[Applause] thank you I understand I am what
thank you I understand I am what
thank you I understand I am what separates you all from happy hour today
separates you all from happy hour today
separates you all from happy hour today but I’m a faculty member I could talk
but I’m a faculty member I could talk
but I’m a faculty member I could talk forever so you got to hope that I’m
forever so you got to hope that I’m
forever so you got to hope that I’m paying attention to the time there and
paying attention to the time there and
paying attention to the time there and it’s really hard to follow Marlon but
it’s really hard to follow Marlon but
it’s really hard to follow Marlon but what I want to talk to you about a
what I want to talk to you about a
what I want to talk to you about a little bit today is kind of flipping the
little bit today is kind of flipping the
little bit today is kind of flipping the ready for everything by building
ready for everything by building
ready for everything by building community capacity by really encouraging
community capacity by really encouraging
community capacity by really encouraging civic engagement or community
civic engagement or community
civic engagement or community participation I have a Margaret Mead
participation I have a Margaret Mead
participation I have a Margaret Mead quote here those of you who are social
quote here those of you who are social
quote here those of you who are social media savvy you probably see this come
media savvy you probably see this come
media savvy you probably see this come up on your Facebook feed all the time
up on your Facebook feed all the time
up on your Facebook feed all the time right it’s an inspirational quote that
right it’s an inspirational quote that
right it’s an inspirational quote that says that the world is changed by a
says that the world is changed by a
says that the world is changed by a small group of committed citizens I find
small group of committed citizens I find
small group of committed citizens I find it inspiring I think it’s kind of a
it inspiring I think it’s kind of a
it inspiring I think it’s kind of a feels like an American ideal I have a
feels like an American ideal I have a
feels like an American ideal I have a second quote for maybe a less famous
second quote for maybe a less famous
second quote for maybe a less famous person on a similar speaker this is how
person on a similar speaker this is how
person on a similar speaker this is how Speaker Paul Ryan saying that basically
Speaker Paul Ryan saying that basically
Speaker Paul Ryan saying that basically every successful individual is
every successful individual is
every successful individual is surrounded by a community of people that
surrounded by a community of people that
surrounded by a community of people that brought them there I think this is a
brought them there I think this is a
brought them there I think this is a almost a uniquely American idea that
almost a uniquely American idea that
almost a uniquely American idea that Democratic participation in all aspects
Democratic participation in all aspects
Democratic participation in all aspects of society is how we reach long term
of society is how we reach long term
of society is how we reach long term sustainable Democratic Change we look at
sustainable Democratic Change we look at
sustainable Democratic Change we look at it in our government we look at it in
it in our government we look at it in
it in our government we look at it in our civil society we look at it in in
our civil society we look at it in in
our civil society we look at it in in our churches we look at it in a variety
our churches we look at it in a variety
our churches we look at it in a variety of places in our lives where we don’t
of places in our lives where we don’t
of places in our lives where we don’t always look at it is is in health care
always look at it is is in health care
always look at it is is in health care and I want to talk to you a little bit
and I want to talk to you a little bit
and I want to talk to you a little bit today from the perspective of a nurse
today from the perspective of a nurse
today from the perspective of a nurse and a public health nurse about why I
and a public health nurse about why I
and a public health nurse about why I see this as important in health care if
see this as important in health care if
see this as important in health care if you don’t already know it and many of
you don’t already know it and many of
you don’t already know it and many of you are in health care so you already do
you are in health care so you already do
you are in health care so you already do we spend more money than anybody else on
we spend more money than anybody else on
we spend more money than anybody else on the planet on our health care system and
the planet on our health care system and
the planet on our health care system and we don’t really achieve much in the way
we don’t really achieve much in the way
we don’t really achieve much in the way of outcomes our outcomes are not
of outcomes our outcomes are not
of outcomes our outcomes are not horrible but they’re mediocre
horrible but they’re mediocre
horrible but they’re mediocre the Institute of Medicine about three
the Institute of Medicine about three
the Institute of Medicine about three years ago did a study where they
years ago did a study where they
years ago did a study where they compared us health outcomes with 17
compared us health outcomes with 17
compared us health outcomes with 17 other countries that are at similar
other countries that are at similar
other countries that are at similar levels of Economic Development with us
levels of Economic Development with us
levels of Economic Development with us so countries that you would expect us to
so countries that you would expect us to
so countries that you would expect us to compete with in the health care arena
compete with in the health care arena
compete with in the health care arena and indeed we did well in some things
and indeed we did well in some things
and indeed we did well in some things but we didn’t do well in a whole variety
but we didn’t do well in a whole variety
but we didn’t do well in a whole variety of things and a couple of them are
of things and a couple of them are
of things and a couple of them are really notable even if you’re not a
really notable even if you’re not a
really notable even if you’re not a health care person one is life
health care person one is life
health care person one is life expectancy so infant born today how long
expectancy so infant born today how long
expectancy so infant born today how long on average can they expect to
on average can they expect to
on average can they expect to and the second is infant mortality
and the second is infant mortality
and the second is infant mortality infant born today how many of them will
infant born today how many of them will
infant born today how many of them will make it through the first year of life
make it through the first year of life
make it through the first year of life those are two really key outcome
those are two really key outcome
those are two really key outcome indicators that tell you something about
indicators that tell you something about
indicators that tell you something about how healthy a community is we were dead
how healthy a community is we were dead
how healthy a community is we were dead last in both of those when you compare
last in both of those when you compare
last in both of those when you compare us to the 17 peer countries so to kind
us to the 17 peer countries so to kind
us to the 17 peer countries so to kind of really critical indicators that we
of really critical indicators that we
of really critical indicators that we don’t do so well despite the fact that
don’t do so well despite the fact that
don’t do so well despite the fact that we spend all kinds of money on this we
we spend all kinds of money on this we
we spend all kinds of money on this we also know that we have problems in
also know that we have problems in
