Upload
others
View
1
Download
0
Embed Size (px)
Citation preview
C 0, M 35, Y 100, K 0
R 252, G 175, B 23
FCAF17
C 45, M 71, Y 85, K 58
R 80, G 48, B 27
503011B
C 0, M 79, Y 100, K 11
R 217, G 83, B 30
D9531E
SCREEN (PowerPoint)
WEB
C 50, M 0, Y 25, K 0
R 122, G 204, B 200
7ACCC8
A Neighborhood- Resident Physic ian Partnership
to Evaluate Health
Written by Katherine Diaz Vickery, MD with contributions by MaryBeth Grewe, BA and Lynda Anderson MA, MPH
Table of ContentsOverview ....................................................................... 2
Background .................................................................. 4
Process ........................................................................... 7
Demographics ............................................................. 9
Findings .......................................................................10
Key Priorities...............................................................12
Local Context .............................................................18
Conclusions ................................................................21
Next Steps ...................................................................22
Appendix .....................................................................23
Thank you!This project would not have been possible without contributions from many, varied partners. A heartfelt thanks to:
• AllparticipantswhorepresenteddiversesegmentsoftheWest7thneighborhood
• Cooperationanddonatedtimeandspacefrommanycommunityorganizations
• MinnesotaAcademyofFamilyPractice,FoundationResidentResearchGrant
• UnitedFamilyMedicine(withaspecialthankstotheBoard)
• UnitedFamilyMedicineResidency
• AllinaHealth–CenterforHealthcareInnovation
• Cooper’sSupermarkets
• deZinnia,Inc.
Adams School
Assumption Church
Church of St.Stanislaus
Czech & Slovak SOKOL Minnesota
Eagle’s Nest Shelter
Fort Road Federation
Mad Hatter’s Coffee Cafe and Teahouse
Jewish Community Center of the Greater St. Paul Area
Jewish Family Services
Listening House of St. Paul
Little Bohemia Neighborhood Association
Mississippi Market
Nova Classical Academy
Neighborhood House
Pax Conversation Salon
St. Francis - St. James Catholic Parish
St. Mark Evangelical Lutheran Church
St. Peter’s Lutheran Church
West 7th Business Association
West 7th Community Center
West 7th Community Reporter
Healthy West 7th Assessment Report 1
BackgroundTherichhistoryoftheWest7thneighborhoodofSt.PaulprovidesthebackdropfortheHealthyWest7thproject.UnitedFamilyMedicineanditsresidencytrainingprogramhaveadecades-longfoundationofpartnershipwiththisneighborhood.Sinceitbegan,theresidencyhasemphasizedCommunityOrientedPrimaryCare(COPC)underthedirectionofclinicfounder,Dr.TimRumseyandresidencydirectorDr.KallyMacken.Residentphysicians(in-trainingtobecomefamilydoctors)completecommunityprojectsasapartofthecurriculum.
TheHealthyWest7thprojectbeganasaCOPCprojectoftheresidencyclassof2008-2011withgoalsofidentifyingcommunityprioritiesforhealthimprovementandbuildingeffectivepartnershipsforfutureprojects.InformedbytheCOPCmodel,HealthyPeoplecampaigns,andthehistoricWest7thCommunityPartnership,theprojecthasgrownindepthandscopesinceitbegan.
ProcessToaccomplishtheabovegoals,residentphysiciansdecidedtouseaCommunity-BasedParticipatoryResearchmodelintheirassetmap/needsassessmentoftheneighborhood.Togetherwithcommunitymembers,individualinterviews(36total)andfocusgroups(14total)werecompletedtargetingdifferentsegmentsoftheneighborhood.(Surveyswerealsodonebutminimallyused).Allmethodsaskedthesamefourquestions:
• Whoareyouandwhoarethoseclosetoyou?
• Howdoyouandthoseclosetoyoustayhealthy?
• Whatdoyouandthoseclosetoyouneedtobehealthier?
• Wheredoyougowhenyouneedhelp?
Intotal,theprojectcollectedresponsesfrom183peoplewholived,worked,orsoughtoutservicesintheneighborhood.Resultswereanalyzedbytheresearchteam,whichincludedresidents/clinicstaffandcommunitymembers,usingqualitativeresearchmethods.
Overv iew
The rich history of the West 7th neighborhood of St. Paul provides the backdrop for the Healthy West 7th project. United Family Medicine and its residency training program have a decades-long foundation of partnership with this neighborhood.
2 Healthy West 7th Assessment Report
ResultsParticipantslistedfamily,friends,faithcommunities,pets,co-workers,neighbors,andmorewhendefiningtheircommunities.Inresponsetohowtheykeephealthy,participantsdescribedpersonalfactorssuchasmotivation,socialnetworks,andhavingasenseofpurposeinlife.Participantsalsostressedtheimportanceofahealthyenvironmentandavailabilityofsafespaceforactivity,avibrantbusinesscommunity,andaccesstohealthyfoods.
Throughinterviews,focusgroups,andsubsequentneighborhoodmeetings,thefollowingeightkeyprioritieswereidentifiedandprioritized(formoredetailsseefullreport):
1. Basic Needs (food, shelter, employment, insurance coverage)
2. Health Education
3. Resource Coordination
4. Nutrition
5. Fitness
6. Community-Building
7/8. Volunteerism
7/8. Activities for Youth
Next Steps ThelargergoaloftheHealthyWest7thprojecthasalwaysbeentosparkcommunityactionaroundneighborhoodhealthimprovement.Forthistobesuccessful,itisessentialthatthecommunityitselfdecidewhat,when,andhowthingsproceed.Thisisalreadyunderwaywithnumerousconversationsandcollaborationsalreadydeveloping:AllinaHealthisnewlypartneringwithseverallocalorganizationsinWest7th.Activecollaborationisunderwaywithdiversepartnersonacommunitygardening/nutritionprojectencouragingintergenerationalvegetablegrowingandhealthymealpreparation.
RepresentativesfromdiversesegmentsoftheneighborhoodareinformingtheongoingrevisionoftheCommunity-OrientedPrimaryCarecurriculumforresidentphysiciansatUnitedFamilyMedicine.Thisincludesacommunitycounciltogivefeedbackandoversighttoresidentprojects.
