Collaboration to Create Healthier Communities in Minnesota

Health-wise, many other countries look better than the United States. The French, the Germans, the Swedes, the Israelis, for example – they all live longer than we do in the U.S. Our nation currently fixates on Obamacare, with narrow-minded public officials and pundits of all persuasions asserting their positions on how to finance health care, arguing over whom to blame for system problems, and debating alternatives.

“Narrow-minded” – I use that term not pejoratively, but rather to raise awareness about the limited scope of the health care debate and to focus attention on the fact that the formal system of health care influences our health to a much lesser extent than other things influence our health – for example, our environment and our lifestyles. The formal health system, despite its 21st century technology which can save the lives of people with injuries and conditions fatal in years past, nonetheless does not influence the length of our lives as significantly as do our income, education, and nutrition.

Cynthia Boyd, a reporter with MinnPost, wrote recently that good and affordable housing might be considered a “lifesaving vaccine.” She used medical terminology to drive home the importance of social, economic, and environmental factors in determining our health.

That’s why Wilder Research teamed up with the Federal Reserve Bank of Minneapolis to promote collaboration in Minnesota between public health practitioners and community development finance professionals. Despite similar missions, these two groups have worked to promote our quality of life using different lenses and independent approaches. Public health has focused primarily on increasing awareness of healthy behaviors (eating nutritious food, exercising, not smoking, etc.), on policies which protect the public from harm (food handling laws, fluoridated water, smoking bans, etc.), and on increasing access to health services. Community development finance professionals have focused on designing living environments best suited to good health and on financing major projects which can offer access to health care, child care, housing, and better food, for example.

So, in 2012, we convened people from throughout Minnesota who share the mission to promote community health. We sought to raise awareness about the social determinants of health, develop a common understanding of how to make progress, and spark additional action.

In 2013, we invited people back – this time emphasizing action. Nineteen projects from around the state shared their experiences with cross-sector collaboration, involving nonprofit organizations, government, private businesses, and academia. These projects showed how they have educated the public, promoted exercise and nutrition, connected people with health care, and improved access to healthy food. National speakers offered insight into how we can do our work better; they also noted that Minnesota has made more progress than many other states. You can see posters from the projects, as well a pick up other information from the conference here.

Elaine Arkin, manager of the Robert Wood Johnson Foundation Commission to Build a Healthier America, delivered a keynote speech at the conference. She described the process of building recommendations for the promotion of healthy communities. Those recommendations will come forward during a webinar on Monday, the 13th of January, 2014. She also drew attention to the use of a national report prepared by Wilder Research and the Minneapolis Fed. The report documents the extent of collaboration around the country and identifies challenges and opportunities for further progress to improve health through collaboration between public health and community development finance organizations.

We took great satisfaction in doing the national research and preparing that report for the Commission to Build a Healthier America. We feel part of a movement, inspired by the Robert Wood Johnson Foundation and grounded in sound research, which can enable all people in our nation, poor or rich, to live healthier, happier, and more fulfilling lives.

How can our state be so good, yet so bad?

It’s the Minnesota Paradox. We need to solve that paradox, to ensure the prosperity of our state and a high quality of life for all of our residents. Minnesota has steadily grown in population since the mid-20th century; projections show continued steady growth for at least the next few decades. How those residents will fare, however, depends on critical choices we must make now.

The good part

Minnesota ranks high overall on many important measures of quality of life.

The American College of Sports Medicine, puts us in first place for overall health. CNN Money identifies several of our Twin Cities area’s municipalities among the best 20 places to live in the United States. Prevention Magazine rated the Twin Cities the 3rd “happiest, healthiest” place in the United States. America’s Health Rankings place Minnesota fifth among the 50 states for overall health.

Among the 25 largest metropolitan areas, the MSP metro region ranks “numero uno” on the proportion of adults who work, fourth on the proportion of adults with a bachelor’s degree, and fifth on median household income. So, we beat out places like Seattle, New York City, Miami, Phoenix, Philadelphia, with our better employment, education, and income.

Based on these numbers, the Land of 10,000 Lakes looks very, very good.

So, what’s the bad?

As I told a full auditorium at the Minnesota Policy conference last Wednesday, these overall numbers mask severe problems.