also know that we have problems in health care even with our outcomes with
health care even with our outcomes with
health care even with our outcomes with disparities between groups racial ethnic
disparities between groups racial ethnic
disparities between groups racial ethnic disparities talk about health inequity
disparities talk about health inequity
disparities talk about health inequity disparities by where you live
disparities by where you live
disparities by where you live disparities by gender gender orientation
disparities by gender gender orientation
disparities by gender gender orientation we know that so even our outcomes as
we know that so even our outcomes as
we know that so even our outcomes as they are are not equitable across the
they are are not equitable across the
they are are not equitable across the country we also know we have a variety
country we also know we have a variety
country we also know we have a variety of other kinds of health care problems
of other kinds of health care problems
of other kinds of health care problems we have chronic diseases that again more
we have chronic diseases that again more
we have chronic diseases that again more telling in minority communities and
telling in minority communities and
telling in minority communities and communities of low income not only do
communities of low income not only do
communities of low income not only do those communities have higher death
those communities have higher death
those communities have higher death rates and lower life expectancy but the
rates and lower life expectancy but the
rates and lower life expectancy but the quality of life for people in those
quality of life for people in those
quality of life for people in those communities as they deal with chronic
communities as they deal with chronic
communities as they deal with chronic illness like diabetes heart disease
illness like diabetes heart disease
illness like diabetes heart disease obesity is really much diminished we
obesity is really much diminished we
obesity is really much diminished we know we have new and infectious diseases
know we have new and infectious diseases
know we have new and infectious diseases coming out Ebola and Zika in the last
coming out Ebola and Zika in the last
coming out Ebola and Zika in the last couple of years that we’re going to have
couple of years that we’re going to have
couple of years that we’re going to have to deal with as a society we know that
to deal with as a society we know that
to deal with as a society we know that in many communities and Chicago has
in many communities and Chicago has
in many communities and Chicago has become the poster child we have a big
become the poster child we have a big
become the poster child we have a big problem with interpersonal and community
problem with interpersonal and community
problem with interpersonal and community violence both in the homes and out in
violence both in the homes and out in
violence both in the homes and out in the street we know that we have a
the street we know that we have a
the street we know that we have a variety of health policy challenges and
variety of health policy challenges and
variety of health policy challenges and I could list them forever but the ones
I could list them forever but the ones
I could list them forever but the ones that are most recent and really caught
that are most recent and really caught
that are most recent and really caught our attention because I thought we had
our attention because I thought we had
our attention because I thought we had fixed these a while back is if you’ve
fixed these a while back is if you’ve
fixed these a while back is if you’ve noticed that northeastern Indiana is
noticed that northeastern Indiana is
noticed that northeastern Indiana is having a big problem with lead in their
having a big problem with lead in their
having a big problem with lead in their water and the people in Flint Michigan
water and the people in Flint Michigan
water and the people in Flint Michigan still don’t have safe and clean drinking
still don’t have safe and clean drinking
still don’t have safe and clean drinking water and that’s coming up on two years
water and that’s coming up on two years
water and that’s coming up on two years so we have a large variety of health
so we have a large variety of health
so we have a large variety of health issues what does community engagement
issues what does community engagement
issues what does community engagement mean for those issues what does it bring
mean for those issues what does it bring
mean for those issues what does it bring to the table so I’ll tell you why I came
to the table so I’ll tell you why I came
to the table so I’ll tell you why I came to this interest I told you I was a
to this interest I told you I was a
to this interest I told you I was a public health nurse researcher educator
public health nurse researcher educator
public health nurse researcher educator and many years ago before I got into
and many years ago before I got into
and many years ago before I got into public health I started in acute care in
public health I started in acute care in
public health I started in acute care in nursing
nursing
nursing as many new nurses do and this was a
as many new nurses do and this was a
as many new nurses do and this was a long time ago and people stayed in the
long time ago and people stayed in the
long time ago and people stayed in the hospital for a long time and I would get
hospital for a long time and I would get
hospital for a long time and I would get to know my patients and I would spend
to know my patients and I would spend
to know my patients and I would spend time with them and I would tell them how
time with them and I would tell them how
time with them and I would tell them how they were going to take their medicine
they were going to take their medicine
they were going to take their medicine and how they were going to test their
and how they were going to test their
and how they were going to test their blood sugar and activity levels and what
blood sugar and activity levels and what
blood sugar and activity levels and what their diet should be like and then I
their diet should be like and then I
their diet should be like and then I would send them home and a week two
would send them home and a week two
would send them home and a week two weeks three weeks a month many of them
weeks three weeks a month many of them
weeks three weeks a month many of them came back in the door with the same
came back in the door with the same
came back in the door with the same problem that we had thought we had fixed
problem that we had thought we had fixed
problem that we had thought we had fixed and sent them home with and as a fairly
and sent them home with and as a fairly
and sent them home with and as a fairly new nurse who had really put a lot of
new nurse who had really put a lot of
new nurse who had really put a lot of time and effort into that I was
time and effort into that I was
time and effort into that I was astounded what had gone wrong how come
astounded what had gone wrong how come
astounded what had gone wrong how come they didn’t listen to my great advice
they didn’t listen to my great advice
they didn’t listen to my great advice and somehow fix themselves up when they
and somehow fix themselves up when they
and somehow fix themselves up when they got home what was happening in those
got home what was happening in those
got home what was happening in those communities so I left acute care and
communities so I left acute care and
communities so I left acute care and went and worked in home health care for
went and worked in home health care for
went and worked in home health care for about a decade where I went in to where
about a decade where I went in to where
about a decade where I went in to where people lived and worked and played and
people lived and worked and played and
people lived and worked and played and it was a great humility lesson for me
it was a great humility lesson for me
