Transcript of Episode 2: Health Across Borders

with host David Richards [DR] and guest Elyse Jardine [EJ].
Listen to the audio

[DR] This week on the Healthy Communities Podcast we talk with Elyse Jardine about community health and equity. We’ll see how a mighty river brings people together. 

[DR] This is the Healthy Communities Podcast Episode 2: Health Across Borders.


 [EJ] My name is Elyse Jardine. I’m the project manager for the Health Collaborative. I have been in this role officially for a year and a half now. Previous to that I was a fellow at the Danville Regional Foundation and the Health Collaborative was a side project for my formal fellow’s project. My position within the Health Collaborative is a collaboratively funded project management position. My position is funded by three of our stake holders: The Virginia Cooperative Extension Health and the Danville Region Foundation. I provide support for our action communities that are working throughout the region.

[DR] That sounds really great. It sounds like there are a lot of stakeholders. Can you define, in your expertise, what is a health collaborative? What does that mean and what does that mean working with so many stakeholders?

[EJ] So when I say the health collaborative, this is how we, the group of stakeholders define it, we are a cross-sector group of organizations and residents who come together to improve the health and well-being of the Danville River Region. We work on uniting organizations and create actions to support health in all in our region and our area. We do this by taking an innovative approach by complementing what our stakeholders are already doing with policy systems and environmental changes to really secure a platform for increasing health equity. In terms of stakeholders, and what that means for us, we are completely open. Anyone who has an interest in and who can play a significant role in our project is welcome. We expand at a pretty large level. Right now we’re at around 110 members that represent over 55 organizations and institutions, community groups and residents. To work at that level, we have a structure in place that includes our coordinating committee and then our action team that specifically work on our goal areas such as active living, healthy eating and access to care and healthy spaces, which is taking healthy living and healthy eating strategies and integrating them to where people are already congregating like work sites, schools and out-of-school programs like faith based communities. Our health in all plans is a 10-year plan that highlights our main strategies and indicates the metrics that we think will show success. They are those intermediate metrics that include single outputs and there are long terms outcomes that we’re ultimately striving for to reduce obesity rates, heart disease, reduce incidences of stroke, so we know those take a long time to show on paper, so the metrics that we’re looking at are really in the middle that can show that we’re making strides toward those long-term outcomes, but also marking our success along the way. 

[DR] What is your baseline? What does health equity look like in your community?

[EJ] The Health Collaborative defines health equity as providing everyone with the opportunities to obtain the highest level of health. In July of this year, we released our first health equity report which broke down health outcomes and factors of social determinants of health, so looking at housing, education, economic stability, by the census track, or in some cases in North Carolina by the zip code. We’re really trying to understand what our baseline is and how we need to restructure opportunities and resources and where they’re headed into the communities to make sure that our built environment and our economic opportunities and our education opportunities really create that kind of platform for everyone to achieve that highest level of health. One of the things that we’re currently working on with our action team now is, as their creating their 2018 work plan, how are we using this information that we found, presented in our health equity report, to inform how we’re building systems and changing policies that are acting as barriers and improving the built environment, but also doing it in a way that makes sense for the community. That will give each community or neighborhood on the census track what they need. We’re working on how we integrate the data with community engagement to really make that positive change towards improving health equity. 

[DR] How did you get that data?

[EJ] It was an intensive nine month process. I created a steering committee of folks from the Health Collaborative as well as outside partners that also hold an interest in this kind of evaluation, data collection work. So we had two main processes that were going on at this time. In conjunction with the Health Equity Report, we also completed our region’s first community health needs assessment for Dansville and Pittsylvania County. Because we’re no served by a nonprofit hospital we haven’t had that requirement to complete a CHA for the last decade or so. We were collecting data for both. The way that the processes broke down was there was the gathering of data from the state health department, from our local health department, from government agencies that really serve the hard data piece. There was also a community engagement piece, which we built a survey which we distributed at the community. We also did key informant interviews with resource providers and then coupled that with focus groups full of community residents. We were able to look at the answers and responses that our providers gave as well as what the communities were giving and be able to try to see where gaps existed and where missed opportunities were to engage, to leverage partnerships, and to create and to build new relationships. 

[DR] I find Danville really fascinating and especially the Danville River Region really fascinating because it does span the two counties in Virginia, but also the county in North Carolina. What has it been like working throughout state boundaries and county boundaries? What has that been like? 