Ifyouwouldliketobeinvolved,pleaseemail:[email protected].
healthywest7th.wordpress.com
Healthy West 7th Assessment Report 3
West7thnowwelcomesdiverseimmigrantsfromaroundtheworldbutremainspredominantlyCaucasian(73.6%),withsomeAfricanAmerican(10.8%),andHispanic(7.9%)presence.Itisamixedsocioeconomicareawith14.4%ofallresidentslivinginpoverty.1West7thhasastrongdistrictcouncil(theFortRoadFederation)2andmanyactiveblockclubsthatpromotealivelyrangeofactivitiesandconnectionsintheneighborhood.AdditionallyWest7thishometomanysmallbusinessesrepresentedinastrongbusinessassociation,severalschools,numerousplacesofworship,anactivecommunitycenter,arangeofmedicalservicesincludingseveralnursinghomes,UnitedHospitalandaffiliatedclinics,UnitedFamilyMedicine,adentalclinic,severalchiropracticoffices,aswellasanumberofformalandinformalresidencesforthoseindrug/alcoholrecovery.
UnitedFamilyMedicinehasahistoricrelationshipwiththeWest7thneighborhoodofSt.Paul,MN.Itsrootsdatebacktothe1930’swhentheWilderDispensaryofferedfreeandlow-costcare(onthesiteoftheMinnesotaHistoryCenterandlatermovingtoMillerHospitaltobecometheMillerOutpatientDepartment(M.O.D.).In1971,Miller
andSt.Luke’sHospitalsmergedformingUnitedHospital.Twentyyearslater,theDispensarymoveddownthestreetandjoinedHelpingHandsHealthCenter.UnitedFamilyPracticeHealthCenteropenedin1992whentheM.O.D.,HelpingHandHealthCenter,andDr.TimRumsey’sprivatepracticecombinedandbeganoperatingwithintheAllinaHealthsystem.
★The West 7th neighborhood of Saint Paul is a unique and vibrant area situated along the bank of the Mississippi River stretching west from downtown. The oldest residential neighborhood in Saint Paul, West 7th historically welcomed European immigrant families and was home to a number of breweries.
Adapted from City of St. Paul District Council map, available: http://www.stpaul.gov/DocumentView.aspx?DID=18476
Background
4 Healthy West 7th Assessment Report
In2003,UnitedFamilyPracticeHealthCenterincorporatedasaseparateorganizationfromAllina.Since2004,UnitedFamilyPracticeHealthCenterhasbeenafreestandingFederally-QualifiedHealthCenterlook-alike(FQHC-la)withapatient-ledindependentboardofdirectors.WiththemovetoanewsiteonRandolphandWest7thin2009,thenameUnitedFamilyMedicinewasadopted.ThisnamereflectsthecloserelationshipwiththeUnitedHospital’sFamilyMedicineResidencyprogram.Throughoutthis70+yearhistory,themissionoftheclinichasremainedclear:“ToServe&ToTeach”whileprovidinghealthcareforthediverse,underservedpopulationsinSt.Paulanditsneighboringcommunities.3
TheUnitedFamilyMedicineResidencywasfoundedin1993underthedirectionofDr.KallyMackenandhascontinuallyhostedsixresidentphysicians(newlygraduateddoctorswhohavechosentotraininfamilymedicine)peryearforathree-yeartrainingcyclesincethattime.TheresidencyhasaspecialemphasisonCommunity-OrientedPrimaryCare(COPC)underthedirectionofDr.Rumseywhoremainsacentralfigureofthefaculty.EachyearresidentscompletecommunityprojectsasapartoftheCOPCcurriculum.Variedintheirfociandapproach,projectshaveincludedpartnershipwiththelocalcommunitycenterforSaturdaymorningopengymtime,foundingaReach-Out-and-Readprogramtoprovidefreebookstochildrenatwellvisits,numerousqualityimprovementinitiativeswithintheclinic,andmore.Reflectingonthemissionoftheclinic,theCOPCmodel,andtheirdesiretotrulyservethedesiresandneedsoftheneighborhood,theresidencyclassof2008-2011decidedtoworktogethertoconductacollaborativeassetmap/needsassessmentoftheareainpartnershipwithneighborhoodleaders.Thegoalwastoidentifythecommunity’sprioritiesforhealthimprovementandtobuildeffectivepartnershipsforfutureresidentprojects.Andso“HealthyWest7th”wasborn!
Thiswasnotthefirstattemptatsuchaneffort.TheWest7thCommunityPartnership(W7CP)conductedasurveyintheearly1990’sasapartoftheHealthyPeople2000campaign,andtheclinicwasoneofthekeypartners.Facilitatedbya$100,000grantfromtheHealthSpanCommunityTrust(whichlaterbecametheAllinaFoundation)andUnitedHospitalFoundation,theW7CPheldaseriesofconversationswithserviceprovidersintheneighborhoodoverseveralyears.Thisculminatedinalarge,communitymeetinginDecember1994whenaprofessionalfacilitatorledhundredsofparticipantsinreflectiononthestrengthsandneedsoftheneighborhoodrelatedtohealth.UltimatelytheW7CPchosefourareasoffocusfortheirimprovementefforts:
• Information&AccesstoCommunityServices Adirectoryofserviceswascreatedastheyfound,“ManypeoplewerenotawareofthehealthandhumanservicesavailabletoWestSeventhresidentsorhowtoaccessthem.”
• YouthEnrichmentActivities Initiativesincludeda“YouthShepherd”project,
andmini-grantsavailabletoserviceprovidersintheneighborhood.
• JobTraining&Availability Aneconomicstudyoftheneighborhoodwasfunded
inpartnershipwiththeUrbanLeague.
• Fear&SafetyConcerns PartnershipsforViolencePreventionwascreated.4
Healthy West 7th Assessment Report 5
TheW7CP’sworkandapproachinformedtheprocessundertakenwithHealthyWest7thandprovidedcomparativedatafrom14yearsprior.TheHealthyPeople2020goalsalsoservedasaresourceandproceduralguide.5
WhiletheHealthyWest7thprojectcouldhavebeendoneasanoutreachactivityalone,theresidentphysicians,alongwithacommunitycouncil,agreedthattheprojectwouldadoptprinciplesofcommunity-basedparticipatoryresearch(CBPR).
Arelativelynewadditiontothefieldofmedicalresearchwithrootsinthesocialsciences,CBPRfocusesonequalizingthepowerdynamicbetweenresearcherandsubject.Traditionalresearchoftenbeginswithanacademicexpertgatheringdataaboutresearchsubject,publishingconclusionsanddiscoveriesaboutthisdata,anddevelopinginterventionsforthecommunitybasedontheseconclusions.CBPRaimstoreversethispowerdynamicbymakingthecommunitythecentralfocusofallstagesofresearchfromsettingtheagendatocreatingprogramsandpoliciesbasedonthedata.
AsDr.AnnMacaulayofMcGillUniversityexplains,community-basedparticipatoryresearchisaprocessofcollective,community-basedinvestigation,education,andaction.