it was a great humility lesson for me because what I found out was what I had
because what I found out was what I had
because what I found out was what I had been telling those patients for all that
been telling those patients for all that
been telling those patients for all that time was pretty much irrelevant in their
time was pretty much irrelevant in their
time was pretty much irrelevant in their lives and they had been very nice to me
lives and they had been very nice to me
lives and they had been very nice to me and they’ve been patting me on the hand
and they’ve been patting me on the hand
and they’ve been patting me on the hand and smiling at me and going home and
and smiling at me and going home and
and smiling at me and going home and doing what they could do given their
doing what they could do given their
doing what they could do given their resources their capacity their community
resources their capacity their community
resources their capacity their community their home environment so when I went
their home environment so when I went
their home environment so when I went into homecare I found that the little
into homecare I found that the little
into homecare I found that the little old man that I said don’t eat canned
old man that I said don’t eat canned
old man that I said don’t eat canned food because you want to really watch
food because you want to really watch
food because you want to really watch your sodium intake because sodium will
your sodium intake because sodium will
your sodium intake because sodium will cause you to retain fluids and that will
cause you to retain fluids and that will
cause you to retain fluids and that will put excess burden on your heart he was
put excess burden on your heart he was
put excess burden on your heart he was unable to get up and down his
unable to get up and down his
unable to get up and down his third-floor walk-up and he had a
third-floor walk-up and he had a
third-floor walk-up and he had a neighbor who shopped for him once a
neighbor who shopped for him once a
neighbor who shopped for him once a month so if you get food in your house
month so if you get food in your house
month so if you get food in your house once a month it’s going to be canned
once a month it’s going to be canned
once a month it’s going to be canned food and that’s what you’re going to eat
food and that’s what you’re going to eat
food and that’s what you’re going to eat the little old lady who took care of her
the little old lady who took care of her
the little old lady who took care of her elderly husband and he needed a lot of
elderly husband and he needed a lot of
elderly husband and he needed a lot of care and so I would remind her take care
care and so I would remind her take care
care and so I would remind her take care of yourself too when I got into the home
of yourself too when I got into the home
of yourself too when I got into the home and met them
and met them
and met them she had no backup she was 24/7 she
she had no backup she was 24/7 she
she had no backup she was 24/7 she couldn’t even get a good night’s sleep
couldn’t even get a good night’s sleep
couldn’t even get a good night’s sleep much less a chance to take a walk around
much less a chance to take a walk around
much less a chance to take a walk around the block or get her hair done or go to
the block or get her hair done or go to
the block or get her hair done or go to church or anything else that might have
church or anything else that might have
church or anything else that might have been re-energizing for her the woman
been re-energizing for her the woman
been re-energizing for her the woman that I setup and said here’s what you
that I setup and said here’s what you
that I setup and said here’s what you need to do during the day here’s when
need to do during the day here’s when
need to do during the day here’s when you need to take your medications here’s
you need to take your medications here’s
you need to take your medications here’s the activity level you should have found
the activity level you should have found
the activity level you should have found out later that her family was glad to
out later that her family was glad to
out later that her family was glad to have her living with them but they had
have her living with them but they had
have her living with them but they had to work 10-hour days and so what they
to work 10-hour days and so what they
to work 10-hour days and so what they did because she couldn’t get around on
did because she couldn’t get around on
did because she couldn’t get around on her own was they put her in a chair in
her own was they put her in a chair in
her own was they put her in a chair in front of the television set at 8:00 in
front of the television set at 8:00 in
front of the television set at 8:00 in the morning with her food her pills or
the morning with her food her pills or
the morning with her food her pills or water
water
water and then they came and helped her again
and then they came and helped her again
and then they came and helped her again at 6:00 at night because that’s all they
at 6:00 at night because that’s all they
at 6:00 at night because that’s all they could do so besides the humility which
could do so besides the humility which
could do so besides the humility which was obviously well needed for me I
was obviously well needed for me I
was obviously well needed for me I thought of two things that I took out of
thought of two things that I took out of
thought of two things that I took out of that experience one was that I had spent
that experience one was that I had spent
that experience one was that I had spent time with my patients but I hadn’t
time with my patients but I hadn’t
time with my patients but I hadn’t engaged with them at all
engaged with them at all
engaged with them at all I had just talked at them I didn’t
I had just talked at them I didn’t
I had just talked at them I didn’t really listened to them and what was
really listened to them and what was
really listened to them and what was relevant to them and what was real and
relevant to them and what was real and
relevant to them and what was real and what their lived experience was like so
what their lived experience was like so
what their lived experience was like so that we could work out together what
that we could work out together what
that we could work out together what they might do to improve their health
they might do to improve their health
they might do to improve their health and the second thing was a lot of what
and the second thing was a lot of what
and the second thing was a lot of what did people’s health happened outside of
did people’s health happened outside of
did people’s health happened outside of the clinical setting here I thought I
the clinical setting here I thought I
the clinical setting here I thought I was in the center of the universe I was
was in the center of the universe I was
was in the center of the universe I was in an acute care setting and doctors and
in an acute care setting and doctors and
in an acute care setting and doctors and nurses are relatively irrelevant to most
nurses are relatively irrelevant to most
nurses are relatively irrelevant to most of what makes people healthy or not
of what makes people healthy or not
of what makes people healthy or not healthy most of what happens to people
healthy most of what happens to people
healthy most of what happens to people with regard to their health happens
with regard to their health happens
with regard to their health happens where they live work play and pray so I
where they live work play and pray so I
where they live work play and pray so I decided after that that I was going to
decided after that that I was going to
decided after that that I was going to go into public health to find out a
go into public health to find out a
go into public health to find out a little bit more about all of these
little bit more about all of these
little bit more about all of these things that happen outside of the of the
things that happen outside of the of the