Before considering those problems, note as context two important features of the state’s current growth. First, the population is dramatically aging – yes, the good old baby boomers pig-in-a-python are progressing into their 60s and beyond. That has positive implications – more people living longer, healthier lives and contributing in various ways to their communities. It also has negative implications – more people with chronic health conditions requiring care for longer periods of time, for example.

Second, our state’s residents have greatly diversified over the past 50 years and will continue diversifying into the future. For instance, in 1960, our entire state had only about 42,000 persons of color; by 2010, that number had increased to about 900,000. In the Twin Cities region, during the first 10 years of this century, residents of color increased by more than 200,000, while white residents actually decreased by several thousand.

Keeping that context in mind, problems become apparent when we look below the top line “Minnesota high ranking” numbers. So, consider the proportion of adults working: Minnesota overall ranks 4th. Yet for persons of color, we rank 22nd, resulting in one of the largest employment gaps between whites and persons of color in the nation, putting us 46th out of 50 states.

Or consider the poverty rate. We rank number 11 among the 50 states. However, for persons of color, we rank 30th; and for the gap between white people and persons of color, we fall near the bottom, at 44th place.

Minnesota sits among the worst five states in the nation for on-time high school graduation for Black, American Indian, and Hispanic young people.

Differences between white residents and residents of color begin early, and they persist over time. You can see them in 3rd grade reading, for example. (See Minnesota Compass.) Some of it relates to income and, as a study suggested this year, results from a “language gap” starting as early as 18 months of age.

Do these disparities matter? Yes, for individuals, and yes, for our communities in Minnesota.

The disparities noted above affect individuals’ health. Some racial and ethnic groups have a greater chance of developing chronic diseases; members of some groups die much earlier than other groups. For example, an African-American in the Twin Cities will likely die 7 years earlier than a white person and 9 years earlier than an Asian person. I don’t know about you, but losing seven to nine years of my life sounds like a big deal; it means something.

For our communities, we risk the debilitation of our rising stars. The younger generation consists increasingly of persons of color. We rely on them to assume positions of community leadership and business leadership, to shape community institutions, and to successfully rear children. How will they sustain Minnesota’s communities without adequate education, health, and other resources? How will our communities support our aging residents if the supply of people in their working ages diminishes not only in quantity, but also in quality? The demographics portend declines in both. However, we can do a lot, if we put our minds to it, to change the trends.

How should we take action?

How to boost Minnesota to the top constitutes a topic more extensive than just this one essay can cover. For sure, the existence of such notable racial disparities suggests a need to eliminate racism. However, it’s overly simplistic to consider the elimination of racism a cure-all. It’s necessary, but not sufficient.

In addition, we will need to identify strategic points of intervention – some short term, to meet immediate needs – others long term, to prevent future problems from occurring. For example, long-term strategies to sustain affordable housing must receive our attention alongside short-term strategies to provide shelter to currently homeless and marginally-housed people. We must create long-term strategies to upgrade the math and science skills of our young people at the same time that we take steps to attract and retain professionals already trained in these skills.

We will need to work “upstream”, focusing on negative social and economic features of our communities which take a while to change. We will need to break out of our common ways of thinking – to recognize, for example, that tax policies can affect health and that early childhood education can influence economic development. Partnerships including business, nonprofits, and government will need to form and act in new ways.

Current demography need not inexorably shape our destiny. I look forward to taking up the challenge to think in new ways and partner in new ways, to make our communities truly number one in all their dimensions, not in just whatever first meets the eye!

50 Years - How much change has occurred?

I vividly remember the 1960s. I remember watching Dr. King speak live. I remember listening to the debates about civil rights, and eventually participating in them. I remember the news reports and the reactions to the murder of Medgar Evers, just shortly before the March on Washington.

The fearful identified with the words that Yeats had used to characterize Europe ravaged by World War I: “anarchy is loosed upon the world…the ceremony of innocence is drowned; the best lack all conviction, while the worst are full of passionate intensity.” The hopeful, however, espoused the vision of Dylan that “times they are a changing”. They heard his call to “gather ’round people wherever you roam,” admonishing the “writers and critics,” “senators, congressmen,” and “mothers and fathers” to lend a hand in deconstructing old systems to create a new world that would serve everyone’s needs.