… [Participatory Research] can break down the rigid boundaries between those doing research and being researched and thus affords all participants access to the production of knowledge.6
Participatory Research can break down the rigid boundaries between those doing research and being researched and thus affords all participants access to the production of knowledge.
6 Healthy West 7th Assessment Report
Residentphysiciansfromthegraduatingclassof2011utilizedexistingtiesbetweenclinicandcommunityleaderstofirstbuildacommunityadvisorycouncil.ThecouncilandresidentphysiciansthendecidedtogetheronaresearchplantolearnmoreaboutthehealthoftheneighborhoodadaptingamodelusedinasimilarprojecthostedbyAllinainMinneapolis,theBackyardInitiative.Theydecidedtoaskthefollowingfourquestions:
• Whoareyouandwhoarethoseclosetoyou?
• Howdoyouandthoseclosetoyoustayhealthy?
• Whatdoyouandthoseclosetoyouneed tobehealthier?
• Wheredoyougowhenyouneedhelp?
Thegroupdecidedonintentionallybroadparticipantcriteriaincludinganyonewholived,worked,orsoughtservicesintheWest7thneighborhoodofSt.Paul(definedbySt.PaulCityDistrictPlanningCouncilboundariesofDistrict9inWard2,seemap,page4).Tomaximizeparticipationandfitthelimitedtimeframe,thegroupdecidedtoasktheirquestionsininterviews(withkeyinformantleaders),focusgroups(withspecificsectorsof
theneighborhood),andsurveys(widelydistributedinthearea),allconductedatthesametime.Inaddition,allparticipantswereaskedtocompleteabasicdemographicsformthataskedabouttheirage,race,primarylanguage,countryofbirth,connectiontotheWest7thneighborhood,andeducationlevel(seeDemographicForm,page8).
Participantswererecruitedusingflyersdistributedthroughouttheneighborhood,advertisementsinthelocalpaper,andpersonalinvitationsbyphysiciansandstaffatUnitedFamilyMedicineaswellascommunityleaders.Communityleaderswithlong-standingtiestotheneighborhoodwereidentifiedbyclinicstaffandinvitedtoparticipate.Allparticipantswereaskedtoinviteotherstoparticipate(Snowballrecruitment).Unfortunately,timeandresourceslimitedtheprojectwithmorepeopleexpressinginterestthancouldbeincluded.
Asummerinterncompletedkeyinformantinterviews(36total).Shespokewithformalandinformalleadersintheneighborhoodincludinggovernmentandpublicserviceofficialsaswellasleadersofsocialserviceorganizations.
Process
The Backyard Initiative Beginning in May, 2008 Allina partnered with the Cultural Wellness Center and the Wilder Foundation to conduct a series
of conversations in the Powederhorn-Phillips neighborhood (home to Allina’s corporate headquarters) to “create a picture
of health and well-being in the backyard.” They conducted “Listening Circles,” or focus group conversations, with people
in the neighborhood asking: (i) How do you keep yourself and your family healthy? (ii) How do you maintain balance and
harmony in life? And (iii) Who do you turn to for help? True to the spirit of community partnership, local residents were
hired and trained to conduct most of the focus groups. The Listening Circles were followed by “Walk-Around Interviews,”
door-to-door surveys of a statistically representative sample of 700 families in the neighborhood. After analysis was
completed, Allina supported the creation of a commission which now oversees the work of Citizen Health Action Teams
(CHAT’s) to address the community’s identified needs.vi
Healthy West 7th Assessment Report 7
Focusgroups(14groupswith96participants)weredoneusingacollaborativemodelpairingresidentphysicianswithcommunityleaders.Thefocusgroupteamsattendedatrainingsessiontogetherandusedadetailedfacilitator’sguidetoattemptstandardizationbetweengroups.Thecommunityleadersrecruitedtheirfriends,neighbors,andotherinterestedpeopletoparticipateandhelpedguidetheconversations.Residentphysiciansarrangednecessarypaperwork,space/foodrequirements,andaudiorecordingofthegroups.(Thepartnershipmodelwasthegoal;however,only5ofthe14groupswereconductedinthiswaywiththeother9groupsfacilitatedwithpartnershipofaresidentphysicianandanuntrainedcommunitymemberorbyonlyresidentphysician(s)/clinicstaff.)Surveys(51completed)werelargelyunsuccessfulduetoshortorone-wordresponsestoouropen-endedquestionsandcontributedlittletofinalresults.
Allfocusgroups(exceptoneduringwhichmanyparticipantstalkedoveroneanother)andkeyinformantinterviews(excepttwoduringwhichparticipantsrequestednorecording)weretranscribedverbatim.Detailednoteswerealsotakenforallkeyinformantinterviewsandmostfocusgroups.(Noteswereusedtoanalyzedatainsessionsthatweren’ttranscribed.)
Inanefforttoclarifyandprioritizetheoften-disparateresponsestothebroadquestions,participantswereaskedtovoteontheirtoppriorityattheendoftheinterviewsandfocusgroups.Thiswasusedtogenerate8topthemes.Thesethemeswerepresentedattwocommunitymeetingsheldtoshareresults,andthoseattendingcommunitymeetingsalsovotedontheir“toppriorities.”Thesevoteswerethencombinedwithparticipants’votestogeneratefinalrankings(seeKeyPriorities,page12).
AnalysisAteamincludingtheproject’ssummerintern,aneighborhoodresident/
communityleaderontheadvisorycouncilwithrelevantprofessionalandeducationalexperience,residentphysicians,andtheirfacultyadvisorcompletedtheanalysis.Theteamreviewedandcodedthetranscriptsfromtheinterviewsandfocusgroupstoidentifycommonthemesfollowingprinciplesofimmersion/crystallization.Theyusedbothformalcodingsoftware(NVivo9.0)aswellasinformal,paper-basedmethods.Communicationbetweentheteamsaboutemergingthemeswasencouragedhowevertimeandgeographicalconstraintslimitedgroupcoding.AnalysisofdemographicinformationwascompletedusingSurveyMonkey(anonlinesurveyprogram).
Age: _______ Sex: Male
Female
My first language was: English
Other: ____________
I was born in: the U.S.
Other: ____________
Race/Ethnicity: White
Black Asian Latino American Indian
Other: ____________
Where do you live? I own a house/apartment/condo..
I rent a house/apartment/condo.. I stay with a friend/family member. I stay at a shelter./ I am homeless.
What connection do you have to the W. 7th neighborhood of St. Paul? I live here.
I work here. I shop here. I get my health care here. I come here for religious worship
Other: _____________________
What is your main form Car
of transportation? Bus Other: _______________
How many people live with you?
