CAMERON FANI IS AN ADVOCATE FOR HEALTHY COMMUNITIES AND PROVIDES CONSULTATIVE SUPPORT WITH THE AIM OF RAISING THE STANDARD AND QUALITY OF HEALTH CARE GOVERNANCE AND DELIVERY.

How Communities Transform

Today we're still talking about building healthy communities, continuing on from my previous post. You may remember from my last post an introduction to the social and economic factors that affect a community's state of health, like crime and poverty rates, education and employment opportunities, environmental concerns, recreational facilities and accessible and safe parks, access to nutritious food options, and after-school programming for children and youth, among others. In this post, I'm going to share two examples of how communities can take action when considering these factors. And in these examples, you'll see how community residents and supporting organizations and individually-led initiatives, of whom can include private for-profit and non-profit and publicly-funded persons and groups, work together to support a community's transition to a healthier state of being.

What does this look like? Let's look at a 'simple' first example:

New rec centre offers plenty of action–11/28/2016–by Andrea Geary–published in the Winnipeg Free Press

A recreation center is a wonderful resource for a community—it provides a safe space for physical and social activities and supports community engagement efforts by, for example, providing space for public discussions, like a community forum or town hall. A recreation center can also include programming that supports education and training, early childhood development and after school care, and activities that supports underserved or socially and economically disadvantaged community members.

In this article, we learn that a pre-existing army fitness facility, repurposed for the benefit of the community after the adjoining army base was closed years ago, was in need of a repairs. And instead of repairing it, the facility was redeveloped in order to better meet the needs of the community. Among other additions designed to improve the physical recreation components of the facility, a new climbing wall, running track, weight and cardio area were built, with an option to open a yoga studio when desired. In addition to physical recreation, a day care facility was developed, addressing a community need for more child care spaces. A coffee shop opened in the facility too. And more than just selling coffee, the shop, in partnership with a local non-profit, will provide employment and training opportunities for those with intellectual disabilities (a great example of how a private business and a non-profit group can work together to serve the needs of those typically underserved in a community).

Simple enough? Ok!—how about a more complicated example next?  We'll look into a seemingly hopeless situation of gang violence plaguing a neighborhood that was addressed through the actions of a small group of residents, on their own initiative and without external support, who tried some novel community engagement techniques to bring about positive change where they lived:

Short article: To reduce Baltimore's gun violence, invest in strategies that work—07/07/2013—by Daniel Webster—published in The Baltimore Sun

Long article: Cease-Fire in Simple City: The day gangs declared a truce in an urban war zone—03/16/1998—by Debra Dickerson—published (in print) in U.S. News & World Report (via lessonsandlaughs.blogspot.ca; original archive link is broken)

Both articles reference the issue of gang violence within the Benning Terrace neighborhood of Washington D.C. The first article, an opinion piece, describes how community engagement efforts successfully applied in that neighborhood could be similarly applied to the gang violence situation relevant today in the U.S. city of Baltimore, Maryland. The latter article is an in-depth look of how violence in that community affected residents and describes in detail some of the factors for why crime escalated like it had. By the end of the article, we learn about how the community changed once the gang violence abated. All quotations (" ") referenced are drawn from the latter article. My summary below:

The time is 1997. A housing project colloquially known as Simple City (formally known as the neighborhood of Benning Terrace) "was so desperately violent that some homeowners nailed their windows shut." Two rival gangs "exchanged gun shots nearly every day", keeping residents in constant fear, avoiding certain areas of their homes where stray bullets could easily penetrate. A court appointed housing authority official was to inspect Simple City, but "his driver refused to drive into the heart of the area." Regardless, the official saw enough of the neighborhood to come to a hard conclusion: seeing "young men neither at work nor in school, despite the hour" and "40-ounce malt liquor bottles and drug paraphernalia" strewn across the project's cul-de-sac, and after investigating "crime statistics, unpaid rents" and "reports of never ending... vandalism", the official concluded that "some of the buildings should be razed".

It was the death of a 12-year boy—affiliated with one of the two prominent gangs in the area, abducted by a rival, and beaten and shot to death following the abduction—that did a curious thing just a few months later: the gangs made peace, and the official suspended plans to demolish the buildings that were originally the target for removal.

How, you ask? Some concerned residents, a group of friends who could be described as "50-something...former criminals, substance abusers, or both" who "rehabilitated themselves through a string of interventions, recriminations, and religious reawakenings" and who had "survived both prison and the streets" were, in middle age, "...becom[ing] increasingly saddened by the carnage in their hometown" and decided to band together to do something about it. Calling themselves the "Alliance of Concerned Men", they took to their vehicles, on their own time, expense and to great personal risk, and "cruised trouble spots" to find groups of youth to "[chat] up". They built relationships with those youth, without talking down to them or chastising them forcefully as they believed that the youth "knew what they were doing was wrong...[but]...did not know if how to stop".

The Alliance, acutely aware that the murder of the 12-year old would signal a coming "blood bath of retribution killings", worked hard to quickly engage gang leaders and encouraged them to attend peace talks in order to deescalate the situation. After facilitating opportunities where gang leaders were able to talk with each other, with some notable early hesitation by a particularly fearsome gang leader, the gangs agreed to a truce.

So, while I tried my best to summarize what I can, I honestly suggest that you read the articles if you haven't already done so. I don't think my summary does the latter article 'justice' in terms of capturing the enduring emotions felt after reading the details within it...

From the latter article, we learn explicitly and can make inferences to the social and economic climate of that community. For example, we learn that there were a lack of 'good' job opportunities for working aged youth, considering many were seen idle and on the streets. Many of the fathers of the youth were in prison, suggesting difficult social and family dynamics that translated into weak social bonds within the community (where gang affiliation perhaps served as surrogate for familial or parental relationships and concern). Many of the youth, it was observed, were not attending school regularly. Neglect (willful or not; it's not clear from the article) by the public housing authority left buildings to fall into disrepair, communicating to an already vulnerable group of residents that their homes and, by extension, the larger community in which they lived, were not a priority for the state (regardless of intention).

So how does this article relate to our discussions on health? It goes without saying that in a situation like this, we would be hard-pressed to initiate a community health supporting intervention like a recreation center when the community is more specifically pressed, in this case, with acute violence, and would need another kind of community health related intervention instead. Naturally, there would be an 'order of operations' for where to begin when addressing the standards of health in any community. In the case of Benning Terrace, we would look to ways of reducing violence in the community first and work to build trust among residents there. In this situation, novel community engagement was what helped reduce tensions and build trust. And perhaps after repairing neglected properties, cleaning up the neighborhood and encouraging and offering social and economic opportunities (we learn that the housing authority later hires a former gang leader to maintain the public housing properties, giving him steady employment responsibilities and income) residents could discuss other community health interventions, like the development of a community recreation facility, the benefits of which were discussed earlier in this post.

Still with me? You're probably tired of reading, so I'll stop now. I'll spend another blog post—a shorter one, I promise—on a resource that I like and one that will introduce you to health interventions that you can perhaps leverage in your own community.

Cam

RWJF – A Great Resource...

Building Healthy Communities - An Introduction