In matters of race at that time, overt discrimination had the acceptance, if not the approval, of many in the majority community. Even in the north, landlords and real estate agents could admit they would not show rental or sales properties to Blacks. Some chose to leverage that stance as a selling point. Although the government had tried to remedy employment discrimination in its civilian and military work forces at least as early as the 1940s, legislation to guide private employers did not arrive until the 1964 Civil Rights Act. I remember one of my relatives who was ostracized by coworkers because he had hired a Black military veteran to work as a janitor in an otherwise all-white business.

These are some of my memories, but what about some facts? Do the data tell us that any of the basic elements of quality of life have changed for the races over these past 50 years?

Nationally, the Economic Policy Institute suggests that the dreams of Dr. King and the other speakers on August 28, 1963 have not yet reached fruition. Unemployment was twice as high for Blacks than for Whites in 1960—it had the same two-to-one ratio in 2012. Integration of our schools has not occurred: three quarters of Blacks attend schools where more than half of students are persons of color. Although the gap in poverty rates between Whites and Blacks has narrowed since 1960, the Black poverty rate remains twice as high as the White rate.

What about Minnesota?

If the dream of those who marched in August of 1963 included equality of opportunity, it looks like Minnesota falls short. The latest data for our state, published just yesterday, shows a 33 percentage point gap between the proportions of White and Black students meeting state reading standards.

If the dream envisioned equality of outcomes, we fall even shorter. For example, in 1960, in Minnesota, White household income was 50% higher than the household income of persons of color (Whites: $4,695; Persons of color: $3,116). In 2011, the difference had increased to 60% (Whites: $57,150; Persons of color: $35,500). For Black Minnesotans, the figure drops to $25,410. So, despite achievements in legislation to promote equality, the numbers, at least for income, suggest greater, not less, disparity between Whites and Blacks.

In 1960, in Minnesota, Whites and persons of color had very similar rates of labor force participation: Just over half of both groups (who were age 14 and older) participated in the labor force. Fifty years later, the situation shifted: About 78% of Whites (ages 16 to 64) participated in the labor force, compared to 65% of persons of color in that age group.

In fact, Minnesota is currently home to some of the very largest White – Of Color gaps in the nation including disparities in poverty rates (7th largest racial gap among states); proportion of adults working (5th largest); and home ownership rate (the largest gap in all of the 50 states). Unfortunately our “above average” quality of life, regularly touted in national media, while true for the state as a whole, is not shared in all quarters of our state.

Should the numbers discourage us? I don’t think so. Our efforts over the past 50 years have changed attitudes, and we have influenced culture. We have improved life for many, even if we have not succeeded in improving life for all. I remain inspired by Dr. King’s assertion that “I can never be what I ought to be until you are what you ought to be, and you can never be what you ought to be until I am what I ought to be. This is the inter-related structure of reality.”

On that note, we need to persevere. As we make life better for any of us, we make life better for all of us.

Should Homeless People Smoke?

I pondered that question at about 11:30 p.m. on a Friday night in June, while attempting to fall asleep on my cot in the basement of a church I had never set foot in previously, where I served as an overnight volunteer for Project Home.

Project Home provides emergency shelter for children and their families in Ramsey County, by arranging sleeping accommodations and breakfasts in the basements of churches and synagogues. The overnight chaperone socializes with the families before bedtime, tries to get a little sleep overnight, and awakens early to offer the parents and children food before a bus arrives early to take them to a day program.

While chatting on the church steps until the mandatory 10:00 p.m. bedtime, several of the parents smoked, and the secondhand smoke caused me to cough a few times – yes, even in the fresh air. Later on, pondering the effects of the smoke on the kids kept me awake.

An article in the July 18 issue of The New England Journal of Medicine notes that, “Although the prevalence of smoking in the United States has declined, vulnerable and marginalized groups continue to use tobacco at high rates.” The article points out that smoking-related deaths among homeless people occur at a rate twice as high as the rate among people in stable living situations.

Unique challenges do exist with respect to reducing smoking among homeless people – such as above average nicotine dependence, psychiatric conditions, and histories of abuse and trauma, in addition to lack of health insurance which limits access to smoking cessation services.

Yet, my experience that Friday night convinced me we must make reducing smoking among the homeless population a priority.

