Transcript of Episode 10A: Village HeartBEAT

with host David Richards [DR] and guest Cheryl Emanuel [CE] 
Listen to the audio

[DR] Hi Healthy Communities podcast listeners, if you haven’t already heard, we’ve announced the winners of the Healthiest Cities & Counties Challenge. These next couple episodes are going to be dedicated to our winners and their amazing stories. Our first episode is with Cheryl Emanuel, health manager for the Mecklenburg County Health Department in North Carolina. Enjoy!  

[DR] Welcome to the Healthy Communities podcast; a public health-themed podcast that breaks down common health issues in our communities, and how Healthiest Cities & Counties Challenge projects aim to address them. I am your host, David Richards from APHA. This is Episode 10A: Village HeartBEAT 


[DR] Do you want to introduce yourself?

[CE] I’m Cheryl Emanuel with Mecklenburg County Village HeartBEAT, here in Charlotte, North Carolina. 

[DR] Thank you so much for joining me and congratulations for being the winner, the first winner of the Healthiest Cities & Counties Challenge. It is very exciting. You and your team have done incredible work. One thing that has really stuck out is that it’s grown into something unbelievable. My first question is do you want to briefly explain Village HeartBEAT and also explain what your community is like?

[CE] Village HeartBEAT, and I think you did it right, is built upon team engagement and built truly on a model of collaboration. That is foremost with the model. When you think about the word village, a village is a community. And heartbeat is building education accountability together. So creating our project really started with us knowing a lot about our community here in Charlotte and creating a village around it. Our initiative entering into the Healthiest Cities & Counties Challenge, we all had to select a health indicator or area that we wanted to work in. When you think about our model there are a couple of what we call main overarching pieces with the model. First and foremost is built with faith-based collaboration at the core of the model. The overarching pieces that we created with the model are the piece around health behaviors and the competition aspect of the model, where all of our participants are required to look at their risk factor around chronic disease. They actually are engaged in to understand what their numbers actually mean. The other part of the platform is what we call the acronym BOLD (Building Opportunity Leadership Development). That component is where we engage faith-based congregations into what we call an authentic partnership, where we are investing resources for them to be in the space in business partnership solutions around the problems in our community around chronic disease. With the business model part, part of the model is to address policies, systems and environmental changes with Village HeartBEAT.

[DR] What’s great. Who are the participants in the challenge? 

[CE] The participants in the challenge how we have defined it in terms of looking at our community. One of the questions that you asked was what is Charlotte like. When you think about Charlotte, we are a beautiful, skyline city; it’s one of the fastest growing cities in the Unites States. We’re the seventeenth largest city. With all that beauty, when you begin to unlayer it, the underneath layers exist, Charlotte is also a community with a lot of economic hardship. There is a lot around racialized poverty and a challenge around low wages. When you think about that with all that beauty, there is a lot of is that aren’t that beautiful. So who is a part of Village HeartBEAT?  We have consciously looked at mapping out what we call public health priority areas. And for us, with these priority areas, we can map them according to ZIP code. The work that we’ve been doing for years is understanding and really being grounded in our community. What was important for us, in order to get true solutions, you have to engage not just systems, but engage real people who really live and breathe in these areas of concentrated poverty. Our partners have been a collaboration of faith-based organizations that we have mapped out. Their all denominations, they have become the American Heart Association, the hospital systems here, academic universities. Our initiative has been one to lead the table on the platform to bring people together for true authentic engagement, a true opportunity for us to move the needle on issues that we know plague our communities where we can do better. 

[DR] That’s a really good point. How did the Village HeartBEAT program begin? Did it come organically from the community asking for it or was it something thought up through the public health department? How did that begin?

[CE] There’s a combination of all of the answers that you just said. For every initiative, you need someone to set the agenda, to be the visionary. I’ve had the opportunity to truly understand who I am as a person, so much of that vision has come from me, but it has come from a team perspective. The name Village HeartBEAT came from our pastors, who came up with the name in combination with me. But more so than that, it came from us understanding the players in our community. It’s been a lot of us coming up with how Village HeartBEAT started not just necessarily one individual. For any project you know that you need a visionary that can see the big picture and not give up and do better. 

