By Jeremy Moseley
Cleveland was once one of the centers of the industrial revolution, leaving behind entire square miles of amazing architecture, hundreds of churches and graveyards filled with enormously wealthy individuals (John Rockefeller is one of many). Many of those amazing buildings are now empty, but the wealth has only compounded over time meaning very firm foundations under many foundations. This is a key to how Cleveland is turning yet one more corner on the journey into the 21st century where the health of the community relies on many innovations from many sectors blending into a coherent whole.
Nowhere is this more evident than in the former wasteland in between downtown Cleveland and the massive health complex on the eastern edge of town. This is where you’ll find the remarkable new Rainbow Center for Women & Children, a brilliantly conceived range of services designed with data, mind, heart and lots of careful listening. The next day, we traveled to the center of the state to Dayton where some of the same dynamics are visible in key local health infrastructure, notably Brigid’s Path, for substance affected children.
Those who do this work well have a firm understanding of how community engagement has many layers and involves a structured approach by key departments within the health system working together. The two examples I witnessed understood that engagement needs to involve concerted efforts to listen to the communities they are serving through faith community leaders and nonprofit leaders in addition to understanding health system data at a geographic level within the context of financial cost and disease prevalence.
Importantly, they did not overlook the internal capacity and infrastructure that it takes to engage communities across various sectors and key stakeholders.
Philanthropy, spiritual care, and government and community relations were catalysts in creating the funding, staffing, and strategies necessary to create internal workflows, programs, time, focus and goals to ensure that the right people within the organizations and their important community relationships could be leveraged in a way that forms a coherent plan of action. That plan often resulted in providing increased resources and improved access to care in targeted neighborhoods, and giving honest attention to deep rooted issues like poverty and racism.
They get it
Simply, they get it. They are not allowing internal politics, research priorities, evidence-based practice, or departmental goals define the agenda. They are transferring power by allowing the community (including but not limited to the CHNA process) to define the agenda and then structuring their teams and internal response around that. They are actually talking with members of the community and getting feedback through focus groups and other means. Furthermore, many of the health system leaders go above and beyond by not only sitting on community nonprofit boards, but by engaging the leadership of those nonprofit organizations in ways that create strategic, long-lasting collaboration and community investment that is shared between that organization and the health system.
So, if I learned anything, I would say that a defined mission, cause, or purpose comes first. But, that cannot happen until you get in close proximity with the people who you want to join in helping them succeed in their health and life journeys. Getting close takes structure too and trusted people within the system who can build bridges before planning the path. Community leaders including those in education, community-based service, community organizations, and faith have to be co-developers in defining your purpose and path. Only then can you design programs, recruit/assign staff, and create the internal collaborations necessary to be responsive to the complexities, absence of trust, opportunities for connection, and health priorities that exist in communities.