Keeping your coalitions going after your grant money runs outTom Wolff, Tom Wolff & Associates, Amherst MA.
Over my forty years in the nonprofit world I have seen many multi-site coalition efforts come and go. They rise and fall with the funding whims/fads of government whether it is substance abuse, violence prevention, teen pregnancy prevention etc. I’ve never seen one of these multi- site networks of coalitions sustain themselves without either new funding or the support of the original lead organization.
The New England Racial Justice and Health Equity is the exception, so it is story worth telling.The original network of Health Equity and Racial Justice coalitions was created by CDC REACH (Racial and Ethnic Approaches to Community Health) grants awarded to the Boston Public Health Commission’s Center for Health Equity and Racial Justice. The BPHC Center funded efforts at 13 sites across New England from Manchester NH to Springfield MA and Bridgeport Ct and obviously in the Boston area as well. I was a consultant/trainer to the Center and many of the New England sites over the five years of funding (See below for references to the Center’s work and to my writing about their work).
The core approach of addressing health equity was through a model (see chart) that acknowledges the critical role of systemic racism in health outcomes.
The goals of the coalitions were to create policy changes to address systemic racism in the social determinants of health (exs. food access, educational disparities).
The issue of racism was central to these efforts from the start. For example the first BPHC brochure focused on breast and cervical cancer in Black women. The brochure language was explicit: “If you are a Black woman living in Boston and you have a greater chance of dying from breast or cervical cancer than a White woman. Why? Racism may play a key role in determining your health status. It may affect your access to health services, the kind of treatment you get and how much stress your body endures”.Based on this health equity framework each team at all 13 sites went thru anti-racism training and learned to re-frame their community health issues in racial justice /health equity terms. This led to struggles to come to grips with racism in both their community and in themselves regardless of their racial and ethnic identity. Over time each community faced significant ‘push back” from some forces in the community to the explicit focus on and use of the term ‘racism’. In fact, most efforts to address health disparities in the U.S. avoid explicitly using this term and instead create programs that ‘blame the victim’ i.e address health disparities in diabetes in Black men by running programs for Black men on eating well.
By acknowledging that racism is the core issue in health disparities, we stirred the social justice roots of the staff and communities at the sites. This was powerful enough to keep the discussion going after the money ran out. At the last meeting before the funding ran out in October 2012, the leaders and staff from many communities expressed the desire to keep meeting. The CDC no longer was providing money, and the BPHC being a city health department could not take responsibility for organizing a New England wide group; but the group was determined. There was a strong desire to keep the discussion of race and the struggle for social justice alive.So we named ourselves the New England Racial Justice and Health Equity Coalition and have kept meeting quarterly on a purely voluntary basis. One site acts as host for each meeting and designs the meeting, and provides the food. Sometimes if the site is short of resources we pass the hat to cover food costs.
At the first meeting we did ‘push back circles” a process designed by one site to allow the group to role play real examples where they experienced difficult ‘push back’ around racism from their community. However, this time in the role play they have three coaches to help them with feeling supported, finding the language to respond, and managing their emotions. Everyone found the experience very helpful and brought their learning back to their communities.
This process of quarterly meetings has now lasted for a full year. Part of each meeting is now spent in ‘affinity’ groups with the White participants, and communities of Color meeting separately for part of the meeting. This allows for a different level of discussion on race than usually occurs in mixed groups. As a White man I have certainly found this approach allows me to explore how I can use my White privilege to best advantage in moving this work forward without making things worse (see the work of Tim Wise as an outstanding example of understanding white privilege http://www.timwise.org/).
I have learned many things in the process of this experience. The lesson around sustainability seems to be that when we tap into people’s strong passions for social justice we are able to keep many people at the table even when the money has disappeared. Thus, we have another great reason to keep issues of social justice high on our agenda.After the Trayvon Martin trial there was a national outcry for discussions of race in America. Is there a place for Community Psychology in those discussions? And for tackling the work on health equity and racial justice through a transformative change lens?
References:The Center for Health Equity and Social Justice’s work has been published and is available at: http://www.bphc.org/chesj/Pages/default.aspx
I have also written about this work (http://www.tomwolff.com/collaborative-solutions-newsletter-summer-10.htm), and have had articles and videos published in the Global Journal of Community Psychology Practice: http://www.gjcpp.org/en/article.php?issue=14&article=68For more of Tom Wolff’s blogs and newsletters www.tomwolff.com