A Texas border town is not the first place that comes to mind as a health-care pioneer. But despite waves of immigration and border challenges, Brownsville was chosen this week as one of six communities out of 250 around the country that’s created a – quote –culture of health. The Robert Wood Johnson Foundation presented the honor – and a $25,000 dollar check – to each community at this week’s Aspen Ideas Festival.
“Eighty percent of our population is overweight or obese, thirty-one percent has diabetes,” says Belinda Reinenger, associate professor with the University of Texas School of Public Health in Brownsville.
“In addition to that, sixty-seven percent of our population has no insurance,” Reinenger says, “Not Medicaid, not private, nothing.”
“We knew we had to take a unique and preventative approach to address those issues,” she says.
Yes, Brownsville started traditional fitness classes, but it also made exercise a part of everyday activity by creating safe trails for kids and parents to get to school and work. It set up a farmers market that accepts Loan Star benefits cards to help people buy fresh food who might not be able to afford it.
Brownsville also looked across, well, a few additional borders for practical, proven ideas to make being healthy easier. One that’s taken off is from Bogota, Colombia called the CycloBia, or bike path.
The other five Robert Wood Johnson Community winners are Durham and Buncombe County in North Carolina, Spokane, Washington, Williamson, West Virginia and Taos Pueblo, New Mexico.
Shawn Duran, the tribal programs administrator in Taos Pueblo, says for a long time, healthcare in her community was a top-down experience. When the tribe established self-governance in 2007, she says it allowed them to break down old notions and come up with new ideas to bridge education and health.
“For example, the senior citizens hot lunch program,” Duran says in the past, the program simply gave hot meals to seniors, “With the changes there’s a public health nurse that goes on the visit and she’s speaking the language, she’s in tune with the cultural needs with the family.”
Taos Pueblo integrated its head start program with child care, started agricultural education with tribe youth and even built greenhouses run on renewable energy.
A Holistic Approach To Community Wellness
Not every “Culture of Health” project is about healthcare in the traditional sense. Leaders in Spokane County, Washington have been focusing on education as a way to improve health, and income, long-term.
Leaders in Williamson, West Virginia are providing resources to entrepreneurs to create sustainable businesses.
Shawn Duran of Taos says change hasn’t been easy.
“In our community It’s been tough to change,” Duran says. “It’s now something we can say, we’ve come this far but we have so much more to do.”
Creating a culture of health requires more than building a few new clinics. It’s about re-designing communities, from the streets to the shops to the schools. This year’s award winners are experimenting with ways to make health a part of everyday life instead of something you find in a doctor’s office.
Here’s more details on the six winners from the Robert Wood Johnson Foundation:
- Brownsville, Texas – Brownsville’s proactive approach to making health a priority has resulted in a more vibrant, mobile, and age-friendly community. Initiatives like Tu Salud ¡Sí Cuenta!, a community-wide campaign to address chronic disease prevention that includes mass media, free exercise and nutrition classes, and the support of bilingual community health workers are essential to helping the many uninsured and chronically ill residents to engage in healthy lifestyle changes. The City has implemented a comprehensive smoke-free ordinance and has approved a Complete Streets Resolution, and a Master Hike and Bike Plan. Activities like CycloBia, where thousands of residents walk, run, cycle, and enjoy outdoor activities in traffic-free streets, and The Challenge, a city-wide, friendly weight-loss challenge, have been highly successful to promote active lifestyles and have demonstrated the strength of community partnerships in action.
- Buncombe County, North Carolina – By creating a broad collaboration of community partners, Buncombe County is on a path to long-term and sustainable change. Focusing on system, policy, and individual behavior change, initiatives include: the Community Navigator Program that helps families access needed health, social, and community services; a partnership between local businesses and civic groups that is creating a safe space for fellowship and community building in the Shiloh neighborhood; and the Family Resource Center that provides food, clothes, and resources to support families in times of need.
- Durham County, North Carolina – To build a healthier community, Durham County is addressing multiple factors that impact health. Local clinicians offer low-cost treatment to the uninsured while others donate their time to improve access to specialty medical services. The East Durham Children’s Initiative is one of numerous parent, family, and child support programs that promote education among underserved populations, and the Holton Career & Resource Center supports high school graduation by providing alternate educational paths for youth. Smoke-free public places, workplace wellness programs, and a comprehensive bicycle and pedestrian plan have contributed to better health.
- Spokane County, Washington – Recognizing the powerful impact education has on long-term health, Spokane County has transformed its approach to health improvement by expanding educational opportunities that empower young people. In 2006, the overall graduation rate for Spokane Public Schools (SPS) was less than 60 percent, while Spokane County’s rate was 72.9 percent. County leaders—including school officials, local universities, the business community, and other partners—responded with a series of innovative steps, including skill-building training sessions for young students; a real-time early-warning system to monitor student attendance and grades; and targeted dropout prevention programs designed to be supportive rather than punitive. By 2013, the SPS graduation rate jumped to 79.5 percent, with an even higher rate (81 percent) for Spokane County.
- Taos Pueblo, New Mexico –Through leadership and self-governance, the Taos Pueblo community draws on its cultural traditions to address modern challenges. Produce grown at the Red Willow Farms pay homage to the community’s agricultural roots and also support economic development. A strong tribal identity is instilled in the Pueblo’s youngest children, as English and Tiwa—the community’s native oral language—are taught side by side as part of the Head Start program. The Pueblo’s Public Health Nursing Department helps to address the health needs of the tribal community, and the Community Fitness Program offers a variety of fitness classes for residents of all ages.
- Williamson, West Virginia –In the heart of central Appalachia coal country, Williamson is committed to improving health and expanding economic development through the Williamson Health and Wellness Center (WHWC), the anchor institution of Sustainable Williamson. As a regional Health Innovation HUB, WHWC is actively linking health and entrepreneurship. To ensure at-risk residents have access to healthy foods, a community garden built next to a low-income housing facility offers neighbors an opportunity to grow fruits and vegetables. Williamson’s monthly 5k races and lunch walk program challenge residents to make physical activity part of their everyday life. Community health workers, serving as liaisons between doctors and patients, empower residents to live healthier lifestyles.
The RWJF Culture of Health Prize is awarded annually. Today also launches the Call for Applications for next year’s prize. Learn more at www.rwjf.org.