Kaiser Permanente Community Fund

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Funding a Farmers Market in Lents

Demand for fresh, local, and affordable produce existed in Lents neighborhood of Portland, even thought there was no farmer’s market to provide it. That is, until a coalition called Healthy Eating Active Living (HEAL) came together, funded by the Kaiser Permanente Community Fund, a donor-advised fund of the Northwest Health Foundation.

“Your environment is a significant factor in whether you can choose to walk instead of drive, or pick up healthy food for dinner. In Lents, we saw an opportunity to actually change that environment and help make the healthy choice the easier choice for residents,” says Noelle Dobson, director of the Healthy Eating Active Living coalition.

Throughout Oregon and southwest Washington, coalitions such as this, many funded by Northwest Health Foundation, are working to address the socio-economic conditions, policies, and physical structures —  like bike paths and recreational trails — that impact the choices people make every day about eating and physical activity.

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Improving Health for Iraqi Refugees

When calculating the costs of war, we often neglect the health and economic costs of traumatized immigrants coming to the U.S. as refugees from violent, and prolonged, conflicts in places such as Vietnam, Afghanistan and Iraq.

Despite being tens of thousands of miles from the war zone, Oregon’s Iraqi population is still struggling with the resonating consequences of violence and displacement. Many who sought refuge and asylum in the United States from the first Iraq war continue to deal with lingering trauma - more than twenty years after immigration.

Research shows that refugees from wars and civil conflicts are particularly vulnerable to ill health. The Iraqi Society of Oregon (ISO) is dedicated to helping immigrants deal with the trauma they experienced in their home country, the culture shock of adapting to new lifestyles and systems, and economic and social isolation they still experience today. These challenges have been identified as “triple factors” of trauma that make so many immigrants vulnerable to ill health.

In December 2011, the Iraqi Society of Oregon received a $50,000 capacity-building grant from the Kaiser Permanente Community Fund to gain social, psychological, and medical support for Iraqi immigrants. “This project will work on researching, educating, and healing the immigrants and refugees so they gain life skills for a positive health attitude and create a change to seek a healthy lifestyle,” said Baher Butti, executive director.

“Many traumas take place, and most are not dealt with properly.”

Even after 20 years, the Iraqi population of Oregon still experiences high levels of poverty, poor health, and isolation, much of it a result of the different phases of loss that they went through in the refugee process. “The local Iraqi community lives in isolation,” Butti says.  “Most arrived as early as the 1990s, after the first Gulf War.”

Baher Butti was a practicing psychiatrist in Iraq until he fled from the most recent war in 2006. He was exiled in Jordan when Dr. David Kinzie, a professor of psychiatry at OHSU, invited him to a world conference to speak about the psychological trauma. Dr. Kinzie ultimately helped him find asylum in the U.S.

Through the Kaiser Permanente Community Fund, the Iraqi Society, the Center for Intercultural Organization, and the Beaverton Mayor’s Office are now working collaboratively to respond to the Iraqi population’s needs by coordinating culturally-specific services, mental health, city government, and schools. This solution moves Iraqi immigrant “upstream” by bringing together social and economic integration with a holistic mental health approach.

“Health inequities are reflected in unjust distribution of resources, power, and opportunities that lead to poor health outcomes for the refugees and immigrants,” said Butti, “However, this project is solution oriented, and aims to achieve multicultural health equity through community members, community organization, and policy and system change.”

“There is an honest desire from the larger community to reach out to new communities, especially refugees and immigrants.”

While the wider community will now have the opportunity to connect with the Iraqi community, Butti says the newcomers have a responsibility too.

“Inclusiveness is a mutual process where people provide support and embrace the newcomers to facilitate their healing,” said Butti, adding, “and the new comers will contribute with their values, and productivity, and even historical background to the new community.”

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Health Grants for a Financial Institution?

The answer makes sense once you know more about the nonprofit financial institution, Innovative Changes, and the grant maker, which in this case is the Kaiser Permanente Community Fund.