_Adults:__________Children:______________ (who live with you 50% of the time or more)
How do you pay for healthcare? No insurance (self-pay).
Private insurance Public insurance (Medicaid (MA), Medicare, MN Care)
Where do you go for regular healthcare? Clinic: United Family Medicine
Other: ______________ Emergency Room Urgent Care I donʼt get regular healthcare.
Do you work or go to school? Unemployed
Work: Student. Retired Other: _______________
Does your household use: Foodstamps
WIC Public Assistance SSI/Disability None of the above
Did you finish? Jr. high school or less
High school/ G.E.D. Community college/technical school College Graduate school
Please help us learn more about you! We want this to be anonymous. No names please! Check ALL boxes that apply!
Demographic Form
8 Healthy West 7th Assessment Report
Theprojectincludedinsightsfrom183peoplewhometthebroaddefinitionofliving,working,orseekingservicesintheDistrict9ofSaintPaul.Thegroupincluded124womenwhomadeup77.5%ofparticipantsand36men(22.5%)(remainingparticipantsdidnotindicategender),andhadaweightedmeanageof51.6years.Therewasanover-representationofBlacksandHispanicscomparedtothe2010censusdata,likelyduetointentionalrecruitmentofminorityandtraditionallyunder-representedgroups(specificallypeoplewhohadexperienceddomesticviolence,homelessness,andwhowereinrecoveryfromdrug/alcoholaddiction).InclusionofrefugeeandimmigrantfamilieswhodidnotspeakEnglish(orspokeitasasecondlanguage)wasattempted,andmostsuccessfulwithHispanicfamilies,with2focusgroupsconductedinSpanish.Overall,15.3%ofparticipantsdidnotspeakEnglishasafirstlanguageinsteadspeakingSpanish,Vietnamese,Tigrinya,Amharic,German,andSioux.And14.7%ofrespondentsreportedbirthoutsideoftheU.S.inplacesasvariedasCanada,Mexico,Columbia,Laos,Vietnam,andRomania.Justover55%ofparticipantslivedinWest7thwhileotherssharedvariedconnectionsincludingworking,shopping,andseekingouthealthcareintheneighborhood.Ofparticipants,16%lackedanyinsuranceandtheremainderwassplitnearlyevenlybetweenpublicandprivateinsurance(46.3%vs.47.5%).
Demographics
Overall, 15.3% of participants did not speak English as a first language instead speaking Spanish, Vietnamese, Tigrinya, Amharic, German, and Sioux. And 14.7% of respondents reported birth outside of the U.S.
Participant’s Race
Connection to W. 7th Neighborhood
White 73.3%
Black 10.8%
Asian 1.8%
I live here. 55.3%
31.8%
24.1%
27.1%
16.5%
14.1%
I work here.
I shop here.
I get my health care here.
I come here for religious worship.
Other (please specify).
Latino 13.8%
American Indian 6%
Other 4.2%
People could respond to more than one option (non-exclusive choice).
Healthy West 7th Assessment Report 9
Defining Community Todefinetheircommunities,focusgroupparticipantswereasked,“Whoareyouandwhoarethoseclosetoyou?”Toclarifythequestionandpromoteconversation,aworksheetwasdevelopedaskingparticipantstofillinwords/picturesdepictingwhobelongedtotheircoreandextendedcommunities.Corecommunityoftenincludedfamily,afewspecialfriends,faithcommunities,andpetswhileparticipants’extendedcommunitymostofteninvolvedco-workers,neighbors,serviceproviders,theirchildren’sschools,workoutfacilities,andcoffeeshopstheyfrequented(manyintheneighborhood).
Findings
Focus Group Introduction Worksheet
Extended Community
YOU
Core Community
Inresponsetothisandotherquestions,focusgroupandkeyinformantparticipants(whoweren’taskeddirectlytodefinetheircommunity)mentionednumerousformalandinformalcommunityorganizationsthatsupportedhealthintheneighborhood.Theseinclude:
• 511Club
• TheAAcommunity
• Allina–UnitedHospital
• Cooper’sSupermarket
• Czech&SlovakSOKOLMinnesota
• DorothyDayCenter
• Eagle’sNestWomen’sShelter
• FortRoadFederation
• HealthEast–SaintJoseph’sHospital
• HealthySt.Paulrecreationprogram
• TheIndianCenter
• Informalnetworksamongnewimmigrants
• JewishCommunityCenteroftheGreaterSt.PaulArea
• MississippiMarketCo-op
• NaturallyOccurringRetirementCommunities(NORC)
• NeighborhoodHouse
• Numerouschurches/synagogues
• PalaceRecreationCenter
• SalvationArmy
• SholomHome
• SmithAvenueNeighborhoodAssociation(nowLittleBohemiaNeighborhoodAssociation)andotherblockclubs
• St.PaulPublicLibrary’sBookClub
• UnitedFamilyMedicine
• West7thBusinessAssociation
• West7thCommunityCenter
• West7thPharmacy
• WestEndArts
• WestEndGardeners
10 Healthy West 7th Assessment Report
Personal Factors Participantsfrequentlyemphasizedhealthycommunitiesbeginwithhealthyindividuals.Severalpeoplediscussedthatpersonalmotivationhastocomefirstinanyhealthtransformation.Participantstalkedabouttheimportanceofexerciseandeatingnutritiouslyandtheireffortstoputthisintopracticeintheirdailylives.Whilediscussingpersonalhealth,abroaddefinitionofhealthemergedfrombothfocusgroupandinterviewparticipantsalike.Oneparticipantshared,
I think a community is healthy when it nurtures the best of each individual, whether that’s their emotional health, their physical health, or their spiritual health…health and well-being.
Practicesthatsupportedemotional,mental,andspiritualhealthwerefrequentlymentionedsuchasyoga,meditation,andsimplywatchingthesunrise.Faithcommunitiesservedasanimportantsocial,spiritual,andemotionalsupportforpeopleintheWest7thcommunity.
Spiritual health comes through the family connections, through Mt Zion temple for me, through JCC that I belong, the Masonic lodge that I belong.
Onefocusgroupparticipantexplained,
To me, spiritual health is the connections we have close to us and widely around us but keeps me in a kind of life—life the way it should be.
Inaddition,manyfaithcommunitiesalsoofferedprogramsfortheircongregantsthatpromotedphysicalwell-being(healthfairs,informationsessions,etc.).KeyInformantsalsohighlightedtheconnectionbetweenphysical,emotional,andspiritualhealthincreatingahealthycommunity.Animportantthemethatcameupinseveralfocusgroupswasthenecessityofhavingapurposeormeaningtolife.Itwasimportanttoparticipantstogivebacktothecommunity,to“haveareasontogetoutofbed.”
