In a Worldwide Health Crisis, Lessons From Resilient Communities

No community has had it easy during COVID-19. Those with a consistent health equity focus before the pandemic have found advantages in facing the crisis. 

The RWJF Culture of Health Prize honors communities—urban, rural, tribal, large or small—that are beacons of hope and progress on creating places that enable health and well-being for all.

RWJF recognizes Culture of Health Prize winners for their broad definition of health and strong collaboration between community partners and residents, and across many sectors and levels of power. In a Culture of Health Prize community, those facing problems participate in shaping solutions. These communities commit to sustainable systems change and policy oriented long-term solutions. They create conditions that give everyone a fair and just opportunity to be as healthy as possible. They use data to measure and share progress and results.

Throughout 2020, winners used the strategies and networks they built to tackle the coronavirus and America’s reckoning with racial justice. We drew lessons and inspiration from these communities. In future posts we look forward to sharing how several Prize winners have put addressing systemic racism at the center of their work to promote health for all and how in other Prize communities, young people are forging networks, leading by example and finding new ways to advance health equity.

In this post, we highlight five examples of how Prize-winning communities—the Bronx, N.Y.; Lake County, Colo.; Santa Monica, Calif.; Shoalwater Bay Indian Tribe of Washington; and Spartanburg County, S.C.—are responding to COVID-19. They shared their experiences as part of a virtual panel session of the Culture of Health Prize learning event in October 2020.

Building Strong Relationships

In the Bronx, N.Y., long-established relationships with community members have positioned the local government and service organizations to offer social support when disaster strikes, said Fernando Tirado. Tirado is the director of new initiatives at Bureau of Bronx Neighborhood Center for Health Equity and Community Wellness, which provides health care, community space, and health and wellness classes.

Tirado said that the isolation that jeopardizes people at risk during a crisis like a heat wave would have been an even larger problem during the pandemic without the existing social supports. Informing people about how they can protect themselves and others, and enabling them to access the resources to do so, has been crucial. Thanks to their previous work, partners in the Bronx knew they could reach people without email or telephones by instead relaying messages at local food pantries, farmer’s markets, and senior events.

Before the pandemic, the 2015 Culture of Health Prize-winning community's “Be a Buddy” system sought to protect people from heat exhaustion by sending volunteers from local universities to check on, provide resources to, and build relationships with individuals who may distrust government programs. With strong relationships in place, once COVID-19 hit, the project morphed to assist people during the shutdowns.

“Resiliency takes practice,” said Tirado.

Finding Common Ground

Early in the pandemic, 2019 Culture of Health Prize-winning community Lake County, Colo., established a committee to address the needs of people who don’t qualify for government assistance, but still struggle with things like housing and utility bill payments. The committee funnels people in need to various service agencies, which review cases and offer financial support. The Unmet Needs Committee was on track to pay half a million dollars in housing and utility bills by the end of 2020, said Katie Baldassar, executive director of Lake County Build a Generation, which conducts research on social issues in the community, opens communication between stakeholders, and mobilizes funding for programs. The group has long-established partnerships with residents of the county’s manufactured housing communities who have organized for better health and safety where they live.

To be able to respond to the pandemic in an inclusive way, the county needed to bridge gaps between people and groups with varying political views. These groups included businesses, nonprofits, social service and other government agencies. For example, the owner of a manufactured housing community raised rents during the pandemic. In response, the committee asked elected officials to write a letter noting that it was not a time to raise rents, given how community members were struggling with lost wages or job uncertainty. Some officials initially didn’t believe the government should intervene in private business decisions. However, the committee persuaded policymakers to send the letter, based on a common desire to make the most of taxpayer dollars in the county’s rental assistance programs and to keep families housed.

“We realized we had really different ideas about how to solve these problems and different mental models about how the world works,” Baldassar said, “so we had to learn how to talk across those differences in a way that would deepen those relationships rather than breaking them. I think being able to do that has brought us closer as a community.”

