‘A Team Effort’: Region garners national ‘culture of health’ award

"Harnessing the collective power of community members" is one of six general criteria for the RWJF award. Artist MacRae Wylde adds bamboo -- habitat for mason bees -- to his art installation at FISH Food Bank, and example of partnerships for community wellness.

Photo by Kirby Neumann-Rea
"Harnessing the collective power of community members" is one of six general criteria for the RWJF award. Artist MacRae Wylde adds bamboo -- habitat for mason bees -- to his art installation at FISH Food Bank, and example of partnerships for community wellness.

The Gorge’s “collective impact” initiative just got a big boost, monetarily and in morale.

Local non-profit leaders learned this week that the Columbia Gorge is one of seven winners of the 2016 RWJF Culture of Health Prize awarded by the Robert Wood Johnson Foundation. The prize honors communities for their efforts to ensure all residents have the opportunity to live longer, healthier, and more productive lives.

The Columbia Gorge region is nationally recognized for bringing partners together to rally around a shared vision of health, drawing especially on the wisdom, voice, and experience of residents themselves.

Culture of Health Criteria

To become an RWJF Culture of Health Prize winner, the Columbia Gorge had to demonstrate how it excelled in the following six criteria:

•Defining health in the broadest possible terms.

•Committing to sustainable systems changes and policy-oriented long-term solutions.

Cultivating a shared and deeply-held belief in the importance of equal opportunity for health.

•Harnessing the collective power of leaders, partners, and community members.

•Securing and making the most of available resources.

•Measuring and sharing progress and results.

The Columbia Gorge will join this year’s other prize-winning communities at the Culture of Health Prize Celebration and Learning Event, taking place at Robert Wood Johnson Foundation headquarters in Princeton, N.J., Oct. 19-20.

Learn more about Columbia Gorge’s work, as well as this year’s other prize winners through a collection videos, photos, and more at www.rwjf.org/Prize.

“It’s a willingness to be open and to listen to our end users and what our community actually needs,” said Paul Lindberg, collective impact health specialist, a position funded by Providence Hood River Hospital through the United Way of the Columbia Gorge, “as well as a willingness to collaborate as community partners to address those needs.”

Those “determinants of health” are food security, affordable housing, jobs and transportation.

The RWJF award comes with a $25,000 prize, to be given to the Gorge Grown Food Network to address hunger issues.

“The Culture of Health Prize is a great recognition that we’re heading in the right direction,” said Sarah Sullivan, executive director of Gorge Grown. “We look at this award as encouragement rather than accomplishment.”

“This award is about the region’s ability to collaborate and work together across boundaries, sectors and issues, all to serve community members who have needs,” said Lindberg.

Chosen from nearly 200 applicant communities across the country, the Columbia Gorge’s award winning efforts include its broad definition of health, which includes social determinants of health efforts to give voice to the region’s vast Latino population, and expanding the scope and role of Community Health Workers.

Thirty-nine organizations participated in a health assessment, sending surveys to residents in three counties in Oregon and two on the opposite side of the Columbia River in Washington. From that outreach, the community lined up around a set of shared priorities, said Kristen Dillon, a family physician and director of the Columbia Gorge Coordinated Care Organization.

“It continues to knit our community together as one community,” Dillon said.

“The RWJF Culture of Health Prize communities show us that in towns and regions across the nation, individuals are coming together to find powerful ways to help people achieve the best health possible. These communities are connecting the dots between health and education, jobs, housing, and community safety,” said Risa Lavizzo-Mourey, RWJF president and CEO. “We’re privileged to learn from this growing network of communities that offer hope for the well-being of the entire nation.”

No one agency gets the credit for the RWJF award, according to Lindberg.

“It was a team effort,” he said, adding, “My work is not possible without Providence. The fact is the (collective impact specialist) idea is Providence’s.”

“It’s a wonderful acknowledgement of what the community has been trying to do and continues to try to do,” said David Edwards, chief executive officer of One Community Health, a federally qualified health center.

The Columbia Gorge region will receive a $25,000 cash prize, join a network of prize-winning communities and have their inspiring accomplishments shared throughout the nation. The other six winning communities are the 24:1 Community in the St. Louis area of Missouri, Louisville, Ky., Manchester, N.H., Miami-Dade County, Florida, Santa Monica, Calif., and the Shoalwater Bay Indian Tribe in Washington.

How Gorge Grown will spend the $25,000 will be decided later, according to Lindberg. One of its more successful initiatives is the “Veggie Rx” program, in which health care and social service providers can issue individuals a monthly “prescription” for $30 of fresh fruits and vegetables.

Sullivan said the health assessment exposed the extent of food insecurity. The Veggie Rx program “prioritizes food not just theoretically or through nutritional advice, but on the ground by screening patients for their food needs,” she said. Recipients have embraced the idea: At senior centers, the redemption rate has been as high as 98 percent.

Lindberg notes that the windy Columbia River Gorge boasts ideal conditions for kite surfers and sailors and high-tech companies have moved into new waterfront buildings in Hood River, joining tourism and agriculture as the area’s main economic engines.

But the Columbia Gorge, a vast rural area larger than the state of Connecticut with only 75,000 people, is characterized by extremes. Not far from the coffeehouses and boutiques of Hood River, White Salmon, and The Dalles are remote towns where some residents live in poverty and the nearest doctor’s office may be an hour away. Orchards produce a bounty of pears, apples and cherries — but one out of five people report running out of food on a regular basis.

To bridge those disparities, the people of the Columbia Gorge region turned an ordinary requirement from Oregon lawmakers into an extraordinary opportunity to improve the health and wellness of all residents, according to Lindberg in a press release.

He said the process started four years ago when the governor of Oregon signed into law a new system for managing federal dollars for the medical needs of low-income residents. The state was divided into 16 regions, called Coordinated Care Organizations (CCO), and each had to assess the well-being of residents and come up with an action plan for improvements.

“We made a big decision,” said Mark Thomas, chaplain at Providence Hood River Memorial Hospital. “We could have a lot more traction and our solutions could be more effective, if we actually slowed down and listened to the people we aim to serve.”

In the Columbia Gorge, that directive became a catalyst for creating a more collaborative approach for shaping policy and improving results. People saw a chance to start a broader, deeper discussion on health, reaching across all sectors of the community.

The community decided on the makeup of the 15-member Community Advisory Council (CAC), mandated by the change in the state’s Medicaid system, and included individuals who rely on Medicaid for their healthcare, Latino residents and a parent of a child with a developmental disability. Drawing on the health survey and input from medical and social-service professionals, the advisers came up with a set of 10 priorities. At the top were concerns about food, housing, transportation and jobs, followed by the need for better access to dental and mental health services, and better coordination between providers of healthcare and social services.

The council gives voice to the region’s Latino population, which had been historically isolated from decision-making on health matters. About a quarter of the population of the Columbia Gorge is Latino, with many families arriving as migrants to work in the orchards. “First we were not heard, then we had to shout to be heard, and now we can talk together in the same room,” said Elizur Bello, a program manager at The Next Door, a social services nonprofit with a large Latino client base.

The action plan for the Columbia Gorge includes expanding the long-standing use of community health workers. For more than 25 years, The Next Door has relied on trusted community members to help Latino clients navigate issues or problems that may arise outside the clinic walls. The goal now is to expand that model, train and certify workers, and utilize them in a broader range of nonprofits, clinics and agencies.

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