A 9-week-old baby staying at the shelter, who appeared healthy for the most part, had a raspy wheeze. And despite the fact he had seemingly very loving, caring parents, they were heavy smokers. His mother said that a nurse informed her that tobacco smoke could cause wheezing. I tried to remain supportive, nonjudgmental, so I mildly affirmed the nurse’s comment, even while I choked back my emotions.

A 30-something father talked with pride about his 12-year-old daughter, who accompanied him to the shelter. She had earned all A’s and B’s at school during the past year, despite the lack of housing stability and despite some stressful events involving racist taunting, which she had to endure. The girl demonstrated athletic ability out on the sidewalk. Her father, who smoked several cigarettes that evening, said that she wanted to play two different sports, but her asthma prevented her from engaging in prolonged and intense physical activity. Might the severity of her asthma have some connection to his smoking? I tried to understand why the girl’s father was unable to make the connection between his daughter’s asthma and the smoke he blew around her.

The children in these shelters are precious resources. We know that their environments – family and community – will significantly shape their health; environmental influences of many types will literally add/diminish years from their lives. (See, for example, our report on “the unequal distribution of health”.) So, at a minimum, we should perhaps seek to transform the adage that “your right to swing your fist ends where my nose begins” to “your right to blow smoke ends where a child begins to inhale.”

In 2004, Minnesota State Representative Marty Seifert proposed that welfare clients who smoke cigarettes should have a reduction in their benefits. As the StarTribune reported, his proposal “drew laughs and criticism from Teresa Nelson, legal counsel for the Minnesota Civil Liberties Union. ‘That's pretty wild,’ she said. ‘Certainly, giving up the right to put legal substances in your body should not be a condition of qualifying for government benefits.’”

Well, giving attorney Nelson the benefit of the doubt, I attempted, to no avail, to identify some justification for her assertion. Smoking typically appears as a condition affecting the cost of life insurance, for example. So, what socially responsible value or principle should inhibit  government from taking a life-saving approach for adults and their children, saying: “If you do not smoke, you will receive X amount of dollars, but if you do smoke, you will receive less”? That approach would put pressure on people to engage in behavior which protects their health and the health of others, and we could evaluate its effectiveness.

Financial rewards and penalties constitute just one approach. We probably need multiple approaches, given the complexity of the issue – addiction, psychiatric illnesses, etc. In the case of homeless shelter volunteers such as me, even some coaching about key messages, what to say when a shelter resident lights up a cigarette, might help. Perhaps you have thoughts to share?

In the final analysis, though, we must not deal with this problem by ignoring it. I concur with the authors of The New England Journal of Medicine article, who conclude strongly that we must “change the culture of complacency that has enabled our acceptance of smoking as an inextricable aspect of homelessness. Though the challenges of addressing tobacco use in this population are many, we believe that ignoring this issue is no longer justifiable — and that the conversation should shift away from the question of whether to address smoking among homeless people and toward the question of how.”

"Independence" Day?

The day after the Fourth of July, I encountered a man wearing a shirt which proclaimed: “I built my business. The government didn't build my business.” His declaration of independence very much tempted me to ask:

• Did you build the roads that your customers use to drive to your business, that your suppliers use to bring the materials you need to conduct your business, and for that matter, that you traverse every day, expecting that the traffic lights will work, that the pavements will contain no hazards, and in the event of severe weather, that maintenance crews will plow snow, clear fallen trees, and do whatever else your safe passage might require?
• Did you create the monetary system that your customers use to make purchases from your business?
• Did you hire the teachers who educated your employees?
• Did you create your own police and fire services, to ensure the safety of your business?

It might have proved interesting to engage in conversation that man with the t-shirt, to determine the extent to which he truly believed that he had “done it alone”, although something about his demeanor suggested that he probably would not have opened up to rational dialogue on the matter. In any case, the notion that the “I” succeeds in this world absolutely independently, with no reliance on government and others, is ludicrous.

The American Founding Fathers declared political independence – the establishment of a separate nation. That very act, however, along with the entire American Revolution, relied entirely on interdependence – mutual collaboration among people, organizations, and colonies, to wage war and to establish a new social and economic order.

The next couple of centuries of European settlement in North America involved extensive interdependence (not to mention the years of interdependence among native people prior to the Europeans’ arrival, but that’s a different discussion). Individuals worked in common to create communities, produce goods and services, and form political, social, and religious institutions. Not to say that people always agreed with one another. Sometimes disagreement even turned violent, the Civil War being probably the most extreme division. However, joint efforts, humans engaging with other humans, produced all notable achievements within these United States throughout the course of the nation’s history.

