hmong Innovating Politics, told the council. "The urban ag ordinance can help mitigate these barriers and revitalize low-income neighborhoods, provide solutions to blight caused by unmaintained vacant lots, and, most importantly, connect the very diverse — linguistically, racially, ethnically — communities within Sacramento." Vang also spoke more personally: "It would also give my family the opportunity to sell the produce that my mom grows in her backyard."

The strategy worked: The city has since passed multiple urban ag ordinances, and the county approved similar regulations, allowing all residents in urban and suburban areas to legally grow and sell produce, as well as keep bees, chickens, and ducks on small lots.

3. Be nimble.

The road to change is rarely straightforward. Initial strategies can fail, but being patient and willing to adapt pays off. That was the case for advocates in Del Norte who stumbled in their first attempts to improve literacy rates. The problem lay in how they were gathering data. At first, early care providers were working in their own silos and looking at their own data, without hearing directly from parents. They moved forward with a tutoring program, which was widely consider a best practice but ultimately faltered because it was based on some incorrect assumptions about the community's barriers to literacy.

"It didn't work," said Jeff Harris, Del Norte Unified School District superintendent. "Why? Because we weren't getting to the root problem."

"When we asked what the story behind the data was, that's when we got the root of the problem," Harris added, referring to the empathy research and interviews with educators and parents that the team later conducted. Once they better understood the problem, then they could move forward collaboratively to create and implement solutions.

In Kern County, advocates understood the root problem — structural racism embedded within the school system — but faced another set of challenges: a school district that was unresponsive to their demands. For years, they urged the district to address its issues with disproportionate suspension and expulsion rates. They met with school board members to try to get a commitment to change and a timeline for when policies would be implemented. During this time, they also engaged parents and conducted trainings to help them become involved in advocating for change. But when it became clear that internal pressure wasn't enough, the group decided to pursue legal action.

Although some individual schools had already begun implementing disciplinary reforms, such changes might never have become standardized across the district without the pressure of a lawsuit.

"My view," lawyer Eva Paterson said, "is that this is a cutting-edge settlement, and if it works well, which we hope it will, it will be a model for other school districts around the country."


To learn more about each BHC site's successes, challenges, and lessons learned, read the full case studies:

From Farm to Every Fork: Rewriting the Narrative on Urban Agriculture in Sacramento

Ending the School-to-Prison Pipeline: A Case Study of Community-Led Discipline in Kern County

From 'Bad Apples' to Broken Systems: How Richmond Residents Rewrote the Narrative on the Formerly Incarcerated

Reading for Health: A Reimagined, Community-Driven Approach to Early Literacy in Del Norte County and Tribal Lands

What community-first models for change are working where you live? Let us know at, @BMSG, or on Facebook.

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