News from the Minnesota Health Equity Networks
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Creating bridges to meet community needs
Network member spotlight: Meeker-McLeod-Sibley (MMS) Community Health Services
View the full April newsletter: MN Health Equity Networks April 2024 Newsletter
Meeker-McLeod-Sibley (MMS) Community Health Services has been working on data-driven health equity initiatives for almost a decade. However, their current work stems from a data gap realized through their most recent Health Equity Data Analysis (HEDA). HEDA focuses on identifying health inequities among specific groups. The analysis showed that Hispanic residents were underrepresented in their area’s data collection.
MMS staff responded by ensuring that the questions used in the HEDA tool were translated and culturally appropriate. They considered the cultural connotations of the tool’s word choices when conducting the survey. The staff collecting responses worked to establish trusted relationships with the Hispanic community with the goal of collecting the most accurate data possible and connecting with community members who might not otherwise participate.
“We’ve had a great response from community members in learning and growing together.” – Vlada Gladis, Health Educator, Sibley County Public Health and Human Services (Meeker-McLeod-Sibley CHS)
Through these conversations, MMS staff deepened their understanding of the Hispanic community and the health barriers its members often face, such as poor nutrition, limited exercise options, language barriers, immigration status, access to and quality of health care, transportation, mental health issues, and racism.
“We were able to learn a lot about the Hispanic members in our communities. For example, that Hispanic is the preferred term when describing and referring to the culture.” – Vlada Gladis
MMS staff understood that to create lasting connections and improve their data, they had to include the community in the entire process. They took the time to follow up, share results, and ask if there was any other information to give. Vlada said that they consistently focus on making sure that when staff connects with a community member, that connection is beneficial for all parties in the present and into the future.
Using Regional Healthy Equity Network Grant funds, the MMS Community Health Services focused on building community connections and educating the public on health equity. They have organized events and led discussions on how to address community needs. MMS Community Health Services recently sponsored a “Bridges Out of Poverty” workshop, which will be followed by more training for community stakeholders. Dr. Terry Wu presented information on the neuroscience of belonging in his presentation of “Us vs. Them,” and MMS will soon host a Poverty Simulation event in partnership with United Community Action Partnership (UCAP).
“At each event, we learn of more members in the community who have the desire to collaborate to advance health equity.” – Vlada Gladis
Vlada says, “We are striving to develop a network of these amazing individuals who can collectively move our communities forward.”
The project also includes building connections with other cities and counties where collaboration already has established momentum. They plan to continue gathering information from community members and use it to create a framework that addresses needed change.
“We’re planning to give individuals from all backgrounds seats at the table. We hope that individuals will share their insights, contribute in a way that they find meaningful, and create bridges to meet the needs in our communities.” – Vlada Gladis
Reframing mental models on aging
Network member spotlight: Arrowhead Area Agency on Aging
View the full March newsletter: MN Health Equity Networks March 2024 Newsletter
As people age in our society, they can become marginalized. The Arrowhead Area Agency on Aging, or AAAA, encourages the development of age-friendly cities and counties where older adults are integral parts of their communities. AAAA’s message is that older adults should have opportunities to contribute and be active, engaged and connected. The Agency offers a breadth of services, working in many ways to keep aging adults involved in creating vibrant communities.
“Changes can be made in big or small ways. Central to our work is reframing the way we talk, think, feel, and act about aging.” - Georgia Lane, Aging Services Planner, Arrowhead Area Agency on Aging
One of the many successful projects organized by AAAA is the Arrowhead Changemakers. Changemakers serve as ambassadors to promote meaningful, lasting changes that help their communities become better places to grow up and grow old. There were sixteen active Changemakers in 2023, and a second cohort launched this month.
"We seek local community members and leaders who have a passion for impacting decisions that enable people to age successfully in their communities and advocate for the needs and wants of older adults." – Recruitment information for Arrowhead Changemakers
Changemakers embrace positive attitudes about aging, which can enhance the quality of life and foster stronger and more inclusive communities for all ages. Changemakers are critical in bringing localized issues and experiences to AAAA, the Governor’s Council on an Age-Friendly Minnesota, and other leaders and organizations. These contributions spark conversations on ending ageism and championing an age-friendly Arrowhead region that respects, honors, and celebrates individuals at every stage of life.
“An age-friendly community (or state) is one that enables all residents to thrive at every age and life stage.” – AAAA website
As a state-designated Area Agency on Aging serving Aitkin, Carlton, Cook, Itasca, Koochiching, Lake, and St. Louis counties, AAAA is responsible for developing a coordinated and comprehensive system of services for older adults and their family caregivers. To help accomplish this goal, AAAA awards grants and contracts to agencies for services that enrich the lives of older adults and their family caregivers. The Agency partners with community organizations to address issues like transportation, meals, health promotion, caregivers, respite, and chore services.
From developing age-friendly communities to providing referrals and assistance through the state's Senior LinkAge Line, the Agency advocates for statewide policies that promote healthy aging and offers informational and wellness classes throughout the Arrowhead region. AAAA planning staff works to address service gaps in the region, support partner organizations, and advocate for aging services.
“What we are doing is a great example of health equity in action. We are listening to the voices of people who are plugged into their communities, and educating about how older people think, talk, and feel.” – Georgia Lane
Building a legacy of welcoming spaces and youth sexual health services
Network member spotlight: The Annex Teen Clinic
View the full February newsletter: MN Health Equity Networks February 2024 Newsletter
Feelings of welcome and acceptance are tangible the moment one enters the Annex Teen Clinic in Robbinsdale, Minnesota. The clinic provides sexual health services and education to youth in Hennepin County and North Minneapolis.