Kaiser Permanente Community Fund (KPCF) is a partnership between Kaiser Permanente Northwest and Northwest Health Foundation. The fund invests grantmaking dollars in the places “where health begins” —projects and organizations whose work addresses the social determinants of health.

As the staff at Innovative Changes can tell you, financial issues can very often be connected directly to health. Research shows a strong correlation between high income and good health. Likewise, financial struggles often lead to a downward spiral culminating in emergency rooms, shelters, hospitals, or even the streets.

People in financial crisis often turn to payday loans, which almost always exacerbate the situation.  A $300 car repair can mean that a single mom with a stable job cannot get her children to daycare or herself to work. This can result in lost wages, and an increase in family stress. If monthly bills aren’t paid, a payday loan can push her into an unsustainable cycle of debt. Her credit and rental history are damaged, and her struggles only get worse.

“We know that financial stress can have serious health effects on an individual and also on family members,” says Victor Merced, a member of the Kaiser Permanente Community Fund advisory board.

Innovative Changes offers an alternative to predatory payday loans by providing comprehensive financial education, small dollar, short-term consumer loans, and credit building opportunities to help people manage short-term financial needs in order to achieve and maintain financial and household stability. 

“This initiative helps ensure that there is an affordable and socially responsible alternative to the provision of predatory financial products and services,” said Mary Edmeades, Vice President and Manager at Albina Community Bank. “The integrated approach to partnerships with the mainstream financial industry, other social service providers and most importantly, the clients themselves, is a collaborative model that promotes innovation, accountability and sustainability.” 

Miriam and José (pictured) came to the U.S. 32 years ago as they fled the civil war in their native El Salvador, and are two appreciative clients of Innovative Changes. Their story demonstrates the strong network of community partnerships developed by the nonprofit. In this case, Innovative Changes worked with two of their partners, Proud Ground, and the Native American Youth and Family Center (NAYA).

“We’re glad we came here and got help,” José said.

Jose works as a pastor associate and deacon at a Catholic church and works extensively with the church’s Hispanic community.

“One of my goals is to be a better administrator of my money, in order to help the community manage their money better as well.”

When asked to comment about the support they received from the nonprofit, Jose explained that “they made us feel secure.”

Miriam added, “This is real.”

“Innovative Changes helped us build our credit,” José said.

“They gave us hope for the future.”

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Adelante Mujeres Nourishes the Community

In Washington County, research shows the health outcomes for Latinos are significantly worse than those of other ethnic backgrounds. The concentrated poverty for immigrant farmers, challenges of adapting to a new culture and poor urban planning have all added to the poor health of Washington County’s Latino population. However, it is also evident that lifestyle choices have also played a large role. For Adelante Mujeres, a Forest Grove, Oregon-based nonprofit, the solution lies in holistic education about health, food, and nutrition to inspire positive lifestyle changes.

“Nourish the Community,” one of Adelante Mujeres’ newest initiatives, aims to incorporate nutrition education into their already established programs such as their Adult Education, Chicas, and Early Education programs. Nourish the Community was funded with a $200,000 Kaiser Permanente Community Fund grant in 2011. “This is an initiative where the values of health, wellness and nutrition are disseminated throughout all of the programs,” said Kaely Summers, Adelante Mujeres’ Farm Coordinator.

“It’s been encouraging and helpful to have the support of NWHF and Kaiser for organizational capacity. Now we have the time to planning this all out the best way possible.”

Adelante Mujeres focuses on education and access, and “one way of doing this is the farmers market,” said Summers, “We have this resource here that we’re bring all of this great food and local fruits and veggies and organic food to the people of forest grove and the greater community. Through our matching program, people come with food stamps or with their WIC checks and can get that same amount matched up to 10 dollars a week. Essentially if they swipe their card for 10 dollars they’ll get 20 dollars in total!”

Adelante also focuses on microenterprise. “We have a microenterprise goal so that our producers, our farmers, as well as food producers like the tamale makers are now contributing to the community as producers of a health resource,” said Summers, “Obviously if people are financially sound they can make healthier choices in their life.”

