As a health strategist and convener, the Clark County Public Health Department has reframed its strategy for supporting vulnerable children and families and forged close relationships with the Vancouver Public School District, faith-based organizations, and a mix of health providers and housing and social service agencies. This rich network of engaged stakeholders in Washington state has established effective channels of communication and the trust that can only develop over time.
Rethinking Its Role
Around 2010, with funding forcing cutbacks in many of its child health and maternity programs, the Clark County Public Health Department in the state of Washington began rethinking its role. “We took a step back and asked what really makes a long-term difference in child health outcomes,” explained Anne Johnston, RN, a public health nurse in the department.
With evidence emerging about the importance of “place” in child health, the health department analyzed local indicators and pinpointed areas of Vancouver where children were at especially high risk of adverse childhood events, including trauma. “We selected this area to try to work in a different way, to address some environmental concerns and really work with the neighborhoods and the community as true partners,” said Johnston. “We didn’t want to focus only on needs, we wanted to build on strengths and assets.”
In the face of diminishing resources for direct services, public health officials sought to answer one overarching question: How can we support programs that do offer services? Their conclusion, explained Johnston: “We can support them with expertise and connections and data.”
“We define ourselves as a health strategist. We have skills to convene and facilitate. We can be a thought processor, a connector, a supporter.” – Anne Johnston, Clark County Public Health Department
Linking Public Health and Education
Strengthening ties to the school system was an obvious early step in the health department’s surging commitment to collaborative efforts on behalf of children. Educators in Vancouver already understood education to be a social determinant of health, said Tamara Shoup, MRA, executive director of school supports within the Vancouver Public School District.
“When children graduate from high school, they are more likely to have greater access to health care, better access to healthier neighborhoods and a greater ability to make educated decisions about their health.” – Tamara Shoup, Vancouver Public Schools
In a community where more than half of students qualify for free or reduced-price lunch, educators recognized that school success requires more than good teaching. “For us, it is the whole child approach,” Shoup said. “Children arrive at our doorstep complete. They bring with them everything they have at home, all of those assets, strengths and challenges.”
Through its Family Engagement and Family-Community Resource Centers, the school system has woven together a network of more than 60 local partners to provide ancillary supports for its students — from weekend food backpacks, clothing and school supplies, to after-school programs and mental health services, to parenting workshops, transportation, and housing assistance. Designed to make sure students come to class ready to learn, full-time coordinators now staff resource centers in 18 schools; 18 other schools in more remote locations are served by two mobile vans.
Many of the community partners, including the health department, meet quarterly as part of the Strengthening Neighborhoods Collaborative. The school district serves as the collaborative’s backbone agency, but it “is really about a shared mission for the children in our community,” explained Shoup. That reflects a culture in Vancouver that seems to value teamwork, rather than competition, recognizing that a grant award to one nonprofit in Vancouver is a win for all.
“Rather than thinking we have to own all of the responsibilities or hold all of the resources and money, we are coming together and saying it will take all of us.” – Tamara Shoup, Vancouver Public Schools
Anne Johnston seconded that perception. “We participate in their meetings and they participate in ours. Each of us brings in expertise and an understanding of the community that brings the work forward.” After receiving a Healthy Eating Active Living grant from Kaiser Permanente, for example, the health department partnered with the schools to design a Bike to Leadership program, which is now operated by Bike Clark County, a local nonprofit organization. Beyond encouraging safe riding to school, the program gives students opportunities to learn bike mechanics and leadership skills.
Outreach to Faith-Based Partners
The research literature is clear about an essential item in the toolkit needed to support high-risk children: “having that caring adult who builds connections with children is one of the biggest things that can change their trajectory,” Johnston said. “We asked who might have the capacity to move this need in our community.”
One overlooked candidate for engagement emerged: faith-based organizations.
“Faith-based partners are often the overlooked stakeholder group. We forget to invite them to the table.” – Anne Johnston, Vancouver Public Health Department
Health department staff scheduled a “faith-based coffee” to share data about the community with leaders of local religious institutions and start talking about partnership opportunities. “They care about children and often times help in neighborhoods, but they didn’t really understand what was happening in their own backyards,” Johnston discovered. “They didn’t understand that kids were going home hungry.”
School district officials saw an opportunity here, too, recognizing faith-based organizations as a potentially valuable new partner. They asked to be part of the dialogue with health officials. For their part, faith-based leaders were clear about wanting to make their contribution through the schools. The health department convening became a bridge across the two sectors.
Before that could happen, all of the stakeholders had to have a candid discussion about the constitutional separation of church and state – religion could not be brought into the schools. “We had to talk about the elephant in the room. This had to be about learning and serving, not about evangelizing,” said Johnston.
“The health department served as a facilitator between the faith-based groups and the schools. Often times we are seen as a more neutral party. We are natural conveners anyway.” – Anne Johnston, Vancouver Public Health Department
Once clear guidelines were established, the faith-based groups began contributing both material and relational support (e.g., supplies, mentoring) in response to needs identified by the schools. Soon enough, social service providers knocked on the health department’s door to ask to be part of the same coffee klatch. “We’ve always wanted to talk to faith-based partners,” they acknowledged. “Can we attend as well?”
Linking Public Health and Housing
As valuable as cross-sector relationships are for the long, slow work of building community health, their power sometimes emerges with special force during a crisis. Shortly before Christmas in 2014, the predominantly low-income residents of Courtyard Village Apartments, a privately-owned rental housing complex in Vancouver, received “no-cause” notices to vacate within 20 days. Frantic family members alerted coordinators at the Family-Community Resource Centers and school staff, in turn, reached out to the public health department and the Council for the Homeless to plan a communitywide response.
“We put out a call for action, and our community responded in a huge way,” said Johnston. Within a month, local agencies had raised $80,000 to help rehouse the affected families and a longer-lasting strategy was crafted soon afterwards, with support from the Council for the Homeless and other housing, education, and legal partners. Through a “Bring Vancouver Home” campaign, advocates helped persuade voters to support a $42 million, seven-year property tax levy to provide or preserve affordable housing for very low-income families and seniors; the ballot measure passed in 2016.
“Public health can’t take credit for all of that,” Johnston acknowledged. “We just happened to have a platform that allowed for some rapid response and getting information out there. What mattered was that the relationships had been built.”
Other efforts to address housing and homelessness in Vancouver continue, reflecting the collaborative impulses of local organizations. For example, the Vancouver Housing Authority has set aside some of its “stable housing vouchers” for families with school-age children who have been identified as homeless or at risk of homelessness by a resource center coordinator. The Free Clinic of Southwest Washington is another engaged partner; in response to a data-rooted alert from public health officials, it has expanded its outreach to an area of the city that has a growing homeless population.
In Vancouver, it’s all about recognizing the overlapping concerns and unique capacities of local partners, pointing them towards common goals, and multiplying their power to grow healthy children.