“We try to make sure all young people feel seen and valued at all touchpoints, whether in the classroom, community, or clinic,” - Khadijah Cooper, Director of Sexuality Education
The organization began in 1971 in response to youth voicing a need for better sexual health services, especially STI testing and treatment.
"As a teen, I went to the Annex [in the 1990s] for testing during a really scary time. It was great to have a resource that I could access confidentially. While I was there, I also got some really valuable counseling advice.” – Former clinic patient
Later, the Clinic evolved into an independent nonprofit, offering comprehensive sexuality-related health services. Youth input has always guided program development, with staff aiming to empower young people to manage their sexual health.
The Annex Teen Clinic provides testing and treatment for STIs, HIV, and other conditions. It offers birth control, emergency contraception, all-options pregnancy counseling, pre-exposure prophylaxes, annual exams, breast exams, and chest exams. The lobby area is designed so young people can pick up condoms and other sexual health products without questions or paperwork.
"If I would not have had Annex, I would be pregnant and have multiple STDs." – Clinic patient
"Having access to healthcare changed my life because it helped me get educated on a lot of thing[s], such as sex, STI and [routine] checking. Sometimes you don't feel comfortable talking about things with your guardians or parents, so it is great to have Annex around." - Clinic patient
All services are confidential, fact-based, non-judgmental, and inclusive, and telehealth is available when possible. Service costs are controlled, and discounts are offered to patients. Khadijah said this model benefits clinic patients more than just financially.
“Young people want to pay for their services. It gives them a confidence boost, helps their mental health. They are learning to navigate the healthcare system for the first time. And we are setting the precedent that they have the right to advocate for themselves and make informed decisions,” said Khadijah. “It’s transformational!”
Many teens have been coming to the Annex Teen Clinic for years, and they appreciate the clinic’s quality of services and staff.
"I have been coming here for four years for birth control, STI testing, pap smears, etcetera, and I always feel so safe and comfortable with the incredibly friendly staff. Thank you for making these appointments so easy and non-judgmental." - Clinic patient
The Annex also provides annual education on topics like STIs, gender identification, sexual exploitation, and mental health. It educates parents and professionals in schools and community settings, too.
"You guys have been helping me navigate my sexual health since I was 15. I love it here and hope you continue to help young adults. I was introduced to y’all at Cooper High School, and y’all need to continue to visit schools and educate our youth!" – Clinic patient
Annex has been able to expand services with a newly remodeled, onsite lab. Additionally, with the support of Health Equity Network grant funding, the Annex Teen Clinic is working to reach more youth through enhanced marketing efforts. Staff magnify their health equity efforts by focusing on reproductive justice and intersectionality.
After over 50 years, the Annex is still pursuing its vision: The Annex will create a community where all young people have the resources and support they need, allowing them to successfully make the transition from adolescence to adulthood.
"It gave me the opportunity that a lot of women across the world don’t have. I feel empowered to make choices surrounding my life and sex life." – Clinic patient
For more information about the Annex Teen Clinic services and parent and professional learning opportunities, visit their website at annexteenclinic.org.
A bridge to community solutions
Network member spotlight: Central Minnesota Alliance
View the full January newsletter: MN Health Equity Networks: Jan 2024 Newsletter
The Central Minnesota Alliance (CMA) began in 2018 with informal coffee meetings between the Stearns County Public Health Director and the Centracare Community and Government Relations Director. Today, the CMA is a partnership involving staff from Benton, Sherburne, and Stearns Counties, and Centracare (formerly St. Cloud Hospital.) The CMA conducts the region’s community health need assessment and community health improvement Plan.
“We discovered that we had so much in common. It is good practice to do this work together.” – Peggy Sammons, Public Health Planner, Sherburne County Health and Human Services
Many county staff have long histories of personal and professional collaboration and cooperation. In some cases, they moved from county to neighboring county or from one position to another, maintaining positive connections that are a basis of the partnership’s success.
St. Cloud has a unique geography in that it lies within three counties: Benton, Sherburne, and Stearns. St. Cloud is the county seat of Stearns County. Benton and Sherburne’s county seats are in Foley and Elk River, which are quite a drive from St. Cloud. In response, CMA operates on a “no wrong door” approach that makes services more accessible to regional community members, removes duplicative efforts, and allows staff to collaborate.
“The key part of all of this is that we voluntarily agree to work together. It’s nothing official, nothing legal. We are driven by our desire to collaborate.” - Peggy Sammons
The CMA Process Managers Team, comprised of representatives from partner agencies, shepherded the process of identifying priorities. According to Sammons, it involved many internal discussions, partnership meetings, community input, and some challenges.
“We had to be willing to have hard conversations, but authenticity and the work behind it is important.” - Peggy Sammons
Currently, the top priorities for CMA are “building families” and “mental health.” Through the most recent community health needs assessment, four “drivers of inequities” have also been identified as areas of focus for the CMA, including: Data access and systems; Structural racism and community power; and Lived experience Historical context.
“Our community partners say that our goals and drivers really resonate with them. It has enriched how we do our work.” - Peggy Sammons
To date, the CMA has conducted two community health needs assessments and two corresponding community health improvement plans. The CMA continues to build upon each effort, with the next assessment starting later this year.
“The CMA allows for a regional approach to planning, and we are seeing how our community health improvement plan is intertwined in many things that we do. This allows for capacity building and really expands our collaborative reach. - Jaclyn Litfin, Community Health Services Administrator, Benton County Public Health
Cooperation, not competition
Network member spotlight: Community Resource Connections
View the full December newsletter: MN Health Equity Networks Dec 2023 Newsletter
Ruth Sherman approaches her work at Community Resource Connections (CRC) with inspiration from her late father, a dairy farmer. He organized cooperative farming with his neighbors, sharing equipment and working collaboratively in the small rural community where Ruth grew up.