As we confront the challenges of the 21^st century, our interdependence motivates us to recognize our common fate, develop joint goals, and collaboratively forge inventive solutions to social, economic, and environmental issues. Those issues range all over the map: international development; national security; local business development; community crime prevention; affordable, energy-efficient housing; long-term care of the aging; climate change; education relevant to a changing world. You can add to the list of local, national, and international issues that we need to address.

John Donne said it poetically:

"No man is an island,

Entire of itself,

Every man is a piece of the continent,

A part of the main. …

Any man's death diminishes me,

Because I am involved in mankind."

At Wilder Research, we work on issues which call for joint effort, sometimes motivated by an inventive, entrepreneurial desire to improve communities’ quality of life and build a better world, sometimes motivated by compassion to remedy a problem, right an injustice, or eliminate an obstacle that prevents communities from thriving. Our understanding of our interdependence leads to our acknowledgement of the responsibility to do nothing less. Not only does the death of another human being diminish us, so also does their inability to acquire adequate education, shelter, food, or nurturing. Because we are all interdependent.

As we move forward from this Fourth of July holiday – Happy Interdependence Day!

Nothing Stops a Bullet Like a Job

That’s the motto of Homeboy Industries in Los Angeles – an innovative program that serves high-risk, formerly gang-involved men and women.

Ponder that for a moment while considering the following:

• The United States spends more money per person on health care than any other country in the world.
• Among the 34 countries tracked by the Organisation for Economic Cooperation and Development, the United States ranks very close to worst on life expectancy, infant mortality, and child poverty.

What’s the connection between the slogan and these health statistics? Social determinants of health­­­—the range of personal, social, economic, and environmental factors that influence health status.

In the case of Homeboy, it’s palpable. They connected the dots. Economic factors influence crime, including gun violence. Crime and violence produce homicides, injuries, mental health problems, and other ills. By improving economic opportunities, we can reduce crime, thereby improving a community’s health.

What about the seemingly contradictory facts on health care spending and the United States’ poor showing on health status indicators? The lack of correlation between them occurs because health care plays a lesser role in keeping us all healthy than lifestyle, economic status, and environment.

Spending more money on clinicians, hospitals, clinics, and drugs will have only a small impact on our health. We can produce a much larger, community-wide impact by improving economic opportunities, increasing high school and college completion rates, improving the housing stock, and cleaning up the air, just to name a few.

A few years ago, we completed a study with Blue Cross Blue Shield of Minnesota Foundation.   It demonstrated that neighborhoods in the Twin Cities located just minutes away from one another have very different life expectancies. Residents in some neighborhoods can expect to live at least 5 years longer than residents in other neighborhoods. That’s a lot less time to spend enjoying life on this planet, just because you have the wrong zip code.

One way to remedy this situation: Greater collaboration between two types of organizations who share similar missions, but who frequently do not work in unison. The first type, community development finance organizations, such as Twin Cities LISC, include banks and other lending institutions which have financial resources to support construction projects, provide start-up funding for entrepreneurs, and meet other capital needs of public and private organizations. They address health by attempting to improve the environment, reduce poverty, and provide infrastructure for the delivery of health and public health services. The second type incudes public health, health care, and human service organizations that promote health, work on prevention, and treat illness and disease.

While these two types of organizations share a similar vision to improve community health, they do not fully understand one another nor share a common approach. The Robert Wood Johnson Foundation recognized this and began efforts to bring these organizations together.

Wilder Research, in partnership with the Federal ReserveBank of Minneapolis, just released a special report commissioned by the Robert Wood Johnson Foundation which documented how this work occurs, what facilitates it, and what needs to occur to promote success.

We noted a number of promising examples in our report, including:

• Brandywine Center in Pennsylvania, which blended public and private money to build a health center, affordable housing for seniors, community meeting space, and a children's library. (Is a children's library a tool for health improvement? You bet!)
• Preschool Without Walls, in California, which provides early learning activities for low-income parents and their children in libraries, public parks, and at home. This strategy has successfully engaged families previously resistant to early childhood programs; it has improved school readiness.
• Bringing Health Home, also in California, which offers households with young children coupons for local farmers markets in conjunction with workshops on nutrition, preparation of healthy foods, and budgeting. 