Helpingotherswasnecessarytogoodhealthanditmadethemfeelhappy.Thisthemewasoftenparticularlystrongwitholdercitizens,withonesuchparticipantsharing
I call it participating in life: I think if you participate in things it makes you healthier and also the people around you healthier.
Environmental FactorsKeyinformantsandfocusgroupparticipantsallidentifiedenvironmentalfactorsthatsupportorhinderhealthylifestyles.Theseincludedbasicneeds(food,jobs,shelter),accesstovitalservicessuchashealthcare(especiallyformarginalizedgroups),nutrition,andphysicalfitness,eachofwhicharediscussedinseparatesubsequentsections.Peoplealsosharedthatneighborhoodsafety,lowlevelsofcrime,andanaestheticallypleasing,cleanenvironmentallhaveimportantimpactonhealth.
Afeelingofsafetyinaneighborhoodallowspeopletobeoutandbeactive.Peoplewhodidn’tfeelsafewalkingorbeingoutdoorsnotedthismadeitdifficulttostayphysicallyactive.Whilemanyparticipantsidentifiedsafetyasaconcern,othersnotedimprovementinthelastfewyearsinthisarea.
Leadersfromthebusinesssectorpointedoutthatwithasafeenvironmentcomestheopportunityfortheneighborhoodtohaveahealthyeconomicandsocialenvironment,otherkeyelementsofahealthycommunity.
Oneshared,
Strong businesses make a healthy community. I think [it is important to have] good businesses, strong businesses, businesses where you can walk in and people know who you are and you know who they are and you can develop relationships.
SeveralkeyinformantsfeelthereisprogressunderwaytoimprovetheeconomichealthoftheWest7tharea.
This community is resurging back to the luster of the old days when it was thriving.
Healthy West 7th Assessment Report 11
The main conclusions for health improvement offered by focus group and key informant interview participants were summarized in eight key themes. Voting (as described previously) prioritized the themes in this order:
Key Pr i or it ies 1. Basic Needs
2. Health Education
3. Resource Coordination
4. Nutrition
5. Fitness
6. Community-Building
7/8. Volunteerism
7/8. Activities for Youth
12 Healthy West 7th Assessment Report
1. Basic Needs Critical basic needs, as influenced by larger systems, must be in place for a community to be healthy.
Whenaskedwhatmakesacommunityhealthy,thefirstthingmanyparticipantsmentionedwasaccesstoandknowledgeofthebasicresourcesnecessaryforhealthincludingfood,shelter,transportation,adequateemployment,nutrition,physicalfitness,andhealthcare.Theseissueswereofcriticalconcerntocommunitymembersandserviceprovidersalike.Theneighborhood’ssocialserviceagenciesarearecognizedresource,butaccesstoandawarenessoftheseagenciesisoftenwhereparticipantssawabreakdown(SeeResourceCoordination).
Problemswiththehealthcaresystemwereafrequenttopicincludinglackofinsurancecoverage,poorcoverage,highcostsofhealthcare,andmedications.Someparticipantssawsystemreformastheirtopprioritytoaddresshealthconcernsintheneighborhood.HomelessparticipantsexpressedtheircriticismoftheCriticalCareDeliverySystem(CCDS)(astate-widereformofthesafetynetpublicinsurancesystem)asconfusinganddisorganized.Oneparticipantshared,
It seems like they’re just making it up as they go along!
Othersmentionedtheneedforcareredesigntooptimizecostandincreasetimespentwithproviders.
Accessibilitytoservicesandremovalofbarriersformarginalizedgroupswasofconcerntokeyinformantswhowereoftenserviceproviders.Theyemphasizedtheparticularimportanceofmakingservicesaccessibletomarginalizedgroupsincludingimmigrants,thehomeless,seniorcitizens,andpeoplewithdisabilities.Mentalhealthaccessibilityforthesegroupswasofspecialconcern.Onehomelessparticipantshared,
if you’re messed up up here [points to head], you’re not going to be okay down here [points to body].
Anotherparticipantstated
[In a healthy community] people [have] access to programs and services that can help them help themselves.
Barrierstoaccessingservicesmentionedincludedlackofmoney,time,trust,acceptableformsofidentification,transportation,childcare,andEnglishlanguagecapabilities.
“In a healthy community people have access to programs and services that can help them help themselves.”
Healthy West 7th Assessment Report 13
2. Health Education Access to information about health/wellbeing is crucial.
FindingreliablehealthinformationonavarietyoftopicswasawidelyrecognizedneedintheWest7thneighborhood.Intoday’sdigitalera,manyparticipantsfeltoverwhelmedwithinformationwithoutawaytosortthroughwhatismostimportant/relevanttothem:Howdoyousortoutalloftheinformationyouget?What’sgood?What’snotgood?Wheredoyoufindgoodinformation?
Topicsofdesirededucationforparticipantsrangedfromhealthmaintenance/wellness,tospecificknowledgeforchronicdiseasemanagement(diabetes,depression),topreventionstrategies,tonutrition(seeseparatesectionbelow),andalsoincludedcomplementarymedicine,anddesireformoreknowledgeaboutvitaminsandsupplements.
TwofocusgroupsofHispanicparticipants,predominantlywomen,fromtheneighborhoodvotedfor“charlas,”orinformalchats,abouthealthtopicswithprovidersastheirmostdesiredintervention.
Anothergroupemphasizedschool-based,interactivesessionstoteachchildrenabouthealthylifestyles,referencinganinitiativedonepreviouslyattheirchildren’sschoolthathassinceended.
Womeninrecoveryandhomelessfocusgroupparticipantsfeltpassionatelyabouttheneedtoimprovetheirexperiencesinthehealthcaresystem.Theycalledfortheeducationofhealthprovidersandothersinthehealthcaresystemabouttheirspecificneedsasmarginalizedcommunitiesandwereeagertobeinvolvedasteachers.
3. Resource Coordination Resource coordination must improve to connect those in need with available services.
Participantsfromallsectorsoftheneighborhoodrecognizedaknowledgegapcontinuallyuncoveredininterviewsandfocusgroups:Peopleareoftenunawareoftheservicesofferedinthearea.Oneparticipantshared,
I think it’s about coordination of information and resources and making sure that people know about what already exists.
Thispresentsastruggleforbothindividualcitizens,whodonotknowaboutservices/programsthatareavailabletohelpthemmeettheirneeds,aswellasforserviceprovidersandprogramcoordinatorswhostruggletokeeptheirorganizationsafloat.