“We need to be cooperative, not competitive. When agencies know and trust each other, clients benefit. It’s the people who participate in this process that make things happen. If others didn’t share that mission, we’d be spinning our wheels.” Ruth Sherman, Executive Director, Community Resource Connections (CRC)
Ruth says CRC’s mission is to provide access to services that allow people to improve themselves and the lives of those around them. She adds that when CRC was founded in the 1980s, nonprofits were often pitted against each other for service contracts. That type of competition led to a lack of collaboration, low staff pay, and short-term thinking. Above all, clients were not getting all the services they needed. CRC formed to change that, and still works to prevent “silos” among agencies.
Now, with offices in four counties, CRC serves as a referral source to help community service agencies reach their intended clients. One of CRC’s community offerings is an up-to-date resource directory. Member benefits include event facilitation, group marketing, consulting, and regular email communication. Ruth’s father’s vision of cooperation and collaboration continues to guide their work.
Bemidji Chamber Ambassadors congratulate Executive Director Ruth Sherman on the new location of Community Resource Connections. Photo courtesy of the Bemidji Chamber of Commerce.
“What has kept me here is that this has been a place where I can interact with the public every day – helping facilitate service education and engagement – while still impacting the larger system of services by networking with agencies, pulling them together in conversation, engaging them in collaboration to improve services to clients. When agencies get together, the results are just magical.” – Ruth Sherman
CRC’s journey hasn’t always been easy. Budget problems required creativity in fundraising to keep CRC going. In 2003 they struggled out of a $35,000 debt, using a variety of approaches, including planting plastic flamingos in community members' yards. But even those challenges had some positive results. Ruth says the situation helped the organization “clarify who we intended to be.”
Ruth came to CRC with a wealth of experience, working at Blackduck Resource Center (formerly Bemiidji Area Council of Nonprofits) and the County Child Protection System. She started at CRC feeling the need to reach out to families and individuals before problems became crises.
Ruth believes that recognizing disparities and looking beyond the surface of every situation is critical to the health and well-being of every agency and every person. She says that understanding equity and inequity is absolutely vital and is a constant learning process.
“I didn’t set out to form or participate in a program that “ensures health equity”. I chose to join an organization that affects people and systems. As providers, I believe it is our job to recognize the privileges and disadvantages that society has handed to people. We are each responsible for ourselves and for others.” - Ruth Sherman
Horizon Public Health revitalizes its health equity efforts
Network member spotlight: Health Equity Action Team (HEAT) at Horizon Public Health
View the full November newsletter: MN Health Equity Networks Nov 2023 Newsletter
In July 2022, Angie Hasbrouck and Amanda Schueler of Horizon Public Health and staff from Horizon’s program areas began a collective effort to revitalize their Health Equity Committee.
“We wanted to bring the committee back and have clear objectives around the health equity priorities of the agency.” - Angie Hasbrouck, Health Educator, Horizon Public Health
Horizon Public Health is located in West Central Minnesota and serves Douglas, Grant, Pope, Stevens, and Traverse Counties. The organization is invested in community work and provides many services to the region.
The internal committee adopted a new name, the “Health Equity Action Team” (HEAT), and rewrote the organization’s health equity policy. HEAT updated its language to reflect new knowledge about health equity, including a full set of terms creating shared vocabulary and understanding within the agency and community.
"Everyone started with a different understanding of Health Equity. If we are able to say what it is and what it means to us, it changes the whole conversation." – Angie Hasbrouck
Horizon Public Health also revamped its mission, vision, principles, and strategic goals, making health equity a guiding practice.
“With updated policy, mission, and strategies, we can direct our work and intentionally use an equity lens in all we do.” - Angie Hasbrouck
The Minnesota Health Equity Network awarded HEAT Round One and Round Two funding to support their project activities. HEAT hosted listening sessions with community members, and over 100 people participated, significantly exceeding their goal of 25. “We created processes to hear from community members and are welcoming people with lived experience [to take] a seat at the decision-making table,” said Hasbrouck.
HEAT has a renewed focus on data disaggregation, which breaks down data in different ways to be looked at with a new lens. This has helped HEAT identify trends and inequities and improve their targeted work plans.
HEAT plans to conduct five more listening sessions and dive deeper into how their data can be used to engage the community.
“Horizon’s goal is to continue to build capacity around their Health Equity Action Team and encourage the group to be a driving force behind their health equity initiative.” -Angie Hasbrouck
In September 2023, Horizon Public Health received the Inclusive Workforce Employer Designation from the Rural Minnesota Concentrated Employment Program (Rural CEP) and the Minnesota Department of Employment and Economic Development (MN DEED).
Addressing the health inequities Latine people encounter
Network member spotlight: Communities Organizing Latino Power (COPAL)
View the full October newsletter: MN Health Equity Networks Oct 2023 Newsletter
Communities Organizing Latino Power and Action, or COPAL, is a member-based organization working to improve the quality of life for Minnesota Latine communities since 2018. Cecilia Calabria is COPAL’s Health and Wellness Director.
“We are beginning to break down the barriers Latines face when accessing healthcare.” - Cecilia Calabria, Health and Wellness Director, COPAL
COPAL connects families to essential services when they need them most.
“During the onset of the COVID-19 pandemic, COPAL launched the Navigator’s Hotline because community members were reaching out to COPAL to get help with a variety of issues,” said Calabria. “Our navigators connected people with food resources, testing sites, contact tracing, public benefits, health care, housing assistance, and more.”
The navigators also partnered with churches, schools, and Latino markets to spread information, communicate with community members, and provide disease prevention education.
COPAL hosted a community conversation to learn about the issues families faced due to the pandemic. One pressing need was accurate health information in Spanish.