things that happen outside of the of the healthcare system this is the health
healthcare system this is the health
healthcare system this is the health impact pyramid I learned about it many
impact pyramid I learned about it many
impact pyramid I learned about it many years ago as the social determinants of
years ago as the social determinants of
years ago as the social determinants of health now in healthcare everyone talks
health now in healthcare everyone talks
health now in healthcare everyone talks about the social determinants of health
about the social determinants of health
about the social determinants of health but actually public health people have
but actually public health people have
but actually public health people have been having these conversations for 40
been having these conversations for 40
been having these conversations for 40 years nobody would listen to us this
years nobody would listen to us this
years nobody would listen to us this health impact pyramid is from dr. Tom
health impact pyramid is from dr. Tom
health impact pyramid is from dr. Tom Frieden who was the head of CDC until
Frieden who was the head of CDC until
Frieden who was the head of CDC until about until the new administration so
about until the new administration so
about until the new administration so about four months ago and it’s hard to
about four months ago and it’s hard to
about four months ago and it’s hard to see from here but the bottom of the
see from here but the bottom of the
see from here but the bottom of the health impact pyramid so the pyramid the
health impact pyramid so the pyramid the
health impact pyramid so the pyramid the things at the bottom have greater impact
things at the bottom have greater impact
things at the bottom have greater impact on the health of populations and
on the health of populations and
on the health of populations and communities the things at the top
communities the things at the top
communities the things at the top require greater resources so the bottom
require greater resources so the bottom
require greater resources so the bottom is things like socio-economic factors
is things like socio-economic factors
is things like socio-economic factors because really health is greatly
because really health is greatly
because really health is greatly impacted by the resources you have
impacted by the resources you have
impacted by the resources you have available whether you have a job an
available whether you have a job an
available whether you have a job an income
income
income it’s greatly impacted by your
it’s greatly impacted by your
it’s greatly impacted by your educational level there’s a really
educational level there’s a really
educational level there’s a really strong correlation between education
strong correlation between education
strong correlation between education level and health it’s greatly impacted
level and health it’s greatly impacted
level and health it’s greatly impacted by weather you have safe of housing and
by weather you have safe of housing and
by weather you have safe of housing and whether you have affordable food
whether you have affordable food
whether you have affordable food affordable healthy food the second one
affordable healthy food the second one
affordable healthy food the second one here it says changing the context to
here it says changing the context to
here it says changing the context to make individuals default decisions
make individuals default decisions
make individuals default decisions healthy turn that into making the
healthy turn that into making the
healthy turn that into making the Healthy Choice the easy choice what can
Healthy Choice the easy choice what can
Healthy Choice the easy choice what can we do that makes it easier for people to
we do that makes it easier for people to
we do that makes it easier for people to make healthy choices so one thing would
make healthy choices so one thing would
make healthy choices so one thing would be we put recessed back in the Chicago
be we put recessed back in the Chicago
be we put recessed back in the Chicago Public Schools recently so kids are able
Public Schools recently so kids are able
Public Schools recently so kids are able to get activity on a regular basis don’t
to get activity on a regular basis don’t
to get activity on a regular basis don’t have to go and start
have to go and start
have to go and start special programs it’s part of their
special programs it’s part of their
special programs it’s part of their daily life or we’ve made cigarettes more
daily life or we’ve made cigarettes more
daily life or we’ve made cigarettes more expensive and made it harder we can’t
expensive and made it harder we can’t
expensive and made it harder we can’t smoke in public buildings so that we
smoke in public buildings so that we
smoke in public buildings so that we make that unhealthy choice a little bit
make that unhealthy choice a little bit
make that unhealthy choice a little bit harder for people so these really um
harder for people so these really um
harder for people so these really um high-impact relatively low-cost things
high-impact relatively low-cost things
high-impact relatively low-cost things are where we don’t spend as much time
are where we don’t spend as much time
are where we don’t spend as much time where we put a lot of our energy as
where we put a lot of our energy as
where we put a lot of our energy as clinical interventions and counseling
clinical interventions and counseling
clinical interventions and counseling and education where those patients need
and education where those patients need
and education where those patients need to know more about what they do now
to know more about what they do now
to know more about what they do now those are good things and they’re
those are good things and they’re
those are good things and they’re impactful but they’re very resource
impactful but they’re very resource
impactful but they’re very resource intensive particularly compared to the
intensive particularly compared to the
intensive particularly compared to the to the outcomes you get from them so the
to the outcomes you get from them so the
to the outcomes you get from them so the more I learned about this I took this
more I learned about this I took this
more I learned about this I took this into my practice as a public health
into my practice as a public health
into my practice as a public health nurse in the community there’s a variety
nurse in the community there’s a variety
nurse in the community there’s a variety of challenges trying to make this happen
of challenges trying to make this happen
of challenges trying to make this happen and I’m just going to talk about a few
and I’m just going to talk about a few
and I’m just going to talk about a few of them
of them
of them the first challenge I found was
the first challenge I found was
the first challenge I found was conflicting priorities so I go in as the
conflicting priorities so I go in as the
conflicting priorities so I go in as the public health nurse I was working in
public health nurse I was working in
public health nurse I was working in Robert Taylor homes which was a public
Robert Taylor homes which was a public
Robert Taylor homes which was a public housing complex on the south near South
housing complex on the south near South
housing complex on the south near South Side in Chicago until a few years back
Side in Chicago until a few years back
Side in Chicago until a few years back and I would go and I would talk to women
and I would go and I would talk to women
and I would go and I would talk to women about the infant mortality rate in
about the infant mortality rate in
about the infant mortality rate in Robert table homes and it was horrible
Robert table homes and it was horrible
Robert table homes and it was horrible and the women were concerned and they
and the women were concerned and they
and the women were concerned and they thought that wasn’t a good thing but it
thought that wasn’t a good thing but it
thought that wasn’t a good thing but it really didn’t feel relevant to their