Thereweremanysuggestedmarketingstrategiestoaddressthisneedincludingthecreationofaresourceguide/list,informationalmeetingsinareaapartmentbuildings,flyersorposters(availableinmultiplelanguages),bulletinboards,storewindowadvertisements,andaWest7thFacebookgroup.Inseveralfocusgroupssuchcoordinationandsharingofknownresourceshappenedspontaneouslyamonggroupmembers(e.g.aboutlocalavailabilityoffreshvegetablesattheSt.PaulFarmer’sMarket).
Alongwiththis,manyparticipantsidentifiedaneedforgreaternetworking,communication,andcollaborationamongexistingorganizations.Onekeyinformantsaid,
I think the name of the game is more and more people have to collaborate and do some of this together so that we become arms…[for example,] a health clinic uses the already existing successful agencies to support that outreach and that linkage back with physicians.
“I think it’s about coordination of information and resources and making sure that people know about what already exists.”
14 Healthy West 7th Assessment Report
4. Nutrition Nutrition and healthy eating is an area of concern. People want access to good food, good information, and good ideas about how to make real change.
Almostunanimously,participantsnotedaccesstolowcost,healthyfoodsasahealthpriority.ThenearbySt.PaulFarmer’sMarket,Cooper’s(afamily-rungrocerystorewithtwolocalbranches),MississippiMarket(anorganicfoodco-op),aswellasthe“FareforAll”emergencyfoodprogram,andavailablemealsforkidsduringthesummerwereidentifiedasstrengthsintheneighborhood.However,manypeopleidentifiedaffordabilityasabarriertoeatingwell,andobservedthatdespiteexistinggroceryoptionssomepeoplemuststilltraveloutoftheneighborhoodtoaccessfarmersmarketsandlargergrocerystoresthatoffercheaper,healthyfoods.
Topromotehealthyeatinginformantssuggestedhostinggardeningdemonstrations,teachingkidstogardenatschool,andencouragingneighborstoshareyardspaceforgrowingfood.
If we just go to every door and knock, and garden West 7th out, imagine the quantity of food we have around here…that’s what it’s going to take to have a healthy West 7th—let’s just start growing!
ManyofthekeyinformantsandafewfocusgroupparticipantswereexcitedabouttheexistinggardeninginitiativesinWest7thandwouldliketoseetheseincreasefurther.Asoneinformantshared,
The gardening, from my perspective, is one of the most crucial things the neighborhood can do to enhance the health of people outside their own personal health…I think it’s the key, I really do. And I’m seeing it. I’d like to see more of that done.
Manyparticipantssharedthattheystrugglewithtimeandknowledgebarrierstohealthyeating.Onefocusgroupmemberstatedfrankly,
We don’t know how to cook. We eat fast food.
Otherstalkedaboutjugglingworkandlifeschedules,somementionedburdensfromtheirchildren’sbusyextracurricularschedule,allofwhichleftlittletimeforhome-cookedmeals.
Aunified,multi-facetedapproachwascalledfor:Improvedaccesstofreshfoodsalongwithteachingaboutcookinghealthymealsandpracticalsupporttoabandonfastfood,ready-madeoptions.
Severalhomelessparticipantsandkeyinformantsexpressedthattheywouldliketoseehealthier,fresherfoodsgivenoutatfoodbanksandinshelters.AType1diabeticparticipantnoted,“everythingisfullofsugar!”Andtherewasconcernbyseveralgroupmembersaboutpreservativesandadditivesinfoodaswellasexposuretohormonesandtheeffectongeneralhealthandfasteragingofcurrentpopulations.Onefocusgroupparticipantwhoishomelessemphasizedtheneedto,“feeddownherehealthy!”
“The gardening, from my perspective, is one of the most crucial things the neighborhood can do to enhance the health of people outside their own personal health.”
Healthy West 7th Assessment Report 15
5. Fitness Getting motivated and having affordable options is an area of concern for many different people in the neighborhood.
Participantsoftendiscussedphysicalfitness.Motivationtobeactiveandstayphysicallyfitwasoftencloselytiedwithone’sfriend/familyandothersocialnetwork(seeCommunityBuildingsection).KeystrengthsenjoyedintheWest7thcommunitynotedbyparticipants(mostlykeyinformant,neighborhoodleaders)includetheexistingbikingandwalkingpathsaswellasthephysicalfitnessopportunitiesattheJewishCommunityCenter,theSalvationArmy,PalaceRecreationCenter,theWest7thCommunityCenter,andSholomHome.
Participantsfrequentlynotedtheneedformorespaceandresourcesforphysicalactivity(althoughsomewereunawareofabove-listed,existingresources).Oneofthechallengespeopleidentifiedwasthatalthoughsitesexistinthearea,thereremainsalackofaffordableplacesforchildrenandyouthtobeactiveandparticipateinexerciseprograms.Manyparticipantsofferedsuggestionsthatincluded:
• low-cost/freefitnessclasses
• creatingabikelaneonWest7thStreet
• improvedworkplacefitness
• betterpromotionofexistingrecreationsites(mentionedabove)
• establishmentofacommunitypool.
Othersthoughtoflow-cost,community-drivensolutionssuchas:
• walkingclubs
• exercisegroupsatchurchesandotherplacesofworship
6. Community Building Healthy communities have a strong community identity and vibrant social networks which combat isolation and loneliness.
Strongsocialnetworkswereanimportantthemethatemergedfromfocusgroupsandinterviews.Peoplesharedthatastrongsenseofsocialcohesionpromotedhealthbothonanindividualaswellasacommunitylevel.EventssuchasNationalNightOutgatheringsandorganizationssuchastheSalvationArmy,theWest7thCommunityCenter,andtheJewishCommunityCenter(JCC)aswellastheexistenceofstrongcommunityleaderswereidentifiedascommunitystrengthsinthisarea.ManyofourkeyinformantspointedoutthestronghistoryintheWest7thneighborhoodofcommunityprideandusinglocalsolutionstoaddressrisingchallenges.
Keyinformantsshared:There are people who live here and have lived here for a long time who are deeply committed the community and seeing it survive and thrive, neighbors who care for each other.
Because West 7th is its own little, personal, private area in St. Paul, I [see] more unity here…and there’s this ownership, and there is a sense of pride.
Healthy communities have residents who care about each other and are invested in their community.
Infocusgroups,wherediscussionsincludedmorereflectionaboutindividualhealth,peopleoverwhelminglyidentifiedsupportfromfamilyandfriendsaskeyfactorscontributingtotheiroverallwell-being.Thisincludednotonlyemotionalsupport,butsupporttomakehealthylifestylechoicesandtakecareofthemselves.