This need led to the Promotoras de Salud, or Health Community Educators’ program. COPAL trained staff and recruited the first cohort of promotoras de salud from the Twin Cities, Mankato, and Rochester areas in 2022. By early 2023, the first group graduated with the skills and knowledge to discuss sensitive health topics and foster productive conversations. Promotoras de salud will continue to play a critical role in bringing preventive health education to Latine communities.
The goals and work of COPAL go on. Calabria said she hopes to train a second cohort of promotoras de salud and expand the program to bring more Latine people into the healthcare industry. COPAL also plans to create new and deeper partnerships with service providers.
“COPAL envisions a future where Latine communities thrive and are fully empowered to lead significant change in their communities and beyond.” – Cecilia Calabria
Connecting to meet mental, physical, and emotional needs | August Health Equity Networks Newsletter
View the full August newsletter: MN Health Equity Networks Aug 2023 Newsletter
Mac Reed was raised in Mora, Minnesota by their grandparents, and from their grandparents learned about community and neighbors helping neighbors. “My grandparents taught me that if you see a need, then fill the need,” says Mac, who uses they/them pronouns. Mac’s grandparents influenced them to carry on their family’s tradition of community involvement.
Mac Reed, Technical Services Assistant at East Central Regional Library
As a librarian at the Mora Public Library (a branch of the East Central Regional Library) at the time of the COVID-19 pandemic, Mac saw the library was a trusted community resource for information and services. “Libraries are so ingrained in our communities. We sometimes were the only people that folks talked with each week,” says Mac.
Mac saw that the library became a key source of information in their community: “[People would] hear something on TV or on the radio, maybe a comment from a friend, and they’d call us, asking, ‘Is this right?’” says Mac. “They looked to us for help and answers, and we did our best.” Finding answers often required deeper research. “We’d call up Welia Health and tell them we needed information,” says Mac, of the health system with a clinic in Mora. “We’d get current and accurate details for our patrons. We’re librarians and we know how to collect and distribute data.”
Connecting people to information proved another challenge. “We started hooking people up to the internet. Before COVID, our library system had a total of 30 hot spots our patrons could check out,” Mac says, of the hardware that enables users to connect their computers or mobile devices to Wi-Fi. “We quickly realized that we needed to get more. Those hot spots were an important way for us to help people connect during COVID.”
“In a way, we were a lighthouse in the middle of COVID.” – Mac Reed, East Central Regional Library
That began driving what Mac calls a “subtle curve” in the direction in which the library helped their patrons, in addition to offering traditional library services. Prior to the pandemic, the library offered free snacks in the teen section. During the height of the pandemic, the snack bin grew to provide snacks for all library patrons, with a collection of easy-to-eat or easy-to-make foods in an inconspicuous spot in the library.
Soon the library started collaborating with a local food shelf to offer even more. “A food shelf volunteer came over, took measurements of an unused coat closet, and built us shelves that fit perfectly,” says Mac. “The food shelf folks brought the food over, and the library staff took care of it.” The library and the food shelf signed a formal contract, and the library food shelf became an important source of emergency food, since the library’s daily hours extended beyond those of the food shelf. In addition, patrons needing food weren’t required to share their names or identification at the library. Mac shares patrons would ask: “So, it’s just free?”
Mora Public Library’s on-site food shelf
Library staff noticed other unmet needs, and community members donated funds for diapers, period products, soap, deodorant, other foodstuffs, and more. Signs in bathrooms hold tags showing a variety of diaper sizes; patrons can grab a tag, bring it to the desk, and staff discretely give them diapers. After the Supreme Court overturned Roe v. Wade in June 2023, the library reached out to local clinics for information on birth control and other resources, and now distributes free pregnancy tests upon request.
Diaper tags are available for patrons to exchange for diapers
Mac thinks of the library as a microcosm of their community, and working there gives them a unique glimpse into it. “We get a layered image, a multi-level snapshot here. We see situations from every angle, and gather information to make a whole picture,” they say.
“At the end of the day, every library works toward health equity in their own way.” – Mac Reed
The library’s work has not gone unnoticed. In October 2022, the Mora Library was awarded Lakes and Pines Community Action Council’s Spirit of Community Award. The library also collaborates with local Master Gardeners, library volunteers, and other community organizations.
In the future, the library hopes to offer more support for sustainable living.
Mac Reed, Technical Services Assistant for the East Central Regional Library System, will present information about their revolving seed library at the Minnesota Library Association Child and Young People’s Unconference, on September 8, 2023.
Laying the groundwork for equity with a Health Equity Advisory and Leadership Council: Network member spotlight with Rice County HEAL Council
View the full July 2023 newsletter: July 2023 Health Equity Networks Newsletter
"This work is just starting and the journey is the goal." - Sara Coulter, Rice County Public Health Clinic and Community Supervisor
Sara Coulter has been working on the creation of the Rice County Health Equity Advisory and Leadership (HEAL) Council since last year, when the county was awarded a grant from the Minnesota Health Equity Network. She and other staff are connecting with community members and organizations, inviting them to join the council, and asking them how they think participation should look. They are starting by talking to the people with whom they have solid relationships and mutual trust. They hope to get input from them about possible new contacts, locations for meetings that are most comfortable for community members, what size of group might feel right to them, what communication needs they should address, and details on other barriers to participation.
"COVID was the quick work. This is an engagement. It’s the slow work of sitting down and listening. We plan to take our time and build trust." - Sara Coulter
Throughout the COVID response, Rice County Public Health staff worked with community groups and diverse media on education and messaging. The HEAL Council aims to build on those existing relationships and connections, and gain a better understanding of the community’s vision of health. "We know that we have much to learn," says Sara. "Above all, we want to know how the HEAL Council can serve as a true source of the work of healing our community."