really didn’t feel relevant to their
really didn’t feel relevant to their lives what felt relevant is this was the
lives what felt relevant is this was the
lives what felt relevant is this was the late 80s the crack cocaine epidemic was
late 80s the crack cocaine epidemic was
late 80s the crack cocaine epidemic was a big deal there was a lot of gang
a big deal there was a lot of gang
a big deal there was a lot of gang warfare about who was going to sell
warfare about who was going to sell
warfare about who was going to sell crack cocaine what felt relevant to them
crack cocaine what felt relevant to them
crack cocaine what felt relevant to them was that they sometimes had to walk
was that they sometimes had to walk
was that they sometimes had to walk their children to school and walk past a
their children to school and walk past a
their children to school and walk past a chalk outline because someone had been
chalk outline because someone had been
chalk outline because someone had been shot outside their building or they
shot outside their building or they
shot outside their building or they couldn’t send their kid out to the
couldn’t send their kid out to the
couldn’t send their kid out to the vacant lot to play or down to the corner
vacant lot to play or down to the corner
vacant lot to play or down to the corner for a gallon of milk because of the
for a gallon of milk because of the
for a gallon of milk because of the level of violence in the community so
level of violence in the community so
level of violence in the community so how do you juxtapose those two things
how do you juxtapose those two things
how do you juxtapose those two things the data is correct there is a problem
the data is correct there is a problem
the data is correct there is a problem but the lived experience is also correct
but the lived experience is also correct
but the lived experience is also correct there is a problem that people need to
there is a problem that people need to
there is a problem that people need to deal with every single day the second
deal with every single day the second
deal with every single day the second set of challenges I found was commitment
set of challenges I found was commitment
set of challenges I found was commitment and sustainability in my community work
and sustainability in my community work
and sustainability in my community work and I’m sure this has happened to any of
and I’m sure this has happened to any of
and I’m sure this has happened to any of you who’ve done this as well I can’t
you who’ve done this as well I can’t
you who’ve done this as well I can’t tell you how many times people said to
tell you how many times people said to
tell you how many times people said to me who is getting their PhD from this
me who is getting their PhD from this
me who is getting their PhD from this what are you doing here and who is going
what are you doing here and who is going
what are you doing here and who is going to get their degree from this work
to get their degree from this work
to get their degree from this work because people in the communities I
because people in the communities I
because people in the communities I worked in were a little bit jaded they
worked in were a little bit jaded they
worked in were a little bit jaded they had seen people particularly people from
had seen people particularly people from
had seen people particularly people from universities come in do a project
universities come in do a project
universities come in do a project collect data and leave
collect data and leave
collect data and leave and then the next group came in and the
and then the next group came in and the
and then the next group came in and the neck how many times are you going to you
neck how many times are you going to you
neck how many times are you going to you know drink the kool-aid with the folks
know drink the kool-aid with the folks
know drink the kool-aid with the folks that came in no matter how nice they
that came in no matter how nice they
that came in no matter how nice they seemed to be and so I had to think about
seemed to be and so I had to think about
seemed to be and so I had to think about being honest with people about what my
being honest with people about what my
being honest with people about what my work was and how long I was going to be
work was and how long I was going to be
work was and how long I was going to be there and I had to think about what I
there and I had to think about what I
there and I had to think about what I was going to leave behind so is it doing
was going to leave behind so is it doing
was going to leave behind so is it doing something and walking away or is it
something and walking away or is it
something and walking away or is it doing something with people so that
doing something with people so that
doing something with people so that they’ve developed new skills and they
they’ve developed new skills and they
they’ve developed new skills and they this is where they live can continue the
this is where they live can continue the
this is where they live can continue the work after we leave and that gets into
work after we leave and that gets into
work after we leave and that gets into whole conversations about ownership and
whole conversations about ownership and
whole conversations about ownership and what participation is it is relatively
what participation is it is relatively
what participation is it is relatively easy to get a bunch of people together
easy to get a bunch of people together
easy to get a bunch of people together and say we want to hear from you about
and say we want to hear from you about
and say we want to hear from you about your issues it’s a little bit more
your issues it’s a little bit more
your issues it’s a little bit more challenging to say to those people let’s
challenging to say to those people let’s
challenging to say to those people let’s get together about how you can impact
get together about how you can impact
get together about how you can impact those issues not suggesting that we
those issues not suggesting that we
those issues not suggesting that we don’t need government hospitals
don’t need government hospitals
don’t need government hospitals healthcare organizations churches etc
healthcare organizations churches etc
healthcare organizations churches etc but you are the missing part of the
but you are the missing part of the
but you are the missing part of the equation here and how can we get you
equation here and how can we get you
equation here and how can we get you meaningfully meaningfully involved in
meaningfully meaningfully involved in
meaningfully meaningfully involved in setting the direction of what’s going to
setting the direction of what’s going to
setting the direction of what’s going to happen to make this community a
happen to make this community a
happen to make this community a healthier better place the third thing
healthier better place the third thing
healthier better place the third thing was to look at assets versus needs John
was to look at assets versus needs John
was to look at assets versus needs John McKnight from Northwestern helped with
McKnight from Northwestern helped with
McKnight from Northwestern helped with this when he said you know we go into
this when he said you know we go into
this when he said you know we go into communities and we do community health
communities and we do community health
communities and we do community health needs assessments and what you do is you
needs assessments and what you do is you
needs assessments and what you do is you leave the community with a whole laundry
leave the community with a whole laundry
leave the community with a whole laundry list of needs when you leave people with
list of needs when you leave people with
list of needs when you leave people with a whole laundry list of needs what they
a whole laundry list of needs what they
a whole laundry list of needs what they feel like is that they are passive
feel like is that they are passive
