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NEW: East5ide Unified/Unido: Reducing Health Disparities Before School Entry

Mobilize the East5ide Unified/Unido community initiative to transform the way neighborhood hospitals approach their mission and business.

Photo of Jodi Hardin
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Updates: How has your idea changed or evolved throughout the Prize? What updates have you made to this submission? (1500 characters)

We have steadily refined our concepts and language to clarify and improve our pitch. Several distinctions and some questions we have been asking through this prize process include: • What do we mean by community mobilization? What methods make most sense to elevate the community voice in influencing the role hospital systems play on infant/toddler health outside of direct medical services? • Emphasizing the principles underlying the operations of East5ide Unified itself (e.g. keep the money local, more than 50% of the decision making body are family and community leaders, hospital partners come in service to community) that demonstrate our capacity for “walking the talk” of authentic, community-led work • Distilling our idea so it communicates broadly • Agreeing on the need for a visual, info graphic way of depicting our approach that, while complex, is grounded in research and theory

Name or Organization

The Civic Canopy is the applicant. However, East5ide Unified/Unido is a community-driven collaborative that includes: community residents, Denver Public Health, Denver Public Schools, community-based organizations and non-profits, and community health care systems (e.g. Denver Health, Kaiser Permanente, Presbyterian St. Luke’s, and Exempla St. Joseph). Conversations are underway to foster a partnership with Mile High Connects, a collaborative providing expertise around anchor institutions.

Geography

Five NE Denver neighborhoods of the 80205 ZIP code: Cole, Clayton, Five Points, Skyland, Whittier

What is your stage of development?

  • Advanced Innovator with 3 to 10+ years of experience in ECD

Type

  • Non-profit

What is the stage of your proposal?

  • Research & Early Testing: I am exploring my idea, gathering the inspiration and information I need to test it with real users.

Describe how your solution could be a game-changer for your selected Opportunity Area (600 characters)

Long standing unequal access to opportunity for families in 80205 has been exacerbated by rapid housing inflation and involuntary displacement, putting strain on the social cohesion and assets of 80205. By advancing policy change and community engagement of hospitals, or other large institutions to infuse two-generation and family-friendly practices, the vast amount of resources (human, financial and influential) can be directed to where it will improve the health and wellbeing of families with young children in the 80205 community, altering the trajectory for infants and toddlers.

Select an Innovation Target

  • System design: Solutions that target changing larger systems.

Tell us more about your innovation (1500 characters)

East5ide Unified/Unido aims to catalyze the consideration and adoption of two-generation and family-friendly policies within anchor institutions to address intergenerational poverty and community and family instability among current and recent residents of the Northeast Denver ZIP code of 80205. EU will leverage the emerging anchor institution movement, its strong relationship with 4 large hospital systems that reside within 80205, and its strength in community mobilization to inform, guide and support a new way for hospitals to be responsive to and supporters of the community determinants of health that strongly influence early childhood development and wellbeing.

What problem are you aiming to solve? (3 sentences)

Hospitals must evolve a new value proposition to survive; one that is contributes to the factors that influence health and are responsive the the communities they reside within. Community is demanding a voice in the drivers of their health, focusing their attention on the social determinants of health rather than sick care. This idea leverages community wisdom on the true drivers of health, providing avenues for hospitals to be part of broader solutions that benefit young children and families.

Explain your idea (5000 characters)

Our project focuses on two social determinants of health from the Aspen Institute’s Two-Generation approach: ● Increasing economic assets through strategies such as access to affordable, safe housing, public supports, and building financial capacity. ● Increasing social capital, especially stability of neighborhood and family networks through strategies such as expansion of job networks, and two-parent participation in caregiving and child development. The project taps into the young anchor institution movement which asks institutions to stand for 3 strategies: 1) employ an “all in” model in operational decisions (hiring, procurement, etc.) 2) assess and refer for basic human/social needs as a standard of care, and 3) reduce toxic/carbon based energy for efficient use of natural resources. Anchor institutions are defined by the Democracy Collaborative as “enterprises such as universities and hospitals that are rooted in their local communities by mission, invested capital, or relationships to customers, employees, and vendors”. Only a small percentage of institutions are currently participating nationwide, with none in Denver. However, uptake of concepts and development of practices is ongoing at a rapid pace and well supported nationally. Anchor institutions maintain a long-standing presence in communities and direct significant human and economic resources. With that, the policies and daily operations of these large, local organizations can have either a supportive or adverse impact on the community in terms of housing, job opportunities, education, and access to public services. Finally, the creative innovation proposed by East5ide Unified/Unido leverages community organizing to influence and support the health care entities in the 80205 ZIP code to think and act differently and be leaders in building the economic assets and social capital needed for young children and their families to thrive. An ABCD model will help enhance communications strategies, support community leadership development, and engage the community at a deeper level. This model “rests on the principle that a recognition of strengths and assets is more likely to inspire positive action for change in a community than is an exclusive focus on needs and problems.”3 The benefit of ABCD to our innovation can be summarized in the following way: “ABCD is concerned with linking community-driven initiatives to the macro environment and promoting a policy environment conducive to such initiatives”.3 These neighborhood-strengthening strategies are critical to impacting both determinants and policies, and ensuring economically stable families. In summary, our idea is to drive the anchor institution work from the community AND from an early childhood/family strengthening position. Because institutions are just learning about the Anchor approach, their planning and efforts are ripe for influence from community, via community organizing, to both hasten and direct the changes of large institutions, assuring that a “two generation” or “family friendly” or “early experiences matter” lens is applied .