One of the HEAL Council's goals of is to make sure that community members feel they can freely express their needs and ideas, and therefore completely participate. Interpreters will be plentiful, to make communication as easy as possible.
In addition, Sara welcomes contact from other organizations working toward health equity, to share information, questions, and experiences. "Susan Brace-Adkins from [the Minnesota Department of Health] calls the people doing the same kind of work as we do 'near peers.' I really like that phrase and have always benefitted from collaborations with near peers," says Sara. "I welcome the contact with others who may have ideas or questions about the HEAL Council. Reach out; send me an email. Let’s build a relationship."
"We hope that at some point in our time together people will mix in new ways and leave meetings feeling as though they are part of the action that will create change for themselves and their communities." - Rice County HEAL Council proposal
Read more about the Rice County HEAL Council: Faribault Diversity Coalition series highlights health equity (Faribault Daily News)
Building on relationships: Network member spotlight with Wright County Health Equity Learning Squads
View the full June newsletter: June 2023 Health Equity Networks Newsletter
"We start with relationships with the people we see day to day, and build on them to make things happen." - Ellie Vanasse, Wright County Public Health Nurse and Health Equity Action Team (HEAT) Organizer
Wright County Public Health Nurse Ellie Vanasse helped start the county's Health Equity Action Team (HEAT) about four years ago. They have organized a number of health equity projects in that time, but the effort with the most impact is the Health Equity Learning Squads project. The squads are micro-discussion groups who meet monthly to reflect on and learn about the way they do the work of health equity.
Squad members begin by reading articles, watching videos, and discussing issues such as identity, as that offers more opportunity for connection. HEAT encourages a focus on a number of values: relationship and connection, practice not perfection, curiosity, realness, collectivism, and strategic and thoughtful risk-taking. According to Ellie, "They can talk about hard things, and don’t just take no for an answer.” Squad members offer each other support and understanding, strengthen their relationships, and experience personal and professional growth. Annually, all of the squads gather for a Squad Summit.
"Employees have resigned or retired, but no one who has joined has dropped out of a squad. People show up because they want to show up, and I’m extremely proud of the fact that they do." - Ellie Vanasse
In the beginning, fifteen people joined Health Equity Learning Squads. Since then, staff participation has increased. There are now seven squads in the department, each made up of three to five people. Squads meet approximately once a month, and sessions last about an hour with another hour of work done between meetings. They have the option of meeting more often if they choose, but never more than once a week. All the squads also gather annually for "squad summits."
The small size of the squads were an intentional choice. Scheduling meetings for smaller groups is less complicated. But more than that, keeping the squads small offers people more time to talk, to build relationships, and have deeper discussions.
When you are in a group of three, your voice is heard. Just because there are less people at the table doesn’t mean they are less involved. - Ellie Vanasse
HEAT also offers monthly opportunities to all Wright County Public Health employees, including training on topics such as name- and identity-sharing, information on social determinants of health, opportunities to participate in book clubs and podcast discussions, in-house newsletters, and surveys regarding staff understanding of health equity work. Management does not participate in the squads, but members of management attend HEAT-sponsored workshops and trainings and are considering creating their own squads.
It all started when in 2019 Wright County staff participated in a climate justice project through the Human Impact Partners Initiative. Six of them decided to use what they learned in the project to address health equity within the Wright County Public Health Department. They liked the Human Impact Partners project model, which includes discussion and a dive into personal and professional perspectives, so used it to draft a plan. They presented the idea of Health Equity Learning Squads to the Wright County Public Health Director, Sarah Grosshuesch, who approved and supported the project. Any staff who was interested, regardless of their position, could join a Health Equity Learning Squad. She also communicated her support throughout the department, and announced that time spent preparing for a squad meeting or attending one would be considered work time. Ellie says, "We came up with the ask and management was super supportive."
Three-quarters of all Wright County Public Health staff now are members of a squad. The original HEAT members are part of the squads, and continue to check with and support other squads. At last year’s MPHA, the HEAT presented information on their project. The team is drafting a squad guide in order to document the experience. They also recognize the gaps in their workforce and are working to encourage more diversity. Above all, according to Ellie, they are aware of the "extreme privilege" they have in "getting paid to talk about health equity."
"The goal is to deepen relationships, disrupt master narratives, answer the question of how to make meaning in the world and transform ourselves and our work toward equity." - Health Equity Learning Squads; Human Impact Partners model, draft document
Want to learn more about the Health Equity Learning Squads? Ben Grimm from Wright County Public Health will present at the Central Regional Health Equity Gathering on July 26, 2023. Register and join us!
The Intersection of Data and Equity: Network member spotlight with Carlton-Cook-Lake-St. Louis Community Health Board
View the full May 2023 newsletter: May Health Equity Networks Newsletter
Members and staff of the Carlton-Cook-Lake-St. Louis Community Health Board wanted to know more about how to build more equity into data systems and make more data-informed decisions. The community health board applied for and was awarded a Regional Health Equity Networks grant to use to provide this training. Stephany Medina, the Program Manager and Public Health Planner for the community health board, remembered attending an excellent data equity training by an organization named We All Count while working for a member of the Feeding America network.
"It was important to learn together so we were coming from a place of shared language and understanding of data equity." - Stephany Medina, Carlton-Cook-Lake-St. Louis Community Health Board
Community health board staff got together with Heather Krause from We All Count to plan and offer two-part virtual training, called "Foundations of Data Equity." It was customized for people who were not experienced data analysts and emphasized a community perspective. Representatives from local public health, nonprofits, academic institutions, public schools, the Minnesota Department of Health, and others attended the training, which was held in early April 2023.