Participantssharedtheimportanceofextendingthissocialsupporttomarginalizedsegmentsofthecommunityincludingtheincreasingnumberofdiverse,newresidents.Theyexpresseddesireformoreprogramsandactivitiestobuildneighborhoodcohesivenessandtostrengthenthecommunity.Suggestionsincludeddiscussiongroups,moreneighborhoodgatherings,potlucks,outreachtoisolatedseniors,andactivitiestomeettheneedsofpeoplewithdifferentculturalbackgrounds.
“Healthy communities have residents who care about each other and are invested in their community.”
16 Healthy West 7th Assessment Report
7/8. Volunteerism Healthy communities have civic engagement, help each other, and support those in need.
Citizenshipandengagementwereidentifiedasakeyareatosupportahealthycommunity.Asdescribedintheprevioussection(CommunityBuilding),participantsfeltavibrant,healthycommunitymusthaveinvestedparticipants.Thisinvolvesalevelofciviccommitmentonthepartofeachindividualaswellasthecommunityasawhole.Informantspointedtotheimportanceofcivicengagementandcommunityactivism,wherecitizensidentifyandreacttoissuestogether.
If you’re going to have a healthy community I think you have to have some group of people that are invested in making it a healthy community. I don’t think it just happens.
Otherspointedoutthatculturaleventsandactivitiesandpublicgatheringspacesareimportantaspectsofcreatingthissenseofidentity.
SeveralparticipantshadideasabouthowtoenhancecivicengagementintheWest7thneighborhoodincludingavolunteertimebankthatofferedhelpforprojectsbigandsmall(especiallybetweenyoungfamiliesandelders)andincreasedpartnershipwithareahospitals.
7/8. Activities for Youth Activities for youth is an area of needed improvement.
Someparticipantsdesiremoreprogrammingandspacesforyouth,particularlyteens.Inparticular,oneinformantshared,
I think they need really good positive role models that are a little older than them.
Focusgroupmembersdiscussedchallengestheyfacefindingaffordableprogramsforchildren/teensincludingeverythingfromchildcare,tosports/physicalactivities,andextracurricularclasses.Oneparticipantwouldliketoseeayouththeatergroupdevelopintheneighborhood.Othersaskedforsafespacesforteenstohangout“withoutbeinghassled”oraplacewherepeopleofallagescouldcomeforsupport,tohavesocialinteraction,andtolearnnewthings.
Whileafewparticipantsaskedformoreservicesforseniors(suchasacheck-in/visitprogram),manyexistingresourcesforseniorswerementionedduringourfocusgroupsandinterviews.
Healthy West 7th Assessment Report 17
TheseresultscanbecomparedtonumeroussimilarandoverlappingeffortsintheWest7thneighborhoodandotherareasoftheTwinCities.Inaddition,effortstoimproveneighborhoodhealthusingCBPRhaveprecedentindiverseareasthroughouttheU.S.andtheworld.Understandingthesefindingsinthecontextofthisworkisimportant.
TheWest7thCommunityCenter,akeycommunitypartnerintheproject,conductedaneedsassessmentoftheirservicesinJuly2008.Despitethedifferenceinscope,theirfinalreportcitesseveralconclusionsthatreinforcefindingsfromHealthWest7th.Thisincludestheneedforacentralplaceforresourcecoordinationintheneighborhoodandrecognitionofcontinuedunmetneedsdespitemanyexistingprogramsandservices.7
FromSeptembertoNovember2010,AllinaconductedCommunityEngagementDialoguesineachofitsnineregionsacrossthestatefocusedon(1)healthyeating(2)activeliving(3)stressreduction/lifebalance.ThedialoguesnotedtheeconomicdownturnandneedforworkandotherbasicneedsasafundamentalpriorityasitwasinWest7th.TheWest7thneighborhoodexistsinAllina’sEastMetroregionandsharesnumerousspecificconcernswithdialoguesdoneinthisarea.ParticipantsintheEastMetronamedsomeofthesameassetsidentifiedWest7thincludingwalking/biketrailsandparkswithregardtoactivelivingbutalsoagreedthatroomforimprovementstillexists.
HealthyWest7thandEastMetroparticipantsagreedabouttheneedforincreasedaccesstohealthyfoods,particularlyexpandedFarmer’sMarketsandCommunity-SharedAgriculture(C.S.A.)programs.Participantsinbothgroupsdiscussedcompetingdemandsonbusyfamiliesjugglingwork,school,andpersonalcommitmentsthatoftendetractfromthetimeneededforhealthyeatingandproperfitness.Bothgroupsalsomentionedconcernoverneighborhoodsafetyasabarriertofitnessandotheraspectsofhealth.
TheEastMetrodialogueechoedthecallsofthepeopleofWest7thforbettercoordinationofresourcesandcitedasabarrierthelackofcommunityawarenessofavailableservices.Theymentionednewsletters,awarenesscampaigns,partnershipsbetweenlocalorganizations,aswellasa“clearinghouse”ofavailablecommunityresourcescloselyparallelingsolutionsproposedintheHealthyWest7thproject.8
Local Context
Participatory Research can break down the rigid boundaries between those doing research and being researched and thus affords all participants access to the production of knowledge.
18 Healthy West 7th Assessment Report
HealthyWest7thprojectquestionsweredesignedtoparallelthoseusedintheListeningCirclesofAllina’sBackyardInitiative.TheBYIfolloweduptheirdiscussionswithamorecomprehensivedoor-to-door“walk-around”surveyofnearly700communitymembers.Despiteobviousdifferencesinscale,severalparallelscanbedrawnbetweenthedatagatheredinthetwoprojects.WhenBYIListeningCircleparticipantswereaskedhowtheykeepthemselvesandtheirfamilieshealthymanypeoplediscussedpersonalfactorsalsosharedbyWest7thparticipantsincludingeatinghealthyandgettingproperexercise. BYIrespondentsdiscussedaccesstocareandmaintaininghealthcarecoverageechoedbyparticipantsinWest7th.
IntheBackyardasinWest7th,therewasmuchdiscussionofbalanceandharmony,andtheimpactofstrongsocialnetworksandrelationshipsonhealth.Spiritualityandparticipationinfaithlifewasalsoemphasizedbyparticipantsinbothgroups.AndsimilartothethemeofCommunityEngagement/CitizenshipthatemergedintheHealthyWest7thproject,participantsintheBYIrecognizedparticipationinthecommunity,providingandreceivingsupport,andfeelingacceptancebyothersisakeypartofimprovinghealth.