Who benefits? (1500 characters)

Current and recent residents, but particularly families with young children, of the 80205 ZIP code will benefit from the implementation of two-generation and family-friendly policies within anchor institutions. Our innovation acknowledges that local economy and resources determine job opportunities, commerce, and education: resources create family economic stability and, subsequently, healthy child development. East5ide Unified/Unido places a high value on relationships and seeks to continue to build and maintain social cohesion by building social capital. By addressing involuntary displacement and uneven investment, our innovation will build social capital. We want to mitigate the impact of adverse childhood experiences and the phenomenon known as toxic stress, brought on by the constancy of stressors on adults and their children. East5ide Unified/Unido has been working as a community-driven initiative for approximately three years, engaging thousands of community and family members in that timeframe. The Civic Canopy, a non-profit that resides within has worked on behalf of the 80205 community for over 10 years and has been entrusted by the East5ide Unified/Unido Council as the lead agency to coordinate, convene and disperse resources into the community.

What kind of impact will your idea have? (1500 characters)

The potential impact of a redirection of billions of dollars in resources, across multiple institutions, focused on the selected 80205 neighborhoods, and driven by members of the community who are invested in young children, is nothing short of staggering. We expect the impact to include: increased access to income and wealth-building mechanisms; increased community and institutional trust, which we expect will increase children’s and families’ access to health care and decrease the impact of bias in health care; greater two-parent participation in caregiving and early childhood development resources; expanded social networks; and increased effectiveness in advocacy for supports for early development, care and learning. All of these will have a broader impact on the development in the earliest years of life, and a continued impact on children throughout the lifespan.

How does or how could your idea impact low-income children? (1500 characters)

Neighborhoods in NE Denver bear disproportionate burdens of poor health and social outcomes, due to the decades-long inequities. Male engagement in family life is lower than in Denver as a whole, as evidenced by a lower proportion of births to mothers who are married, 49% higher unemployment among men and 34% more children in single-mother families. Childhood education performance lags; 3rd grade students are less likely to be proficient readers than in Denver as a whole. Residents of NE Denver ages 25 years and older are more likely to have less than a high school education and a lower proportion of 3-4 year olds are in preschool. Community safety is an ongoing challenge; violent crime rates are 2.7 times higher in NE Denver than Denver County. Property crime rates are 6.9 times higher. As more affluence moves into NE Denver, inequities between groups increase, creating a larger gap in determinants, including a reduced sense of belonging and respect between groups. This innovation is designed to address these health, education and social inequities for families with young children who live in poverty in 80205.

Innovation: What makes your concept innovative? (5000 characters)

The evidence tells us that innovative, transformative strategies to reduce child health disparities require cross sectorial, multifaceted, and community based efforts that address multiple social determinants of child health simultaneously. By mobilizing the authentic community engagement present in East5ide Unified, we harness momentum for a sustainable, inclusive, and value focused strategy. Our Aim: To disrupt the usual community-hospital relationship by changing the power dynamics and the process by putting a diverse, broad thinking and committed set of players (East5ide Unified members) in a position to lead hospital C-suite decision makers to adopt practices that make our community a healthy place for all children. Our Assertion: • The rare combination of the community development, public health and health sectors offers unique leverage to solve stubborn, persistent problems that negatively effect healthy child development. • By flipping the power structure on its head (community leads executives) and by driving organizations (hospitals) away from sick care and to wellness support, we assert the hospitals’ goals of community engagement and “difference making” and the community’s goal of impacting the social determinates of health for children will be achieved. Our Assumptions: • Health Care is a small part of health • The community environment in which a child is raised is key to health and development • A “Life Course Health Development” framework (Halfron and Forrest) promotes prevention and population-level interventions throughout early childhood, and especially during the sensitive perinatal and birth – 3 years of life to address the upstream resolution of the social determinates of health. • Community mobilization is an underutilized tool for small “p” policy change in institutions that large employment, economic, environmental and political foot prints.