Ensuring the Well-Being of a Community

Santa Monica, Calif., proved that developing health-equity tools in normal times can make operations move more smoothly during a crisis. Before the pandemic, the 2016 Culture of Health Prize-winning community designed a “Wellbeing Index” to measure how people are doing, from their sense of community to their opportunities for health and economic opportunity. For example, said Lisa Parson, special assistant for equity and community recovery, do they have frequent social contact? Can they afford medical services and housing?

Parson said the index, regularly used for long-term planning, also informed the city’s pandemic-response efforts. The data they had already gathered revealed where to direct aid and guidance. For example, in one neighborhood where residents had the lowest wellbeing rating in part due to food insecurity, the city started a food pantry. The city has also boosted communication with its local nonprofit and business partners. Together they’ve solved new problems that emerged during the pandemic, such as keeping restaurants open through open-air dining or offering food delivery to comply with pandemic guidelines.

Creating an Inclusive Response

At the onset of the pandemic, Shoalwater Bay Indian Tribe—a 2016 Culture of Health Prize-winning community—was already well-positioned to leverage the community’s strengths in order to respond in an inclusive way. The tribe’s location in the tsunami zone, an area of the Pacific coast that is at risk for tidal waves, has forced the tribe to focus on emergency preparedness and plan for most types of crises—including a pandemic.

In the early days of COVID-19, the tribe’s crisis planning enabled it to quickly open a food pantry so families could get food without leaving the reservation, amp up efforts at their community garden, and hire more kitchen staff to prepare and deliver meals to elders.

According to Shoalwater Bay Indian Tribe planner Jamie Judkins, another secret to the tribe’s success was quickly establishing communication. “Any communication is key—making sure you have opportunities for people to come in and share ideas and build good solid foundations for wellbeing,” Judkins said.

Addressing Economic Conditions

For about five years, Spartanburg County, S.C., a 2015 Culture of Health Prize-winning community, has emphasized race, equity and inclusion in its health and social services efforts, said Paige Stephenson, president and CEO of United Way of the Piedmont. So, when COVID-19 exacerbated existing inequalities in access to health care, education, and economic stability, she said, “We doubled down.”

The pandemic gave momentum to discussions that the community had long had, such as improving broadband infrastructure and access. “It’s become clear to our local leadership that that’s what we really need to hone in on,” Stephenson said.

Improving child care infrastructure has also gained new urgency for this community with a large workforce in manufacturing, which happens round the clock. Stephenson and others have consulted with other communities that have a track record providing reliable 24/7 child care.

“Child care is an invisible foundation for the workforce,” she said.

They show how important it is to provide not only immediate crisis relief, but to work toward long-term change by boosting access to affordable housing, good wages, food, child care, and broadband.

Inspiring Examples

Prize-winning communities shine a light on what’s possible when community leaders and residents unite to leverage community strengths and address the barriers to a fair and just opportunity for health for all. Their responses to COVID-19 demonstrate the importance of collaborating and taking data-informed and inclusive approaches. They show how important it is to provide not only immediate crisis relief, but to  work toward long-term change by boosting access to affordable housing, good wages, and food.

We are grateful that Prize-winning communities for sharing their stories with others who can learn with and from them. Since 2013, RWJF has worked with the University of Wisconsin Population Health Institute to carefully select places that meet our criteria for promoting better health for all. It’s a highlight of our year to showcase the winners, whose spirit of collaboration and commitment to change are truly inspiring. We love introducing these examples of how to build a Culture of Health to the rest of the nation.

This year, in light of the COVID-19 pandemic, we postponed awarding the 2020 Culture of Health Prize. Instead, we’ll choose them this year, alongside the 2021 winners.

Learn more about Prize-winning communities, visit www.rwjf.org/prize. We look forward to sharing more examples from Prize winners in future posts and hope you are inspired to take action in your community.