Pulse
A Dose of Housing
Why would a health foundation take interest in a housing project or environmental toxins?
Rick Goodemann isn’t a doctor or nurse, and he has never taken a course in public health, but as executive director of the Southwest Minnesota Housing Partnership, he thinks he has a role to play in the health of the public.
Goodemann hasn’t always thought that way. About five years ago, when he was talking with school and health officials in Watonwan County about high lead levels in kids, he learned that although nurses and social workers were going to homes to help children with asthma exacerbated by allergens or behavioral issues caused by lead, no one was doing anything to improve the houses they lived in. It hit him that he had part of the solution. “We’re sitting with the resources, and we should be investing those resources to try to deal with this stuff,” he says. He then realized that in order to truly improve people’s health, the housing and public health sectors needed to communicate better.
Goodemann was well-versed in the connection between housing and health when, a few years later, the owner of the Viking Terrace apartments in Worthington approached the partnership about purchasing the buildings. Viking Terrace had become one of the city’s most troubled properties. The 60-unit facility housed some 200 low-income residents, many of whom were Southeast Asian, Latin American, and East African immigrants who had moved to the town to work at the pork-processing plant. Built in the 1970s, the three wood-frame buildings were in need of repair. The heating and cooling systems were inefficient, the roof leaked, the carpet was worn, the plumbing and wiring were outdated, and some windows wouldn’t open. Not only did the buildings have problems, so did the people who lived there. Far too many suffered from respiratory and other illnesses made worse by the buildings’ problems with moisture and poor ventilation.
The partnership acquired the buildings in 2004 and decided to do a “green rehab.” They developed a plan to use low-VOC and energy-efficient materials, add insulation, do mold and radon abatement, improve ventilation, and install a geothermal heating and cooling system. As they worked with specialists to assess how the new buildings would perform once they made the changes, they wondered whether they could measure the effect of the green buildings on the residents’ health. “You look at the balance between energy conservation, ventilation, and moisture content—all relate to health,” Goodemann says.
That’s when the partnership asked the Blue Cross and Blue Shield of Minnesota Foundation for funding to support a study that would document whether the people living in the newly renovated apartments were healthier than they had been before the upgrades.
Foundational Issues
Why would a philanthropy focused on health and funded by a health plan even consider a request about housing? About the same time that Goodemann had his personal epiphany about the relationship between healthy people and the buildings they live in, the foundation was rethinking its mission.
During its first two decades of operation, it had focused on access to care and prevention of illness. By the early 2000s, there was a sense that although those issues were important, something wasn’t working. The nation was in the bottom third of industrialized countries for average lifespan, and although Minnesota always had a high ranking within the United States, the health differences between rich and poor and white and minority populations were huge in the state. Emerging research was pointing to the importance of socioeconomic and environmental factors in determining health.
But how could the foundation tackle things as large and amorphous as economic inequities, poor housing, pollution, social isolation, and racism? Where would they start? How would they allocate their resources? To find answers, foundation leaders sought advice from state and national experts.
One message came across loud and clear: No one could solve those problems alone. “Our board and staff learned that cross-sector partnerships are key to this kind of upstream work,” says Joan Cleary, vice president of the foundation, “and that the health sector alone was going to be unable to make the difference.” They needed to join forces with people working on housing, the environment, and early childhood development if they wanted to have healthier communities. They were also told to focus on kids. “We heard that kids are our future,” she says. “We needed to focus on how communities can help nurture the healthy development of children and their families.”
By 2005, the foundation’s board and leaders decided on a new direction—to address influences on health that were beyond the reach of the health care system. And with a new sense of purpose, the board and staff focused on projects that fostered the social adjustment and health of the state’s most vulnerable populations—new immigrants and children.
Recent Grantees
The following are some of the projects the Blue Cross and Blue Shield of Minnesota Foundation has funded.
- Indigenous Environmental Network, Bemidji; $60,000 to teach children on the Leech Lake reservation about nutritious wild foods and cultural and environmental stewardship.
- Women’s Environmental Institute, North Branch; $60,000 to provide information to low-income communities and communities of color about the consequenses of exposure to environmental toxins.
- Central Minnesota Community Foundation, St. Cloud; $50,000 to deepen understanding of different cultures among new immigrants and established residents of central Minnesota and improve health.
- Main Street Project, Minneapolis; $50,000 to strengthen relationships between new immigrants and established residents of the Fargo-Moorhead area and create a healthier community.
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Foundation leaders decided they had other work to do as well. They needed to promote awareness about the relationship between health and socioeconomic and environmental factors. Toward that end, they’ve sponsored screenings of the PBS documentary
Unnatural Causes: Is Inequality Making Us Sick?, a seven-part series that through the stories of real people explores such issues as how wealth and where you live predict health, and they’ve produced videos and reports on topics ranging from how to use community health workers in clinics to tax policy.
The foundation also decided it needed to help train leaders in the organizations it was funding. “This is one of the ways we’re innovative and nontraditional,” Cleary says. “We provide dollars. But we also provide technical assistance of various kinds.” The foundation contracts with a coach who meets with grantees individually and conducts workshops to help build their skills as leaders. It also convenes grant recipients periodically to share stories about what they’ve learned. “Once we do make a grant, it’s just the beginning of the relationship,” Cleary says.
Spreading the Word
In 2006, the foundation, along with the U.S. Environmental Protection Agency and Enterprise Community Partners, gave the National Center for Healthy Housing funding to survey residents of Viking Terrace about their health and to educate them about how to maintain their homes in order to stay healthy. The center also hopes to show that the added costs of using green materials and building techniques will be offset by reductions in health care expenses and lost work and school days.
Today, Goodemann talks excitedly about the changes in the apartments. “They’re much more comfortable. Ventilation is better, there’s much less moisture, and they [residents] can see out of their windows,” he says, explaining that old window air conditioners were removed. He’s particularly excited about the playground, basketball court, and shelter that houses picnic tables. He admits that although those amenities weren’t added with health in mind, the outdoor space has the potential to affect people’s health in a number of ways. “It encourages kids to get out of their apartments and play, and the parents are there as well,” he says. “It’s bringing the community together.” And that delights him. “This stuff is so much fun,” he says.
Goodemann clearly gets what the foundation is trying to impart: that health relates to much more than just medical care. If all its grantees are as enthusiastic as Goodemann, the foundation will have an army of policy advocates around the state, perhaps enough to make a dent in the huge undertaking of altering the many socioeconomic determinants that affect health.—Carmen Peota