Scale: Describe how your idea could reach a significant number of end-users. (1500 characters)

This innovation has the potential to reach multiple levels of end users, including individual families with young children living in 80205, networks of community leaders influencing systems change that build healthy communities for families, anchor institution leaders, and city and state policy makers. This Innovation could reach a significant number of end-users through the size and reach of its organizational partners. As just one example, Denver Health employs over 7,000 people and provides care for 150,000 patients each year. Consider the reach of deploying family friendly policies as well as community economic enhancing strategies by just this one institution. East5ide Unified/Unido has strong working relationships with four such large health care organizations that reside within and serve 80205 as well as emerging partnerships with other large education and cultural organizations that could be engaged as this innovation is piloted.

Feasibility: Where are you with understanding the feasibility of your idea? Describe what you’ve done so far and your plans. (3000 characters)

As a new stage innovation, East5ide Unified/Unido has begun exploring other communities that have embraced anchor institutions as a policy lever to build economic assets and social capital in lower income neighborhoods. An example is The Cleveland Clinic, which moved from paying high costs to a national company for laundry services to investing in an employee owned co-op institutional laundry business. This saved money for the clinic, created jobs and invested in long-term stability in the community. The Clinic also invested capital into the creation of affordable housing in the neighborhood so its workers and community members had the opportunity to have safe, accessible and quality homes to rent or own. Reducing economic and housing stressors and improving relationships provides the environment proven to improve long-term health trajectories for young children (Adverse Childhood Events study). We believe this innovation is scalable in several ways: expanding the anchor institution concept to large cultural, educational and business entities in the community, to replicating it in other neighborhoods or communities. To be transparent, however, we have a different kind of challenge in Denver than in a city with a blighted area around its institutions. We have a booming economy, in which some are being left behind. Our challenge is to innovate in such a way that the experiences in other areas can be used in this setting. And with the rapid rate of transitioning taking place in the 80205 community there is a sense of urgency among residents, and a desire to act now in order to strengthen the increasingly threatened stability of families and young children.

Business Viability: How viable is your business model? (5000 characters)

The financing of health care is a rapidly evolving space. Both mission driven and profit driven health care systems are reexamining the value proposition. Traditionally the end user, the patient, has not had a significant foot print in this thinking. We assert that customers, i.e community members themselves, should co-create health care. Hospitals say they want this, communities say they want this, public health says they want this. Yet individually, there is not clarity on how to actualize these visions. East5ide Unified/Unido proposes a way to innovate at a fundamental level of decision making with a focus on the factor that will make the most fundamental and lasting difference….the healthy development of infants and toddlers within stable families. Examples like the Cleveland Clinic and Cincinnati Children’s Hospital have proven the financials…..our challenge now is to inspire decision makers to be bold, take risks, and learn from both what works and doesn’t work.

HCD: How have you used human centered design to build or refine your concept? (5000 characters)

If eliminating health and developmental disparities among young children before they start school was easy, or even complicated, it would have been achieved by now. This problem is complex – the more assess, examine, and peel away the layers of the onion, the harder it can be to understand. Our best strategy for finding the “right next step” has been problem solving in a whole new way. If you put the same people in the same room for long enough, they will come up with the same answers over and over again. In early childhood, for example, we see the “quality early care and learning environments” as the answer over and over. Yet research shows that quality, accessible ECE is one important strategy yet alone, doesn’t ensure all young children are valued, healthy and thriving. It’s more complex than that. You must disrupt something - the people who are there, the place you are in, the time constraint – if you want different ideas and strategies. In East5ide Unified/Unido we changed all three – new people, new environment and new sense of timeline. IDEO says Human Centered Design is “a process that starts with the people you're designing for and ends with new solutions that are tailor made to suit their needs.” We like to frame it as “nothing about us without us”. A top priority for the additional resources we are seeking is to more formally and systematically use design thinking to deliver those tailor made solutions for everyone…institutions, community, advocates, and most of all children.