[DR] I’ve heard from countless people how important you are and how amazing your role has been. I think I know that firsthand, so thank you. 

[CE] It’s all about relationships, David. I believe that the space that we work in everyday in public health, if we’re doing a good job, we’re supposed to work ourselves out of a job and make things better. We should be our brothers and our sisters’ keeper at all times.

[DR] What does it mean to be a finalist? What does it mean to be recognized? 

[CE] Well, to us it means everything. It’s a platform. We say like a mustard seed, that truly was a mustard seed. Sometimes with mustard seeds, their unseen and discounted only until they start to grow. That’s sometimes the same thing with our communities; they’re often invisible to the greater community and unseen and disadvantaged. Winning this challenge for us has been an opportunity to say that when the seeds are nurtured, they can grow. But they have to be nurtured with the right attitudes, the right compassion, and most of all, they have to have the right people who believe that we can love each other better so that we can become better. Winning this challenge put us in this platform, not only to learn new information, but also to share our own journey. It’s allowed us to see that where some days may have seemed impossible, but that being a part of the greater platform, the healthiest cities and counties challenge, there are always possibilities because we have access to resources and individuals that we previously did not have as part of the challenge.   

[DR] You touched on that but what were some of those challenges along the way?

[CE] Well, one of the roadblocks, and that’s me being completely authentic, when you are developing an initiative like we are and operating in a government structure like a health department we have built a collaborative really based on the people. We make no decisions; I make no decisions, without the Village input. Everything comes to the table and we decide when and how we should do it. Often, some of the challenges, when you are trying to help systems understand that faith-based organizations are great partnerships, sometimes you have to do more because those systems aren’t in the space or amenable to saying that faith-based organizations can be equal partners in an initiative like us. One thing that we know about churches, or faith-based organizations, they’re in every corner of our community and they have a multitude of talent and resources and you cannot discount them. What’s been rewarding for our initiative is when our board of county commissioners and leadership agree to take a chance and invest their own resources on an idea. We kept saying that you can’t continue to look past faith-based organizations. For them to open up their doors, for partnerships that aren’t always authentic, they are institutions that are set around business principles. We should do more engagement with them around being business partners in the model. Once we decided to do some investment, you could see, just the additional resources that came to the table, not only that but the kind of data that we’ve been able to collect. It is fascinating to know that there is promise in the future. These institutions can collect data quicker than anyone in our community.          

[DR] Let’s talk about the growth of it. You have this great example of starting out as a mustard seed, but now it’s a field, it’s everywhere. You started out as a couple of these faith-based organizations starting out as these hubs, now it’s grown into something more. Do you want to talk about that? 

[CE] Yes. You know with growth, it can be rewarding, and you can also have growing pains. The growth has been great but we also realized that for this year, there is no question in mind; we can scale the model in terms of quantity. It’s most important to us when we scale the model that we’re all on one accord so that we have a quality product that we’re putting out. When something grows that quick and when you begin to identify problems, you have to figure out how to navigate through a complex health system. Then it takes time to make sure you have the right people who are going to be willing to help break down some of those social barriers. To a certain degree, in the times too, there is an element of social justice aspect around how you break down some of those barriers. That’s why it’s important to have a team effort and approach when you look at the model. Yes, we have grown and that’s been great, but the beauty behind it is that we have a lot of pride form the participants. We can show their milestones and their progressions, and we often tell individuals that you don’t see a change until you end something for a while. When you hear the testimonies among the participants, those are the types of stories that they will tell you to see the beauty. They we’re close to 500 pounds and over a three year period have lost an excess of 200 pounds. They’ve done it the right way without the surgery or the extra medication, but have really changed their behavior and believing in exercise. We also have a support system that Village HeartBEAT has wrapped around them, it has been beneficial. On the other side with the part with the hubs, what we’ve seen there is they have the opportunity to understand more about how they can be in the space around policies, systems and environments changes. When you see our neighborhoods now, many of our churches had policies, but didn’t necessarily have policies that they were smoke free environments. Now, when you arrive, you see signage that they are smoke free campuses. Not only having a sign there, their community and congregation understands that if a member was still smoking, they have an opportunity to come into our community health leadership academy, which is the foundation and structure around Village HeartBEAT, to be able to understand what kind of classes and what kind of resources that may be affordable to them to help to smoking if they choose to. 