[EJ] What we consider the Dan River Region is actually an independent city of Danville, and Pittsylvania County to the north of that and Caswell County to the south in North Carolina. In terms of collaboration, it’s been a region for multiple different initiatives. Working across state lines and thinking about engaging stakeholders in each jurisdiction, it’s something that I’ve always done throughout my position, whether it was as a fellow or now as a project manager to the Health Collaborative because both of my organizations serve that area. From a larger standpoint of engaging stakeholders from all areas, it plays a large part in what the Health Collaborative is trying to do. If we don’t have representation from all of our communities, we won’t be as successful as we could be. Engaging and creating the collaborative, its first step was establishing those relationships. As the health collaborative grows and expands, and becomes older as a community coalition, we are turning that eye now and asking are we really as regional as we need to be. A large part of this next year is thinking about how we build stronger relationships and add the workgroups in Pittsylvania County and Caswell County. One of the things that we’ve learned along the way is that we have to be flexible and adaptable. If we spend two years thinking about it in terms of here’s this regional platform of active living, healthy eating, access to care, and healthy spaces. Is it time to flip that in Danville and what strategies it needs in those same four areas in Caswell County and what are the specific resources it needs in Pittsylvania and its resources? I think for us, it’s always about taking a step back and thinking about the regional platform and making sure we’re providing the right strategies for each place and realizing that sometimes it comes easier in one than the other in thinking about what policies need to be changed in the long run and what advocating looks like across boundaries. Those relationships mean between our three primary jurisdictions look like in terms of brining everyone together around an issue. 

[DR] What are some of those specific initiatives and have you seen success in them?

[EJ] Two initiatives that are currently running right now that are probably our most regional are, one is our community health workers initiative. It came out of the access to care action team. We have ten community health workers that work in neighborhoods in Danville and within a few mile radiuses around Danville to capture Pittsylvania County and Caswell County. They work in those communities as resources connecting residents to reduce ER usage and primary care providers and other resources such as housing, SNAP benefits. They really becoming those champions within the community to improve health outcomes and to reduce the barriers that many in our communities are feeling. We think about how we can connect transportation, to work place development skills, and going from there as they participate in that program. The second is the thrive challenge. Our healthy spaces action team has created a challenge where they interact with schools and worksites, faith-based communities, and after school programs throughout the region and are helping to inform wellness committees and help provide technical assistance as those community groups work through a menu of health options where they can select some options such as we’re going to start implementing healthy eating or we’re going to provide reimbursement for gym memberships or allow or allow our employees to take an hour and a half at lunch to encourage physical activity in that time. We’re addressing healthy eating and healthy living at the end of the year, tied with our annual health summit, there are the Thrive Awards, which recognize those organizations and individuals who go above and beyond to in looking to improve health outcomes throughout the Dan River Region. For example we had winners from all three locations so we had a middle school parks’ project where Pittsylvania County Parks and Rec built the first four county parks in its 250 year history in Pittsylvania County through joint use agreements with the school and collaborative funding structure. In Caswell County, the food council won a Thrive Award; they actually won two, for a place-based initiative where they create a second farmers market this year for the town of Yanceyville. Then, as well as their lunch on Wednesday, where they provide free lunch to everyone in the community. They provide a place for community connection to bump and spark. In the city, Danville, Pittsylvania County, community services won a Thrive Award for their program and policy work within their organization. The Thrive Challenge really pulled our strategies together to take them to a specific organization and places throughout the region. After those two, the community health workers and the Thrive Challenge are two of our successful regional initiatives that we’re running right now. 

[DR] It sounds really impressive. I have one last question for you. What advice do you have for other communities? And how can they take what you’ve learned and apply them to their projects? 

[EJ] The general advice is to always keep going. There were multiple times in our work in general or tied in with our Healthiest Cities & Counties Challenge work where you feel like you’re hitting that wall. And generally, to get over that or through that, it’s finding that one person or one resource that you haven’t connected to yet. The more people that get involved are more people that lend their voice and input and their skills and resources, the more successful the collaborative will be as a whole. One thing that we learned is that one community of any size can take is building those relationships and really taking the time to build trust in those as well. It may not be the easiest thing to show on paper, but its impact on the work, on the project, on the initiative and intervention is immense.                                                                              


[DR] That’s the show this week. The show is produced by David Richards. Thanks to my guest, Elyse Jardine and thank you all for listening. See you next time.