Like most of the United States, the city teams participating in the Invest Health initiative found their priorities upended by the COVID-19 pandemic in March 2020. The national Invest Health initiative, a project of Reinvestment Fund and the Robert Wood Johnson Foundation, has brought together cross-sector collaboratives in 50 small and mid-size cities since 2016 to develop health and equity-focused strategies for community investment; its second phase, Field Building, provided ten of those cities with ongoing targeted support for their work. The pandemic’s disproportionate impacts on the health of Black, brown, and low-income communities brought into stark focus the inequities the city teams were already fighting. However, despite the challenges of COVID-19, leaders in Akron, OH, Missoula, MT, and Greensboro, NC also found opportunities to leverage the cross-sector relationships and community engagement practices they had fostered since 2016 through Invest Health.
Cross-Sector Leaders, Resident Leaders
When COVID-19 hit, Missoula activated its designated disaster response entities, Community Organizations Active in Disaster (COADs). Invest Health team members who were directly involved with the COADs, including Hallie Carde, Health Equity Coordinator for the City-County Health Department, ensured resident voices were being heard throughout the crisis.
In addition to government partners, non-profits, and the broad-based community organizing network Common Good Missoula, community residents participated actively in COAD efforts for the first time, made possible by Carde’s involvement and community connections. Carde’s Health Equity Coordinator position itself was created through the Invest Health work. “If Hallie hadn’t been in [that] position, we wouldn’t have had some of the smart decisions [we had during the crisis],” said Susan Hay Patrick of United Way.
In Akron, Marissa Little of Neighborhood Networks works with the What’s Next Committee, an organization of resident leaders that implements the Invest Health team’s long-term plans. This relationship strengthened during the pandemic, as What’s Next worked to meet immediate community needs while other team members made sure their critical programs for workforce development and minority capital access didn’t fall by the wayside. “Our ability to keep in touch is a testament to Invest Health and the What’s Next and Workforce Coalition groups,” said Little. “Community outreach is tough when you can’t reach out in person. The relationships from the last four years are coming in handy.”
In Greensboro, residents took the lead in tackling food distribution challenges during the pandemic. Residents had relied on one organization that had been distributing food at Cottage Grove, an affordable housing complex that was renovated during the first phase of Invest Health with Reinvestment Fund financing. So, when that organization suddenly halted its activities during the pandemic, residents were left without access to essential resources. Josie Williams of the Greensboro Housing Coalition recalled a representative from Cone Health saying to residents in a meeting, “You guys have more power than you think you do, and you don’t have to put all your eggs in one basket.” Those residents proceeded to take the lead and organize their own food distribution entities through churches and other local institutions, partnering with the University of North Carolina at Greensboro’s Center for Housing and Community Studies.
Moving forward, partnerships and networks should be leveraged to keep bringing residents to the table and help them spearhead initiatives, Williams said. “Let’s get to the point where it’s…second nature to say ‘we brought all these fantastic people [onto this committee]— bring your fantastic community members into this group as well’.”
Recovery and Beyond: Towards Racial Equity and Justice
Williams believes that long-term, sustainable solutions are needed to capitalize on the momentum from the response to COVID. “People are forced to do things differently right now…funders are funding [different kinds of projects]….but will that last [beyond the pandemic]?” she said. “What can we put in place now that will be equitable now and in the future?” Housing is a critical piece. Kathy Colville of Cone Health emphasized that the Invest Health team must facilitate a “mindset shift” throughout the city that will help prioritize housing and health.
In Missoula, the City is budgeting for more Equity Coordinators in 2021. The new Community Housing Trust Fund has a Citizen Advisory Committee, which marks the first time citizens are making decisions about how to spend public money from such a fund. “This is huge, so let’s celebrate…and collect the data about where people are at, and where they want to be in 2022,” said Lisa Beczkiewcz from the City-County Health Department. Missoula’s Invest Health team is also working to promote Black and Indigenous leadership in all new initiatives.
The Akron team hopes to develop longer-term plans for addressing social determinants of health. In the wake of the recent uprising for racial justice, racism was declared a public health crisis at the county level. Invest Health partner Summa Health System has created a social justice plan, and its board of directors is actively discussing ways to address health inequities. “We’re really looking at how we can advance health equity through [SDOH planning], and that’s where […] the synergies we’ve been able to make because of [Invest Health] come in,” said Marlo Schmidt, who works with Summa.
While the impact of COVID-19 has been devastating, it has also illustrated the importance of relationships, connectivity, and involving those most affected in decision-making. The Invest Health city teams’ experiences highlight the importance of engaging authentically with residents to improve community health and well-being, even from six feet apart.