Finally, Adelante focuses on community advocacy. “We want our participants to be more politically, and civically active in the community and what they’re doing.” said Summers, “we want them to learn things in the walking club and share them with their neighbors and extended families.” 

Adelante acknowledges that the Forest Grove community represents many different levels of health and wellness. “Some people are struggling with diabetes and don’t know a carrot from a radish, and others are farmers who are producing kale and eating that, and are walking every day,” said Summers.

“We want to meet people where they are and work with them so they not only become healthy themselves in the choices that they make, but so they can contribute back into the community.”

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Highlands Does Better with a Community Coach

The Highlands neighborhood in Longview, Washington has, for decades, gone without many of the advantages enjoyed by other communities – a strong retail district, an adequate park, thriving social service organizations, etc. It’s also one of the poorest districts in the state and has some of the highest rates of unemployment, drug use, and debilitating medical conditions such as lung cancer and diabetes to be found anywhere. 

Clearly, the people who live there deserve better.

In 2006, the Longview City Council made revitalization of the Highlands a top priority, and in 2008 the City of Longview adopted the Highlands Neighborhood revitalization Plan. Soon afterward, the city and the newly formed Highlands Neighborhood Association applied for a Kaiser Permanente Community Fund (KPCF) grant to employ a community member to improve connections among the people in the Highlands.

As one City employee said in requesting the KPCF funds, “to make a difference in the Highlands, change needs to come from within the neighborhood.”

The grant request was funded, and after some searching, they finally found the right person for the job.

Meet Elizabeth Haeck, Longview’s “Community Coach.”

Most people in the Highlands already knew Liz. She volunteered everywhere from the Homeless Outreach programs to the Juvenile Detention Center, so she met a lot of the 4,900 residents who live in the neighborhood.

What she envisions, she told the Longview Daily News is a “‘front porch society,’ where neighbors know each other and help each other as needed.”

To do this, she brought people together, mostly through the newly formed Highlands Community Center.

Now the Highlands has a thriving community garden. And a new walking and biking trail is under construction.

The community center is full of programs, such as:

• Cub Scout and Boy Scout troops
• Foster family support groups
• Teen outreach programs
• Roundtable conversations about health
• Medical screenings
• A community library
• Volunteer clean-up groups

“All it took was an opportunity,” she says.

Everyone agrees that the community coach grant has been a success. Despite that, Liz works outside the coaching job to find other partners and ensure that the progress continues long into the future.

“It’s now so much more than the coach work,” she says. “The city continues to be involved, and other foundations have become interested. Parks and Rec has completed a planning process for remodeling the outdated Archie Anderson Park. There are many improvement projects that have been identified that would benefit residents of the Highlands.”

“It’s not one big thing that will make a difference.” she points out. “It’s a network of activities.”

When asked about the health impact of all this work, her response is immediate.

“Reducing isolation.”

One influence of her work is that people in the community are beginning to know and communicate with each other. “For so many people, the norm was to be afraid of your neighbors and isolate yourself,” she says. “This is terrible for health outcomes.”

“Social connections are very important but so is educating people about where to access services. When money is scarce, it’s hard to know where to begin to find the social services you’re entitled to. The community center has helped people with that.”

Now, a local family health services program comes to the community center and provides information for people, instead of waiting for people to come in on their own. “Riding a bus to these places can take half of a day, so when services come to the community center, it makes a world of difference,” she says.

This has carried through to even the police department, which has worked with the community center. As a result, she says, “people are beginning to see the police as their friend – not their enemy.”

She adds that the recent National Night Out also went a long way in helping build more social trust and community cohesion.

Despite the outstanding success that the community coach role has achieved, there’s much more work to be done. The Highlands Neighborhood Association remains critical to future success, and its sustainability will be essential to keeping the positive momentum that is currently underway.