We surveyed professionals around the nation in fields related to community development and public health.  To our pleasant surprise, they described a number of existing joint efforts to promote a culture of health in schools and workplaces, increase access to healthy foods, and improve the quality of early education and child care.

Perhaps not surprisingly, we also learned that good leadership, mutual respect and understanding among those working together, shared vision and common goals were at the top of the list of ingredients necessary for success.

Momentum exists to improve health and life expectancy for everyone. To build on the momentum:

First, we need to develop leadership at the national level to nurture collaborative initiatives and build a network for communication and learning.

Second, we need to learn how to work better in partnerships, and gain knowledge and technical skills related to funding and operating cross-sector programs.

Third, we need to build the evidence base for cross-sector initiatives to improve community health. Practitioners should initiate action based on what we know works and does not work.

We look forward to continued work to improve the large scale social trends and the small scale elements of our neighborhoods, which so strongly influence the quality and length of our lives.

35 Years - Older and Wiser

The first week of May, 1978 – where did you find yourself? The Monday of that week, I arrived at 355 Washington Street in Saint Paul (current site of The Ordway Theater), to begin working at Wilder Research, continuing a career dedicated to improving the lives of individuals, families, and communities, through social research. 

• In 1978, Jimmy Carter served as President, with Minnesota’s own Walter Mondale as Vice President.
• The United States had about 223 million residents – who could expect to live, on average, 73.5 years. 
• A first class stamp cost 13 cents; it rose to 15 cents mid-year. 
• Military rebels in Afghanistan murdered both the president and his brother during a coup. 
• The United States began to mint dollar coins with the image of women’s suffragist, Susan B. Anthony. The public largely disliked them, due to their resemblance to quarters. 
• Lesley Brown, who died just last year in 2012, gave birth to the world's first test tube baby. 
• The average cost of a home was $54,800. 
• The first, public, dial-up “computerized bulletin board system” went online in Chicago. 
• 400 of the world’s top climatologists met in Geneva to discuss climate change and if changes in climate were influenced by pollution. 

Clearly, the world has evolved in some ways, but has perhaps remained very much the same in others. The Internet has all but replaced computerized bulletin boards; Afghanistan remains turbulent; many people have not made up their minds about how to address climate change.

You can observe similarities and differences in the practice of social research over the past 35 years – the topics, the findings, and the methods.

In the 1970s, poverty among aging people consumed far more attention than did poverty among children. Social and health programs benefiting the elderly eventually alleviated much of that concern. Meanwhile, as the twentieth century ended, trends in childhood poverty and the condition of children in the United States began to trouble us. Awareness increased regarding the effects of social, environmental, and economic factors upon children – even effects upon early brain development, which occur prenatally.

Some words and issues common today did not appear on the radar screen, or just barely did so, in the seventies. The concept of “diversity”, for example, had limited circulation since at least the 1940s, but had not emerged in general use. Desegregation and affirmative action comprised policy approaches to eliminate discrimination. Racial issues stood as a major threat to the well-being of our communities. However, the notion of a diverse society, building on the collective strengths of multiple races and cultures, just approached the horizon.

The “achievement gap” did not receive the widespread attention it receives today. “Immigration issues” engendered less vitriol. Nobody even cared about the dependency ratio – the ratio of working age people to aging people who need support – given the large number of baby boomers in the beginning phase of their economically productive years. But that has certainly changed now, with the large number of aging and imminently retiring boomers, succeeded by a numerically smaller generation.

Researchers assessed public behaviors, attitudes, and opinions in the 1970s by means of mailed surveys and phone surveys.  With one (and usually only one) landline phone number in each household, researchers could use “random digit dialing” effectively, to produce representative samples of respondents. Today, with the proliferation of cell phones, a large proportion of households without even one landline, and the high mobility of some populations, researchers require new methods to locate survey respondents who will supply credible, representative information.