Healthy West 7th Assessment Report 19
Whenaskedaboutwheretheyseekhelp,BYIparticipantsmentionedthesamecirclesoffamilyandfriendsandsocialservicesthatvarydependingonone’scircumstanceorspecificneed.Participantsalsorecognizedthatclosefriends,especiallyingroupssuchasAlcoholicsAnonymous,canbecomepartofone’sfamilynetwork.IntheBYIthecommunityandresearchpartnersdidnotaskspecificallyaboutbarrierstohealth.Nevertheless,theyheardmanyofthesamebarriersintheirstudyaswedidincluding:
• Accesstoinsuranceandaffordablehealthcareisaproblemformany.
• Challengewiththecurrenthealthcaresystem’slimitsonthedevelopmentofrelationshipswithproviders
• Needformoreproviderswhoaresensitiveandattentivetopeople’sculturalandpersonalexperiences
• Improvedeaseinnavigatingthehealthcareandinsurancesystems9
InOctober2010theBlueCrossBlueShieldandWilderFoundationspublishedareportentitled,“TheUnequalDistributionofHealthintheTwinCities.”TheysystematicallydocumentedthatnationalandinternationaltrendsinsocioeconomicdisparitiesinhealthalsoexistintheTwinCities.Inthisarea,asinmanyothers,“aperson’shealthisstronglyinfluenced—asmuchas50percentormore—bysocialdeterminants,includingincome,education,andneighborhoodconditions.”ThedataspecificallyhighlighttheWest7thareaasoneofpoorestsectorsofSt.Paulwithsomeoftheshortestlifeexpectanciesofanyareainthestate.PeopleintheWest7thneighborhoodliveonaveragetoanageof70to74.9years.Thisiscontrastedby83+yearsinsomeofthebestperformingsectorsoftheTwinCitiesincludingthenearbysuburbofMendotaHeights,lessthanfivemilesfromtheWest7thneighborhood.10
“National research suggests that a person’s health is strongly influenced—as much as 50 percent or more—by social determinants, including income, education, and neighborhood conditions.”
20 Healthy West 7th Assessment Report
Thefindingsofthisreporthighlightcommonthemesfoundacrossdiversesegmentsofpeoplewholive,work,andseekservicesintheWest7thneighborhood.Thefindingshavebeencorroboratedbyseveral,separateinitiativesbothlocallyandregionallyandrepresentaboldcallforimprovementofhealthacrossavarietyofareas.
Whilediverseintopicandscope,manyofthesolutionscalledforbyparticipantsinvolvemorere-structuringandorganizationalchangesthanlarge,complex,expensiveprograms.Participantsuniversallyrecognizedtheirownuntappedpotentialasneighbors,leaders,andorganizationsalreadypresentintheWest7tharea!
RatherthanacceptthefindingsoftheBlueCrossBlueShield/Wilderreportasinevitable,numerouscitizensofallages,fromneighborstoprofessionals,havetakenthesefindingsasachallenge.
Theyareasking:
What might we accomplish if we work together to improve the health of our neighborhood?
Conclus i ons
What might we accomplish if we work together to improve the health of our ne ighborhood?
Healthy West 7th Assessment Report 21
Next Steps ThelargergoaloftheHealthyWest7thprojecthasalwaysbeentosparkcommunityactionaroundneighborhoodhealthimprovement.Forthistobesuccessful,itisessentialthatthecommunityitselfdecidewhat,when,andhowthingsproceed.Numerousconversationsandcollaborationsareunderwayrelatedtothisproject:
• AllinaHealthisexploringpartnershipswithlocalorganizationsandneighborhoodeffortsinWest7th.
• Activecollaborationisunderwaywithdiversepartnersonacommunitygardening/nutritionprojectencouragingintergenerationalvegetablegrowingandhealthymealpreparation(see:www.healthywest7th.wordpress.com).
• RepresentativesfromdiversesegmentsoftheneighborhoodareinformingtheongoingrevisionoftheCommunity-OrientedPrimaryCarecurriculumforresidentphysiciansatUnitedFamilyMedicine.ThisincludedpresentationsofproposedprojectsbyresidentphysicianstoacommunitycouncilinDecember2011.
• Acouncilmadeupofbroadrepresentativesfromthecommunitymeetsregularlytoworkontheprioritiesidentifiedinthisreport.Recently,thegroupapprovedamissionstatementforHealthyWest7th:“ToimprovethehealthandwellnessofSt.Paul’sWestEndinmeasurablewaysbybuildingrelationshipsthroughoutourcommunityfoundedontheuniquestrengthsofourneighborhood.”
If you would like to be involved, please email: [email protected] or call 651-241-1010.
healthywest7th.wordpress.com
22 Healthy West 7th Assessment Report
1Census2010dataassummarizedbyMNCompass,http://www.mncompass.org/_pdfs/neighborhood-profiles/StPaul-West7thFortRoad-102011.pdf
2http://www.fortroadfederation.org/
3www.unitedfamilymedicine.org/index.php/about-us/our-history/,August5,2011.
4WestSeventhCommunityPartnership“ReporttotheCommunity,”October1996.OrganizationalPublicationbyWestSeventhCommunityPartnership.
InformationalInterviewwithConnieWalsh,WestSeventhCommunityPartnershipSteeringCommitteeMember,byMaryBethGrewe,June,2010.Unpublished.
5http://www.healthypeople.gov/2020/default.aspx,March26,2012.
6NAPCRG(NorthAmericanPrimaryCareResearchGroup),Macaulay,AC,etal..“ResponsibleResearchwithCommunities:ParticipatoryResearchinPrimaryCare.”Internet.20Jan.2009.Available:http://www.napcrg.org/responsibleresearch.pdf
7Mitchell,Joeetal.,“West7thCommunityCenterNeedsAssessment,”doneasaprojectattheCarlsonSchoolofManagement,UniversityofMinnesota,July29,2008.Unpublished.
8Johnson,Kirsten.“AllinaHospitals&Clinics:CommunityHealthAssessment,”Nov.,2010:http://www.allina.com/ahs/aboutallina.nsf/page/community_health_improvement
9AllinaHosptialsandClinicsandthePowderhornPhillipsCulturalWellnessCenter,“CommunityattheCore:BackyardInitiativeAssessmentReport,”April,2011.
10Helmstetter,Craigetal.,“TheunequaldistributionofhealthintheTwinCities,”BlueCrossBlueShieldFoundationandWilderFoundation:October,2010.Availableat:http://www.wilder.org/reportsummary.0.html?tx_ttnews[tt_news]=2337
Appendix
Healthy West 7th Assessment Report 23
allina.com
12-12473 5/12 © 2012 ALLINA HEALTH SYSTEM ®A REGISTERED TRADEMARK OF ALLINA HEALTH SYSTEM
If you would like to be involved, please email: [email protected]
or call 651-241-1010.
healthywest7th.wordpress.com