"The folks from the Carlton-Cook-Lake-St. Louis Community (Health Board) training asked some really fabulous questions that are directly related to the importance of making thoughtful, equity-informed choices for the unique needs of projects rather than try to develop some type of across-the-board checklist of best practices. They’re well set up for small, sustainable steps – which is the ideal (in order) to find success in equity and data projects." - Heather Krause, Founder, We All Count
Data-informed decision-making is becoming a bigger priority for many health departments and related organizations, as they learn from COVID-19 response and adapt to future challenges. "Data-informed decision making" means that organizations use numbers to guide decisions and, due to this, have more confidence that they are making the right choices. Numbers are the tools used to plan programs, evaluate initiatives, or create improvement strategies. But inequitable data can also lead to inequitable decision-making.
"The first thing that was highlighted in the training is the fact that data isn’t objective. As much as we’d like to believe that we use objective processes to gather and analyze data, and that if we use that data just right, we can come to objective and conclusive answers; that isn’t reality." - Stephany Medina, Carlton-Cook-Lake-St. Louis Community Health Board
Organizations and people make subjective decisions at every step of data projects from motivation to data collection, from analysis to interpretation, and even how to use and share results. Organizations and people make decisions about who to center in every data project (e.g., students, teachers, or researchers). Organizations and people also make decisions about which results to consider significant, and which results are not significant. The training addressed the question, "If objective data doesn’t exist, what does that mean for equity goals?"
During the training, We All Count made some basic recommendations:
- Be clear about equity goals.
- Decide who to center in your project.
- Determine the learning goal.
- Find out if all partners (program participants, funders, program coordinators) want to learn the same things.
- Be intentional.
- If you wish to center program participants, design your evaluation or data project to center the goals and perspective of program participants.
- Be transparent.
- Communicate the choices made and the reasons you made those choices in your results.
Heather also shared the data equity framework below, outlining a systematic way of looking at data projects. It organizes every project into seven stages:
Above all, the data equity training offered people the opportunity to learn about how to craft more equitable data plans and design clear, intentional, and transparent programming.
"Since taking this training a week ago, I haven't stopped thinking about it. It totally reframed how I think about equity and data. And, as a non-data scientist, I found it very approachable and relatable to my work, which was an exciting surprise!" - Foundations of Data Equity training participant
Carlton-Cook-Lake-St. Louis organizers were pleased with the success of the training and with attendee responses.
"We All Count shared a wealth of knowledge during the Foundations of Data Equity training. While we know this training doesn’t mean all our data-informed decision making efforts are now equitable, we hope this brings us one step closer to embedding more equity into the work that we do." - Stephany Medina, Carlton-Cook-Lake-St. Louis Community Health Board
Image credit: We All Count
Community means connection: Network member spotlight with Growing Up Healthy
View the full April 2023 newsletter: April Health Equity Networks Newsletter
In many ways, Fatima Ponciano grew up alongside Growing Up Healthy. In 2006, as a high school student, she started volunteering with Growing Up Healthy as a community representative. Now, as an Early Childhood Navigator with the organization, she says, “It’s been interesting and wonderful to see it grow.”
Growing Up Healthy works with partner organizations and Latine and immigrant families in Faribault and Northfield to transform communities by cultivating neighborhood leadership, fostering social connectedness, and collectively advocating for systems-level change.
That connectedness is key, says Fatima. “When we started, we held community meetings to hear from people about the challenges and issues they were experiencing,” she says. “One of the things that we kept hearing was that people felt disconnected from the community and resources and also disconnected from each other.” The organization hopes to continue expanding in Rice County, supported by the Healthy Community Initiative, its parent organization.
“We want this to be a place where no one has to worry about the forecast or whether their furnace is working,” says Fatima, “where everyone can afford childcare, preschool, or day care, [and] above all, where everyone has a safe place to live.”
Growing Up Healthy works with partners to help fill some of these gaps by:
- Connecting residents in Faribault and Northfield mobile home parks with home energy improvement programs; organizing a Heat Tape Outreach program; partnering with Xcel Energy to organize Home Energy Squad visits
- Helping parents and caregivers develop leadership skills and organize to positively change systems to benefit children in their communities
- Organizing community events to deepen social connections and promote neighborhood outreach
- Working with Faribault and Northfield expectant parents and families with young children to connect them with early learning and kindergarten preparation, in partnership with WIC, HealthFinders, Rice County Public Health, Allina Partners, and others
- Providing free home visiting services in Rice County to a number of children, thanks to a partnership with Jewish Family and Children’s Services and Parent Child Plus; promoting learning through play, enhanced parenting skills and school readiness
- Supporting families and childcare providers navigating Child Care Assistance
- Improving elementary school students’ attendance and engagement by working with students and their caregivers to promote success in schools
- Distributing breakfasts, lunches, and weekend meals during the pandemic, funded through a grant collaboration with No Kid Hungry, Faribault Public Schools, and Growing Up Healthy
“There are barriers and obstacles that we are unable to tackle, but that’s where our partners and referrals come in,” says Fatima. “Luckily, we have strong connections, and we’ve learned to get all our community organizations involved. Thanks to those collaborations, we’ve seen some systems-level changes.”
Photo credit: Growing Up Healthy
Connecting people to the care they need leads to "best possible outcomes": Network member spotlight with HealtheMed
View the full March 2023 newsletter: March Health Equity Networks Newsletter
Avery Kennett understands the challenges often faced by Minnesotans using Medicaid waivers. As enrollment manager at HealtheMed, she is part of a team that helps people overcome health care access barriers by connecting them with medical services right in their homes. “Being able to monitor and share client data and medication information with their doctors helps clients remain happier and healthier,” says Avery.
“We work to reduce not only the stress on the client, but also on the county and the health care system,” says Avery. HealtheMed offers remote-patient monitoring with a variety of devices including automated medication dispensers, contactless thermometers, pulse oximeters, blood pressure cuffs and weight scales. All are connected through a 50-inch Smart TV installed in the clients’ home. Physician visits occur on the Smart TV rather than a cell phone—which makes the experience more immediate and effective. Clients can access health information, educational videos, and other services via the Smart TV.