feel like is that they are passive consumers who need help to fix their all
consumers who need help to fix their all
consumers who need help to fix their all of their needs John McKnight said let’s
of their needs John McKnight said let’s
of their needs John McKnight said let’s take a look at the assets in communities
take a look at the assets in communities
take a look at the assets in communities as well and help them think about how
as well and help them think about how
as well and help them think about how they can bring their assets to address
they can bring their assets to address
they can bring their assets to address their needs and all communities have
their needs and all communities have
their needs and all communities have assets it may be the park it may be the
assets it may be the park it may be the
assets it may be the park it may be the closeness to CTA to public
closeness to CTA to public
closeness to CTA to public transportation it may be the public
transportation it may be the public
transportation it may be the public library which is a clean safe space
library which is a clean safe space
library which is a clean safe space that’s open to everybody it may be
that’s open to everybody it may be
that’s open to everybody it may be individual capacities maybe somebody
individual capacities maybe somebody
individual capacities maybe somebody bakes a great pie maybe somebody can fix
bakes a great pie maybe somebody can fix
bakes a great pie maybe somebody can fix cars how do we help communities see all
cars how do we help communities see all
cars how do we help communities see all of those things they have and bring it
of those things they have and bring it
of those things they have and bring it together to help them address their
together to help them address their
together to help them address their needs in ways that work and are
needs in ways that work and are
needs in ways that work and are sustainable in our capacity building and
sustainable in our capacity building and
sustainable in our capacity building and the last challenge I want to talk about
the last challenge I want to talk about
the last challenge I want to talk about is the idea of resilience versus
is the idea of resilience versus
is the idea of resilience versus capacity so the Department of Defense
capacity so the Department of Defense
capacity so the Department of Defense and the RAND Corporation have been doing
and the RAND Corporation have been doing
and the RAND Corporation have been doing a lot of research on community
a lot of research on community
a lot of research on community resilience how come you have two
resilience how come you have two
resilience how come you have two communities they look a little bit alike
communities they look a little bit alike
communities they look a little bit alike a disaster happens one
a disaster happens one
a disaster happens one comes back and the other really just has
comes back and the other really just has
comes back and the other really just has a hard time recuperating I want to
a hard time recuperating I want to
a hard time recuperating I want to switch that around and say how do we
switch that around and say how do we
switch that around and say how do we build community capacity so that yes if
build community capacity so that yes if
build community capacity so that yes if a disaster occurs god forbid they’re
a disaster occurs god forbid they’re
a disaster occurs god forbid they’re able to recoup but that they have
able to recoup but that they have
able to recoup but that they have capacity on a daily basis to help
capacity on a daily basis to help
capacity on a daily basis to help improve the health and well-being in
improve the health and well-being in
improve the health and well-being in that neighborhood to help get stronger
that neighborhood to help get stronger
that neighborhood to help get stronger and better every day the California
and better every day the California
and better every day the California Endowment has this quote on their
Endowment has this quote on their
Endowment has this quote on their website where they say if you can plug
website where they say if you can plug
website where they say if you can plug the community into the right kind of
the community into the right kind of
the community into the right kind of political power grid it’ll do more to
political power grid it’ll do more to
political power grid it’ll do more to create health and wellness than any
create health and wellness than any
create health and wellness than any other single intervention it is the
other single intervention it is the
other single intervention it is the untapped thing we do a little bit of
untapped thing we do a little bit of
untapped thing we do a little bit of talking about communities but mostly
talking about communities but mostly
talking about communities but mostly it’s to get them to participate in the
it’s to get them to participate in the
it’s to get them to participate in the things that those of us in health care
things that those of us in health care
things that those of us in health care have already decided to do mostly it’s
have already decided to do mostly it’s
have already decided to do mostly it’s to say oh we asked for your opinion and
to say oh we asked for your opinion and
to say oh we asked for your opinion and we got your opinion and now we’re still
we got your opinion and now we’re still
we got your opinion and now we’re still going to go ahead it’s not serious civic
going to go ahead it’s not serious civic
going to go ahead it’s not serious civic engagement of the type that I think
engagement of the type that I think
engagement of the type that I think Margaret Mead and hopefully Paul Ryan
Margaret Mead and hopefully Paul Ryan
Margaret Mead and hopefully Paul Ryan we’re talking about so the last thing I
we’re talking about so the last thing I
we’re talking about so the last thing I want to talk about a little so what I’ve
want to talk about a little so what I’ve
want to talk about a little so what I’ve done more recently in this work is I had
done more recently in this work is I had
done more recently in this work is I had sabbatical last year it’s a lovely thing
sabbatical last year it’s a lovely thing
sabbatical last year it’s a lovely thing and I looked at the concept of community
and I looked at the concept of community
and I looked at the concept of community engagement and spent some time in the
engagement and spent some time in the
engagement and spent some time in the literature as we like to do and then I
literature as we like to do and then I
literature as we like to do and then I went and interviewed people around the
went and interviewed people around the
went and interviewed people around the country who have done successful
country who have done successful
country who have done successful community health and development
community health and development
community health and development projects and I said how did you involve
projects and I said how did you involve
projects and I said how did you involve people at the grassroots level what
people at the grassroots level what
people at the grassroots level what worked what didn’t what challenges did
worked what didn’t what challenges did
worked what didn’t what challenges did you find what wisdom do you have to
you find what wisdom do you have to
you find what wisdom do you have to share and I’m in the midst of analyzing
share and I’m in the midst of analyzing
share and I’m in the midst of analyzing that data right now so I don’t have
that data right now so I don’t have
that data right now so I don’t have anything definitive but I have a few
anything definitive but I have a few
anything definitive but I have a few themes that I wanted to share with you
themes that I wanted to share with you
themes that I wanted to share with you as kind of a positive thing one thing
as kind of a positive thing one thing
as kind of a positive thing one thing they said is strong civic participation
they said is strong civic participation