[DR] That’s fantastic. I wanted to turn to the data that you’ve been collecting and you also recently partnered with the local college to help with the data collection. What are you measuring? I know it’s BMI, what else are you looking for?

[CE] So when we started our initiative, we partnered with Gramercy Research firm, which is an independent research firm and it’s not here in Charlotte, it’s actually in Winston Salem, not far. They were our independent evaluator working along with us. We’re looking at A1C, blood pressure, BMI; those are the main biometrics with cholesterol. Those are the biometrics we’re looking at as it relates to the challenge. Then as it relates to our policies, systems and environments, we employ different tools to see what levels of engagement the church can actually engage in. Because the significance that we’re trying to make in our project, we are trying to have congregations have health and wellness ministries so that they can be sustained over a long period of time. Although our model has the competition component that we run similar to a playoff as the part of gamification, the information that the church team may be participating in, all of the information goes back to try to build a strong congregation around health and wellness. We’re measuring, not only the biometrics but when the participant comes into the challenge they go through an extensive survey. We want to know how many of them have a medical home and how many of them are skipping medication or can’t afford the medication. We want to know how many of them have cell phones. We know from the academy that as we move into the era for them to have to go into a doctor much of the information now is around technology. Some of our participants aren’t savvy enough around technology. Our academy, the Theresia Elder’s Community Health Leadership Academy, is the foundation where that training has actually takes place, so we partners with Google Fiber and some of the colleges here to do some classes around social media. There are multiple types of questions on our instrument that we’re asking and each question that we ask, we look for solutions to keep the participant moving along. 

[DR] I just have a couple more questions left. My next one is turning it back to the Challenge. How has the Challenge been important to your community and what role has it played in your work? 

[CE] I’m going to use what I call the four P’s: The people. The project needs to understand that the people are very valuable. And that for all data, there are faces behind the data. The other P is partnerships. We can’t do anything unless we have partnerships. Truly, we can see progression happen when we have authentic partners. The other one is definitely progress. This is what the Challenge has helped us to do. It allowed us to be accountable so that we could see progress. And one of the biggest parts of the P’s is pride. It has given our community a lot of pride and our participants who see themselves elevated. And the one underlying piece with the for P’s has been love. It’s given a lot of love in this community where ideas can be elevated when we come together. 

[DR] My last question is what is the future of Village HeartBEAT? Where do you go from here? 

[CE] We have about six bullets. We’d like to scale the project to a larger community and larger platform. We often get phone calls from people around the country. Our project has gotten a heartfelt reach from the world council of churches and so this past summer and past December we had the second round. We hosted the world council of churches, including eight representatives from WHO. There were four countries that came to visit the project so we’re in the process of working with the world council of churches to look at a health promoting handbook working in Village HeartBEAT, which working in this space could be replicated. We’re hoping in terms of our project in terms of the Healthiest Cities & Counties Challenge to advance the level of our hub responsibilities, hopefully incorporating more, and I don’t like the word, case management services. We have to make sure that when we’re asking questions that we find out that there are problems that we have to have solutions for. As Village HeartBEAT grows, we hope that our hubs become a best practice model. I often say it that I may not see it in my lifetime, but I’m a dreamer. I believe that if we dream, we can create these regional playoffs around neighborhoods and faith-based organizations leading the efforts for us to be healthy. That’s where we hope to go that with the model we can have a higher level think tank with experts to look at the pieces that our working and looking for encouragement and direction for how we can make this an evidence model for the future. 

[DR] That is a great place to end this conversation. I really appreciate talking with you. It’s been fantastic. 

[CE] Thank you so very much.                       


[DR] That’s the show this week! Thank you to my guest Cheryl Emanuel, and thank you all for listening. Links to more resources can be found on the Healthiest Cities & Counties Challenge website at healthiestcities.org under about the challenge, podcast. I’ll see you next time.