Attendance for Neighborhood Association-sponsored programs must increase, and new funding partners will have to be added in order to ensure financial stability.

“It’s still fragile. We still haven’t built a solid foundation for the people to thrive, and that’s what we’re after,” she says, adding, “I’ve completely fallen in love with the people of the Highlands.”

“Many struggle and none of them deserve to.”

——

Thanks to photographer Hakan Axelsson for his portraits of some of the residents of the Highlands neighborhood. More photographs can be found here.

Appendix: 2010 Census Statistics for the Highlands Neighborhood of Longview, (Cowlitz County) Washington:

Population: 4,858
Housing Units: 1,778
% City Population: 13%
% Youth under age 18: 33% (City’s highest)
% Elderly Persons: 6% (City’s lowest)
% Latino Population: 21%  (City’s highest - up from 12.7% in 2000) (City’s highest)
% Family Households w/ children: 47% (City’s highest)
% Single Parent Households: 24% (City’s highest)
Poverty Rate: 44% (City’s highest)
Median Household Income $24,000 (City’s lowest)
% Public Assistance: 20% (City’s highest)
Unemployment Rate: 18% (City’s highest)
25+ years old without h.s. diploma: 36.60% (City’s highest)
25+ years old with Bachelors: 3%  (City’s lowest)

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Healing Decades of Trauma through Oral History

During the mid-1970’s, the radical Cambodian Khmer Rouge killed nearly one-fourth of the entire Cambodian population through executions, torture, starvation, disease and exhaustion. The regime sought a nation completely exempt from Western influences such as education, religion, and city life. As a result, 1.7 million Cambodians lost their lives.

Many Cambodians escaped the war, and settled in Oregon and Southwest Washington in the early 1980s as refugees. Even after thirty years, many Cambodians are still traumatized from their experiences, and are still unable to speak about them. As Cal State Long Beach sociology professor Leakhena Nou pointed out in Street Roots Magazine, the long term stress of this trauma can linger for decades, manifesting in diabetes, stroke, drug addiction, alcoholism, and family violence. “When you cut yourself deeply, a scar remains. That’s how I see the state of mind for the Cambodians.”

By 2010, there were as many as 10,000 Cambodian-Americans living in Oregon and southwest Washington.

Funded in part by a $50,000 Kaiser Permanente Community Fund grant, the Cambodian American Community of Oregon (CACO), began a unique and creative project to help Cambodian-Americans begin to heal.

The Cambodian Oral History Project had young Cambodian-Americans interview their parents and grandparents about their lives, without shying away from the brutal and repressive years under the Khmer Rouge. Eventually the interviews would be compiled into a 35-minute documentary film, and screened for public viewing encouraging community members to speak out in order to heal.

“By having the youth understand their parents and grandparents history, they will hopefully appreciate the freedom and liberty they have; and take the opportunity to educate others about the effects of genocide,” said co-director of the project, Mardine Mao, “Similar to the Holocaust survivors, Cambodian-Americans have a culture of silence when it comes to sharing their story of the genocide.”

20 adults and 19 youth, age ranging from 13-75, volunteered to participate in the interviews. Interviewers were given formal training with a two-session oral history workshop. Interviews and recording were spread out over a two month period.

Many of the youth felt that the interview process brought them closer to their elders than before speaking about the traumatic experiences in Cambodia.

“I already think of my mother as wonder woman and my hero, but with this project it just makes me think even more of her, if that was even possible,” said Kimberly Im, who interviewed her mother with her sister as part of the project, “Learning about her struggles and her life story makes me put things into perspective.”

“She feared for her life, her family’s life. She had no food to eat, no safety, nothing. The experience robbed her and her other commmunity members of that. She lost her childhood and the innocence that I got to have freely and without struggles,” said Im.

The documentary has had viewings in over 15 venues, including high schools, universities, nonprofit and community-based organizations. CACO hopes to pursue a screening on public television.

“Being a part of this project opened my eyes. It made me more compassionate and aware. I am closer to my mother after this,” said Im.