they said is strong civic participation you really need to get people involved
you really need to get people involved
you really need to get people involved from the get-go
from the get-go
from the get-go a woman in Maine says she does something
a woman in Maine says she does something
a woman in Maine says she does something called community circles where she
called community circles where she
called community circles where she brings groups of people together summer
brings groups of people together summer
brings groups of people together summer community residents some might be
community residents some might be
community residents some might be professionals or church leadership
professionals or church leadership
professionals or church leadership around an issue and she said sometimes
around an issue and she said sometimes
around an issue and she said sometimes it doesn’t work sometimes they’ll meet
it doesn’t work sometimes they’ll meet
it doesn’t work sometimes they’ll meet once or twice and say you know we got
once or twice and say you know we got
once or twice and say you know we got nothing for each other we’re going to
nothing for each other we’re going to
nothing for each other we’re going to disband but some of them have been very
disband but some of them have been very
disband but some of them have been very effective
effective
effective so her mental health community circle
so her mental health community circle
so her mental health community circle has been meeting every six weeks now for
has been meeting every six weeks now for
has been meeting every six weeks now for four years and they have actually
four years and they have actually
four years and they have actually developed some things that they’ve
developed some things that they’ve
developed some things that they’ve implemented in this small rural
implemented in this small rural
implemented in this small rural community to help people with mental
community to help people with mental
community to help people with mental illness cope better and to help the
illness cope better and to help the
illness cope better and to help the community figure out how to support them
community figure out how to support them
community figure out how to support them better and
better and
better and how to live congenial e together the
how to live congenial e together the
how to live congenial e together the second thing that people my interviewees
second thing that people my interviewees
second thing that people my interviewees have told me what’s wrong said wrong
have told me what’s wrong said wrong
have told me what’s wrong said wrong with thing is that engagement starts at
with thing is that engagement starts at
with thing is that engagement starts at home and you got to start by knowing
home and you got to start by knowing
home and you got to start by knowing your neighbors and I think that’s true
your neighbors and I think that’s true
your neighbors and I think that’s true for all the communities we belong in not
for all the communities we belong in not
for all the communities we belong in not just the ones that I work in but the
just the ones that I work in but the
just the ones that I work in but the ones that I live in as well the Westside
ones that I live in as well the Westside
ones that I live in as well the Westside health authority here in the Austin
health authority here in the Austin
health authority here in the Austin neighborhood in Chicago has a project
neighborhood in Chicago has a project
neighborhood in Chicago has a project they’ve been working on called um every
they’ve been working on called um every
they’ve been working on called um every black sub village and what they’ve tried
black sub village and what they’ve tried
black sub village and what they’ve tried to do is take blocks and say let’s
to do is take blocks and say let’s
to do is take blocks and say let’s connect people on a block cuz you can
connect people on a block cuz you can
connect people on a block cuz you can get your head around your block it’s not
get your head around your block it’s not
get your head around your block it’s not that huge let’s find out what the assets
that huge let’s find out what the assets
that huge let’s find out what the assets and the needs are and see if we can
and the needs are and see if we can
and the needs are and see if we can connect people on this block to solve
connect people on this block to solve
connect people on this block to solve those immediate problems but also to
those immediate problems but also to
those immediate problems but also to create ongoing social connectedness so
create ongoing social connectedness so
create ongoing social connectedness so if this is the retired couple at one
if this is the retired couple at one
if this is the retired couple at one side of the block who has a little bit
side of the block who has a little bit
side of the block who has a little bit of extra time maybe they can do
of extra time maybe they can do
of extra time maybe they can do childcare for the young family here who
childcare for the young family here who
childcare for the young family here who the parents have to work and they could
the parents have to work and they could
the parents have to work and they could use some less expensive childcare and in
use some less expensive childcare and in
use some less expensive childcare and in return the young couple will come and
return the young couple will come and
return the young couple will come and cut grass and shovel snow and maybe take
cut grass and shovel snow and maybe take
cut grass and shovel snow and maybe take them to the doctor occasionally so it’s
them to the doctor occasionally so it’s
them to the doctor occasionally so it’s a lovely model to start at the very
a lovely model to start at the very
a lovely model to start at the very small to create connections across
small to create connections across
small to create connections across community in very concrete ways civil
community in very concrete ways civil
community in very concrete ways civil discourse is another thing my
discourse is another thing my
discourse is another thing my interviewees talked about it’s really
interviewees talked about it’s really
interviewees talked about it’s really important that we learn how to talk to
important that we learn how to talk to
important that we learn how to talk to each other in a civil way I think we’ve
each other in a civil way I think we’ve
each other in a civil way I think we’ve particularly lost that in the last year
particularly lost that in the last year
particularly lost that in the last year or so in this country we’re going to
or so in this country we’re going to
or so in this country we’re going to disagree we’re good I we probably
disagree we’re good I we probably
disagree we’re good I we probably couldn’t all agree on what to order for
couldn’t all agree on what to order for
couldn’t all agree on what to order for dinner if we got together and someone
dinner if we got together and someone
dinner if we got together and someone offered to buy us all dinner in this
offered to buy us all dinner in this
offered to buy us all dinner in this room so how do we spend the time and
room so how do we spend the time and
room so how do we spend the time and energy it takes and use conflict
energy it takes and use conflict
energy it takes and use conflict resolution skills and use communication
resolution skills and use communication
resolution skills and use communication skills so that we can get to know one
skills so that we can get to know one
skills so that we can get to know one another we can recognize our differences
another we can recognize our differences
another we can recognize our differences but try to find some larger commonality
but try to find some larger commonality
but try to find some larger commonality that we could work on together and
that we could work on together and
that we could work on together and through the course of doing that get to
through the course of doing that get to
through the course of doing that get to know each other and trust each other and