As I look back at Wilder Research over the past 35 years, what makes me the most proud, personally? It’s probably facilitating the growth and accomplishments of so many talented people – starting with about a dozen Wilder Research staff at the time I became Executive Director, to approximately 100 who serve here today. They carry out 200 or so projects each year, working directly with 150 to 200 organizations – evaluating effectiveness, assisting agencies to develop and improve their work, assessing changes in community trends and the implications of those trends. Wilder Research staff serve thousands more locally, nationally, and internationally by distributing information, sharing reports, training, and advising nonprofit, government, and neighborhood organizations who strive to make their parts of the world better places.

What has remained constant at Wilder Research, not just from the 1970s to now, but since our first study in 1917, is the commitment to provide objective, credible, culturally-responsive research to improve lives and communities.

We have seen that research can enable all people of all types to overcome challenges and live their lives better than if we never asked questions, never challenged conventional wisdom, never provided facts to inform judgment.

We should never and can never give up our searching for answers.

Trying Real Hard...

“You can’t always get what you want”

The number of homeless people does not reflect a situation that we want: More than 10,000 homeless people in Minnesota, including about 3,500 children with their parents, and about 1100 age 21 and under without parents, were counted in our 2012 study.

Our triennial statewide homeless study produces more than this simple tally. Over the next several months, we will report on the backgrounds and characteristics of homeless Minnesotans, for example: how many are mothers, fathers; how many find themselves on the streets because of abuse or neglect or because their family simply lacked the ability to care for them; how many have physical and mental impairments that create barriers to obtaining and keeping a job; how many earn incomes and maintain employment, but their resources don’t suffice in an expensive rental market. This information will be used by the state, service providers, and others to address homelessness.

To paraphrase the Rolling Stones:

“But if you try real hard, you’ll get what you need”

We can never completely eliminate homelessness, especially the short-term, acute variety. Beyond that, however, what about chronic homelessness? How close to zero can we bring the numbers? What should we consider as we “try real hard”?

“Trying real hard” involves a commitment to some short-term solutions - doing all we can feasibly accomplish to provide temporary shelter to house people with different needs. However, the short-term shelter response does not address larger social and economic issues which produce homelessness.

We need to do more; we need to think long-term. Homelessness constitutes a large issue. As concerned community members, we can perhaps feel overwhelmed. So, it helps to break our thinking about solutions into meaningful parts.

“Trying real hard” compels us to distinguish individual causes of homelessness from social-structural causes, and to address each as necessary.  Some of the reasons for homelessness relate to characteristics of homeless people themselves. Other reasons derive from society and the economy in general.

For example, for one portion of the homeless population, poverty explains their situation. With income sufficient to afford suitable housing, they could remain out of shelters. Their individual routes to homelessness include lack of education and job skills. So, if we want to create an effective community solution, we face the task of doing whatever we can to upgrade their abilities to match the needs of available jobs (not jobs in general, but available jobs in our labor market).

However, as skilled as people might be, they will not find jobs unless jobs exist for the finding. Economic development initiatives and job creation initiatives can reduce the rates of homelessness, if they offer employment at sufficient wages to secure permanent housing. We need to recognize that solutions to homelessness do not fall solely within the housing sector. Our business sector, finance sector, and anyone else who can promote the creation of economic opportunities – they all have a role in reducing homelessness.

The path to homelessness can include experiences of violence or abuse. Strategically, we need to sort out the implications. For the currently homeless, we need to ask whether those fleeing abuse or violence require just temporary safety and symptom relief while they recalibrate their life plans, or whether they need more significant help. If they need more significant help, we need to determine how to provide it most effectively and economically. Addressing homelessness long-term, though, means looking beyond the currently homeless, to prevention. Our actions as individuals, as well as our collective actions through policies and programs, to reduce violence and abuse will reduce homelessness in the future.

A portion of the homeless population will require more than just shelter for the rest of their lives. This includes some severely chronically mentally ill people and some people with functional impairments that preclude independent living. For these, we need to continue to enhance the most effective and economical assisted living environments.

Nevertheless, much of the solution does not lie in the strategic and the rational. It does not demand economic analysis and the formulation of strategic plans. A substantial portion of the solution lies in compassion. Merriam-Webster defines compassion as “sympathetic consciousness of others' distress together with a desire to alleviate it.”

A few hours before his death, Thomas Merton, a significant shaper of the conscience of the peace movement of the 1960s, told a conference: “The whole idea of compassion is based on a keen awareness of the interdependence of all these living beings, which are all part of one another, and all involved in one another.”