But HealtheMed doesn’t just rely on technology to close the access gap for its clients: HealtheMed collaborates with providers to deliver mental health and pharmacy services. Skilled nurse consultants meet in person with clients quarterly, and regularly connect the clients to their practitioners. Avery adds, “The nurse consultants can really help guide and educate. They add a layer of support and a safety net.”
“We have been able to bring health care access into our clients’ homes, which has been super powerful, and has increased their quality of life. We want them to have the best possible outcomes,” she says.
Four founders developed HealtheMed five years ago, working with the Minnesota Department of Administration to find creative solutions for reducing the cost of care and bridging service gaps. “We started by becoming a Home and Community Based Provider,” says Avery. “Then we found doctors and behavioral health specialists who were very motivated to serve Medicaid enrollees with waivers. That was our genesis.” HealtheMed refined its business plan and launched in September of 2020, exactly when telemedicine technology was sorely needed during the height of the COVID-19 pandemic. Currently, the organization serves 200 clients in 22 counties.
One problem HealtheMed staff tackle is medication non-adherence: “Our clients have achieved an overall medication adherence rate of 79 percent so far,” says Avery, emphasizing the successful results that have been achieved.
Remote patient monitoring also helps families when health care settings are stressful: “One of our clients has three children, all of whom are on the autism spectrum, and are on three different medication regimens. One child was so stressed before doctor appointments that it was necessary to medicate them. The remote patient monitoring eliminated a lot of barriers for the family. The mother was able to track the medication management far more easily. Above all, it resulted in less stress for everyone, especially for the kids.”
Another client, a double transplant recipient who is also receiving mental health care, found it overwhelming to track and manage his health issues. He worked with HealtheMed’s team, who helped him successfully set up and use remote patient monitoring. “He gets reminders to step on the scale, take his vitals, and it stores the data for him,” says Avery. “Now he feels empowered because he can help navigate his own health.”
HealtheMed is constantly evolving and plans to continue to expand its footprint in Minnesota. “The more we learn about our clients,” Avery says, “the more we can expand and keep people in their homes and out of the hospital.”
“Not many organizations are doing both service and technology. We have the capability to be individualized, and that sets us apart,” says Avery. “Above all, we know that the human touch is essential and that every one of our clients has a different story to tell.”
Join your regional Health Equity Network and find ways to partner organizations like HealtheMed, to connect, strengthen, and amplify health equity in your region!
Photo credit: HealtheMed, Adobe Stock
Trust and collaboration help build healthy families: Network member spotlight with First Steps to Healthy Families
View the full February 2023 newsletter: February Health Equity Networks Newsletter
Kami Kelm understands the fear some families feel when they interact with county social services or other government programs. She sees it in her work as case manager for First Steps to Healthy Families in Beltrami County: "One of my biggest challenges is just to get people to answer the door or the phone." But she also knows that the power of connection. When a community supports a family, that family can more easily get what it needs. "When I can connect and we can talk honestly, we have had some amazing turnarounds," she says.
Eight years ago, Beltrami County started First Steps to Healthy Babies, in partnership with the Red Lake Nation, Sanford Health, and others, to help parents with prenatal care and sober supports. It provided postpartum services until a baby turned one year old. Today, that program has expanded to operate as First Steps to Healthy Families, and Kami works with families until children turn five years old.
"We really have to work together to meet the needs of our community. We have to do a lot with less, and that requires relationships." – Jeff Lind, division director, Beltrami County Social Services
Above all, First Steps to Healthy Families seeks to help participating families understand that pregnancy is not a cure for addiction. Their model has expanded to other counties and communities, and the team networks with similar programs to compare notes. "We were the guinea pigs. To see it now is really cool," says Kami.
Jeff looks at the big picture, and thinks a county made up of rural and small-town residents has the strength of community and collaboration on its side. "We certainly have all the challenges you’d see in urban areas,” says Jeff. “Our rates of overdose and deaths from overdose are very high. But what we do have in our county is [our] collaborative nature. We don’t have the resources that other more urban areas do, so we really have to work together to meet the needs of our community. We have to do a lot with less, and that requires relationships."
"There’s not always a quick answer for every person, but within the community we can piecemeal things together. That’s what happens when you do enough collaboration. It is those connections that lead me to opportunities to help someone." – Kami Kelm, case manager, First Steps to Healthy Families
Kami recalls helping a mom of four living in unstable housing. Without any means of transportation, the family couldn’t connect with the services they needed on their own, so Kami drove them to the Red Lake Nation government office for the day, where the children were enrolled as members and they could get on a tribal housing waitlist. "We just took a day, drove over, and got it all done," explains Kami.
Kami and Jeff explain that First Steps to Healthy Families has evolved and changed through the years, as grant funding comes and goes, resources ebb and flow—not to mention COVID, which "threw a curveball, and changed partnerships and routines," says Kami.
People also use different substances than they did when First Steps first started. Substance use has moved from opioids to heroin and meth to fentanyl. "People are getting stronger and stronger drugs," says Kami. "We have to be aware of the trends and also the resources available. When we see something new, we all share information with each other."
Jeff and Kami have also seen advances in approaches to substance use such as an emphasis on harm reduction and medically assisted treatment, which means First Steps to Healthy Families has more options to help support the families in the program. "The freedom that we have to tailor this project to the community is really cool," says Kami.