Tell us more about you (3000 characters)

The idea began in 2015 in response to the Denver Dialogues for Young Children, a series of conversations led by family leaders who expressed a strong interest to take action to better support young children and their families in the affected 80205 neighborhoods. Through a yearlong planning process, the values, vision and mission of East5ide Unified/Unido as a community-driven initiative committed to mobilizing residents and partners to ensure every child and family had the opportunity to reach their full potential, took shape. Through a series of community events, health care organizations became increasing involved, providing needed matching funds for a national grant and committing time and expertise to the initiative. As community members and health care partners built a shared understanding of community interests and priorities, they began to identify strategies that aligned with the anchor institution movement. Health care partners C-suite executives, in hearing from community members, are increasingly more committed to learning from the community what and how they can best be responsive and leverage their economic assets to benefit community. Who are we? We are business people, public health geeks, non-profit leaders, social workers, early learning champions, concerned neighbors, committed family leaders, disrupters, peace makers, graduate students, workers working, and we are ALL passionate about the youngest lives we feel are the responsibility of all of us. We have a chance here to raise a generation of children with what they need to thrive….the science has shown us all the way. We know what is needed…..we just need the collective will to provide it. East5ide Unified/Unido takes a life-course perspective – recognizing and embracing that the first three years are such as sensitive period in human development. Anything, even small things, we can do right during the earliest years, bolsters trajectories for healthy child development and success in the early school years, all of which are predictors for longer term health and economic wellbeing. The early childhood years are a leverage point like no other. The health and wellbeing of all our children, our communities and our state is a stake here – we must act as a community to put our resources where they can truly generate a brighter future for us all.

Do you have the people and partners you need to do what you’ve described? (600 characters)

East5ide Unified/Unido has the core set of partners and community members needed to lead and launch this effort to through this next phase. We will need to continue to expand and deepen partnerships with the all levels with the health care institutions, mobilize more residents to inform and guide the work, and link strategically to local and national partners who are providing leadership in each of the three theoretical underpinnings (e.g. two-generation approach, anchor institutions, and asset-based community development) in order to learn from and leverage that expertise.

As you consider your next steps, what kinds of help could you use? Is there a type of expertise that would be most helpful? (1800 characters)

We need assistance in ensuring the soundness of our approach, communicating it clearly, and crafting the evaluation framework to test our ideas in a way that helps us learn and adjust along the way. Finally, we need help understanding the world of an executive in a large (health care) institution – someone responsible for both short and long term financial health on the enterprise first and for most - and strategies that will ensure community-responsiveness.

Would you like mentoring support?

  • Yes

If so, what type of mentoring support do you think you need? (1200 characters)

Communications and evaluation design support would be helpful

Are you willing to share your email contact information submitted on OpenIDEO with Gary Community Investments?

  • Yes, share my contact information

[Optional] Biography: Upload your biography. Please include links to relevant information (portfolio, LinkedIn profile, organization website, etc).

East5ide Unified/Unido's website is found at: http://east5ideunified.org/ The Civic Canopy's website is found at: http://www.civiccanopy.org/ Sample of EU leaders are found at: www.linkedin.com/in/jodi-hardin-52352913 ; https://www.linkedin.com/in/kellie-teter-7986709/ ; https://www.linkedin.com/in/diversitydyanmicsgeneral/ ; https://www.linkedin.com/in/chuck-ault-70087a16/ ; https://www.linkedin.com/in/voradel-carey-65941812/ ; https://www.linkedin.com/in/jason-vitello-54b7a2a/

[Optional] Attachments: Please upload relevant attachments or graphics or show us how you prototyped.

Mentorship: How was your idea supported? (5000 characters)

Working with the mentor help us to see the value of widening our lens in describing our idea. Because we have been working with the East5ide Unified/Unido for two years now, and the Health Care Systems work group has been learning about the Anchor institution movement for a number of months, our thinking had become rather focused, or portrait like. Our mentor helped us to see that we needed to paint a landscape for the reader, one that situated our idea in a context – a context of our understanding and work to date as well as the context in which we are operating. Our appreciation for the multifaceted nature of our existing intuitive, as well as our ambition to push that multisector, multifaceted, aspect even further with Anchor Institution work is now more clear in our writing about our innovation.

Updates: How has your idea changed or evolved throughout the Prize? What updates have you made to this submission? (1500 characters)

We have continued to refine our idea through this process -- from updating the title and short description to adding more theory and research base. We are inspired by others participating in the Prize and feel honored to be among the ideas that will be considered.

Name or Organization

The funding will go to The Civic Canopy on behalf of East5ide Unified/Unido. Resources will be distributed and monitored by the East5ide Unified/Unido Council, comprised of family and community leaders and partner organizations.

Geography

The 80205 Zip Code, Denver, Colorado.

What is your stage of development?

  • Advanced Innovator with 3 to 10+ years of experience in ECD

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Photo of kellie teter
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Jodi, it looks really great. The visuals are helpful and the spirit really comes through.