know each other and trust each other and
know each other and trust each other and maybe be a little bit better at
maybe be a little bit better at
maybe be a little bit better at addressing some of our differences the
addressing some of our differences the
addressing some of our differences the one thing all of my interviewees agreed
one thing all of my interviewees agreed
one thing all of my interviewees agreed on is it takes time there’s no shortcut
on is it takes time there’s no shortcut
on is it takes time there’s no shortcut for this it just takes time and
for this it just takes time and
for this it just takes time and attention and commitment one of the
attention and commitment one of the
attention and commitment one of the stories that people told me was
stories that people told me was
stories that people told me was community health centers have to have
community health centers have to have
community health centers have to have 51% of their board as community members
51% of their board as community members
51% of their board as community members and she said they would always have
and she said they would always have
and she said they would always have dinner before the board would meet and a
dinner before the board would meet and a
dinner before the board would meet and a lot of times the professionals wouldn’t
lot of times the professionals wouldn’t
lot of times the professionals wouldn’t come to dinner
come to dinner
come to dinner they didn’t have time they were busy
they didn’t have time they were busy
they didn’t have time they were busy they would just come for the meeting
they would just come for the meeting
they would just come for the meeting what they found out is when everyone
what they found out is when everyone
what they found out is when everyone showed up for dinner the later business
showed up for dinner the later business
showed up for dinner the later business meeting was much more productive because
meeting was much more productive because
meeting was much more productive because people had a chance to develop
people had a chance to develop
people had a chance to develop relationships and start to trust and
relationships and start to trust and
relationships and start to trust and then they were able to work more
then they were able to work more
then they were able to work more effectively together the last thing my
effectively together the last thing my
effectively together the last thing my interviewees shared with me is Community
interviewees shared with me is Community
interviewees shared with me is Community Action strategies we have to figure out
Action strategies we have to figure out
Action strategies we have to figure out ways and some of them had some methods
ways and some of them had some methods
ways and some of them had some methods like my community circles lady and
like my community circles lady and
like my community circles lady and hopefully as I get into the data will
hopefully as I get into the data will
hopefully as I get into the data will find more we have to find ways to
find more we have to find ways to
find more we have to find ways to develop mutual goals again even beyond
develop mutual goals again even beyond
develop mutual goals again even beyond our disagreements and then how to
our disagreements and then how to
our disagreements and then how to develop structures for action it’s not
develop structures for action it’s not
develop structures for action it’s not enough to set goals if we don’t do
enough to set goals if we don’t do
enough to set goals if we don’t do anything about them and our structures
anything about them and our structures
anything about them and our structures for action have to be inclusive so that
for action have to be inclusive so that
for action have to be inclusive so that people feel like their participation is
people feel like their participation is
people feel like their participation is meaningful to the overall effort and to
meaningful to the overall effort and to
meaningful to the overall effort and to their expenditure of their time so how
their expenditure of their time so how
their expenditure of their time so how do we develop those inclusive structures
do we develop those inclusive structures
do we develop those inclusive structures and knowing that people are going to ebb
and knowing that people are going to ebb
and knowing that people are going to ebb and flow in their participation you may
and flow in their participation you may
and flow in their participation you may be at a time when you have an ill family
be at a time when you have an ill family
be at a time when you have an ill family member and you can’t spend as much time
member and you can’t spend as much time
member and you can’t spend as much time in your community other people may be at
in your community other people may be at
in your community other people may be at a time when they’ve retired and they
a time when they’ve retired and they
a time when they’ve retired and they have more time so knowing that we’re
have more time so knowing that we’re
have more time so knowing that we’re going to have that ebb and flow how do
going to have that ebb and flow how do
going to have that ebb and flow how do we keep those structures going the last
we keep those structures going the last
we keep those structures going the last thing all of my folks talked about was
thing all of my folks talked about was
thing all of my folks talked about was we need to think about the long term
we need to think about the long term
we need to think about the long term horizon so we need some short-term
horizon so we need some short-term
horizon so we need some short-term outcomes like setting up a X getting a
outcomes like setting up a X getting a
outcomes like setting up a X getting a clinic to come into our community or
clinic to come into our community or
clinic to come into our community or cleaning up a vacant lot or getting a
cleaning up a vacant lot or getting a
cleaning up a vacant lot or getting a playground but we need to have the long
playground but we need to have the long
playground but we need to have the long horizon we need to think we’re in this
horizon we need to think we’re in this
horizon we need to think we’re in this to improve the health of this community
to improve the health of this community
to improve the health of this community and well-being for the duration and that
and well-being for the duration and that
and well-being for the duration and that means a commitment and a long-term set
means a commitment and a long-term set
means a commitment and a long-term set of outcomes and that means we need to
of outcomes and that means we need to
of outcomes and that means we need to talk to our government and philanthropy
talk to our government and philanthropy
talk to our government and philanthropy people about a long term a long timeline
people about a long term a long timeline
people about a long term a long timeline for outcomes as well so the last quote I
for outcomes as well so the last quote I
for outcomes as well so the last quote I want to leave you with is a hero of mine
want to leave you with is a hero of mine
want to leave you with is a hero of mine Marian Wright Edelman who says the
Marian Wright Edelman who says the
Marian Wright Edelman who says the challenge of social justice is to evoke
challenge of social justice is to evoke
challenge of social justice is to evoke a sense of community that we need to
a sense of community that we need to
a sense of community that we need to make our nation a better place just as
make our nation a better place just as
make our nation a better place just as we make it a safer place and I would say
we make it a safer place and I would say
we make it a safer place and I would say and a healthier place so have a good
and a healthier place so have a good
and a healthier place so have a good weekend and go talk to a neighbor
weekend and go talk to a neighbor
weekend and go talk to a neighbor [Applause]
”
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