"Every community should have something like this and work with families, not against them." – Jeff Lind, division director, Beltrami County Social Services
Read more about how First Steps to Healthy Families helps families get the help they need:
- Epidemic led to dramatic rise in foster care cases, emergency calls (Bemidji Pioneer, 2022)
- First Steps to Healthy Babies: Program aims to reduce opioid-affected births at rural hospitals (MinnPost, 2018)
- Sanford Bemidji’s First Steps program helps addicted mothers, babies (Bemidji Pioneer, 2017)
- A heart-breaking consequence of the opioid crisis: Addicted babies (Minnesota Public Radio, 2017)
Join the Northwest Health Equity Network and find ways to partner with First Steps to Healthy Families and other organizations to connect, strengthen, and amplify health equity in your region!
Photo credit: Adobe Stock
It's all about relationships: Network member spotlight with Dakota Child and Family Clinic
View the full January 2023 newsletter: January Health Equity Networks Newsletter
Metro Health Equity Network member organization Dakota Child and Family Clinic turned 10 years old last year. After facing closure in 2011, the community around the clinic organized, formed a board, and applied for nonprofit status. Community members even personally painted and improved the clinic building, living out their mission: Providing healthcare for people, not for profit.
Kelly Kenley, Executive Director, shares the the clinic's "whole person, whole picture" focus, and notes its emphasis on a nurse practitioner model. Clinic highlights include:
- After meeting with staff, it is discovered that a patient suffering from back pain is also homeless. Some of the problems are because the patient is sleeping on floors and couches. The clinic works to help the patient find a comfortable place to sleep.
- A child with medical trauma isn’t able to be inside the clinic for a visit. The clinic staff walks out to the family car in the parking lot and examines the child there.
- Another patient has high blood pressure, apparently related to stress. The clinic assists with medications, but they also support the patient by helping them access mental health services.
- A family new to the country brings a child into the clinic who is suffering from severe abdominal pain. It becomes clear that they need to go to the hospital. The family has applied for insurance, but it is still in process, so affordable transportation options are limited. The staff arranges and personally pays for Lyft transportation to get them to the hospital.
- The clinic provides free initial health care appointments at Mission Outpost, a local food and resource center, with a sliding fee scale for continued care if needed.
- Services for Spanish-speaking and Russian populations are available, and some staff have completed a medical translation program to assist in case management.
The clinic also offers mental health services. Kenley relays the clinic's struggle, "We aren’t going to one-to-one our way out of the current mental health crisis. So what other things can we do to support mental health?" The clinic organizes support groups under headings like "It’s Complicated" and "Safety Net," alongside Spanish-speaking support groups, support groups for families with challenging children, and a local Transforming Families chapter. A social worker attends many of these meetings, connecting participants to services and follow-up. "When something is hard, it helps when somebody knows you’re struggling," says Kenley.
Kenley also notes COVID has been the impetus for significant growth. "It offered a unique opportunity we would not have had otherwise," she says. The clinic offered barrier-free COVID testing and drive-up testing in three locations in Dakota County, with no ID required. The clinic also offered on-site testing at three local school districts during the 2020-2021 school year. By advocating with Dakota County, the clinic could reduce barriers and wait times.
And in the future? Dakota Child and Family Clinic's hope is to expand to other food shelves and shelters. Staff dream of outfitting a mobile unit. According to Kenley, "Our efforts raised our profile in the community. We built more trust, and it’s a privilege to have earned that. Now that we have, there is so much to do. It can be overwhelming at times. But it’s all about relationships."
To learn more about Dakota Child and Family Clinic, join us at the January 24 Metro Region Health Equity Network gathering for the region's member spotlight.
Join the Metro Health Equity Network and find ways to partner with Dakota Child and Family Clinic and other organizations to connect, strengthen, and amplify health equity in your region!
Photo credit: Dakota Child and Family Clinic
We're building health equity together!
View the full November newsletter: November Minnesota Health Equity Networks Newsletter
Inaugural newsletter from the Minnesota Health Equity Networks
View the full October newsletter: Welcome to the inaugural Health Equity Networks newsletter!
Connect: Who should join their Health Equity Network?
A note from Shor Salkas, project supervisor...
The Minnesota Health Equity Networks are based in the power of relationships.
Relationships are a core human need. We need to know the people that are our neighbors, that we work with, that live in our communities. The people around us lift us up and support us in our struggles. We thrive as individuals and as communities when we are connected.
And this applies to our work in public health and advancing health equity, as well. A relational approach to changing our world is not new, but it is still revolutionary. We are asking you to show up, get curious about each other, and deeply care about each other and about changing our communities and systems to ones that heal, not harm.
We invite you to regional network gatherings and connect to each other in intentional ways—to get curious about how to lift up your successes and collaborate on how to go deeper in supporting your communities. The networks will also offering trainings and coaching throughout the year to deepen knowledge on a variety of health equity issues that are important to communities across the state. All of our offerings are open to your thoughts and feedback, because mostly, we want to get to know you.
To find the coordinators, dates of gatherings and trainings, check out our website at Minnesota Health Equity Networks and click on "Events and training opportunities."
Who belongs in the Minnesota Health Equity Networks?
The short answer is anyone. One of the goals of this project is to support the public health system and to come together around health equity and community engagement issues in new and different ways. So expect a lot of folks from "the public health system" in network gatherings and spaces. But network staff have also been building relationships with community organizations, folks in Tribal health, and throughout our regional communities.
Come as you are, and we invite you to come:
- With an open mind and open heart
- With curiosity
- Ready to get comfortable with discomfort
- Ready to meet and connect with people, new and familiar
- As a life-long learner
There are no membership criteria. We hope that you will join us and together we can connect our communities, strengthen our work, and amplify our achievements. Together we can work toward promoting health equity in Minnesota.
Read the rest of the October 2022 newsletter at: Welcome to the inaugural Health Equity Networks newsletter!
Funding for this project is provided by the CDC OT21-2103 COVID-19 Health Equity Grant.