Interdependence characterizes our community – including the homeless and the non-homeless – whether the connections among us appear obvious or not – whether we have volunteered at a shelter, just driven past one, or don’t even know their locations.

Our homelessness study raises consciousness about others’ distress. To fulfill our obligations as community members, it is incumbent on us to alleviate this distress as much as we possibly can. We can’t always get what we want, but through a combination of rational planning and greathearted compassion we can try real hard to provide to the homeless much of what they need.

Information is Intervention

“Information is Intervention”: Those words describe how, in this Information Age of the 21st century, Minnesota Compass, the Wilder Research-led social indicators project, can produce tangible impacts on the quality of life in our communities, on the health and well-being of every one of us, and on the lives of future generations in our state.

About 130 community and foundation leaders, managers of nonprofit organizations, and others participated in the 2013 annual meeting of Minnesota Compass. The meeting built upon the premise that, in light of the social and economic opportunities and challenges for our state, we need to identify creative, innovative solutions – other than simply “more money” – in order to maintain strong communities and to protect vulnerable populations.

Craig Helmstetter, from Wilder Research, shined a light on our aging population, growing diversity, and large racial disparities in poverty, high school graduation, proportion of adults working, and homeownership.    

The number of people over age 65, many with significant health and social needs, will increase dramatically over the next 15 years. At the same time, there will be fewer working-age people to support older adults, lowering the dependency ratio from 5 working-age adults for every older adult, to 3 working-age adults for every older adult.  However, the older generation will include a lot of people interested in, and fit enough, to continue contributing productively to their communities, if suitable opportunities emerge. That prospect – an increase in needs on the one hand, but an increased potential for older paid and unpaid workers to meet those needs – should motivate us to think innovatively how we harness the constructive energy of the “silver tsunami”.

As for the young people in Minnesota, most of you working to improve the lives of youth already have developed great familiarity with the achievement gap. (Some of you even advised us on the measures we use to track that gap. We thanked our advisors at the meeting; and I thank you again!) The negative implications of the achievement gap lie just a generation away, unless we do something now. As Dr. Helmstetter showed, children of color constitute the fastest growing part of our population. They will become the workforce of Minnesota’s future, the community leaders of the future, and the parents of the future. If children of color cannot achieve in math and reading – if they cannot complete post-secondary education, or even complete high school, at a time when, as The New York Times reports, businesses increasingly demand college degrees for all positions, then we face a serious obstacle to sustaining this state’s economic productivity and its quality of life.

We cannot expect money to help us meet the challenges our communities face in the coming decades. With the federal debt in the teens of trillions of dollars, and with the state budget problem at about $1.1 billion, no new big bucks will begin to flow. Even if we do witness some increase in funding to address the demographic and social challenges which I just noted, it would not suffice to produce the impacts we require.

So, our annual meeting keynote speaker, Alex Cirillo, illustrated how people working to build strong communities can adapt the 3M model of innovation as an effective tool. He explained the importance of including people "not like us" in collaboration and defined key roles: specialists; scouts; architects; adapters. He also explained the potential payoff of looking for ideas that work in one realm, to apply them to another – success factors in agriculture that might work in human services, models in education that could apply in health care, principles of transportation logistics that could assist in channeling volunteers to productive opportunities for service. Some of these thoughts might seem bizarre, but idea links like these can stimulate worthwhile change (and, in the for-profit world, often garner a lot of money!).

Information is intervention. We plan to continue using Compass to change thinking, policies, systems, and behavior – with the ultimate result, a better Minnesota!

You can see more about all of the annual meeting presentations on our Event Spotlight page. Please take a look!

Language Assets, not Limited Proficiency

You have probably heard the joke:

What do you call someone who speaks three languages? Tri-lingual.

What do you call someone who speaks two languages? Bi-lingual.

What do you call someone who speaks one language? American.

Although a joke, it elicits serious questions about whether United States residents, on average, fall below par on multi-lingual ability. It also perhaps relates to the perception that we Americans less often carry a passport than do the people of most other developed countries.

At a meeting this morning with government, foundation, and business leaders, Mayor RT Rybak asked: “Shouldn’t we start to view multi-lingual competency as an asset, rather than a deficit?” A child who speaks a language other than English may need a few years to master the English language. However, the Mayor wondered out loud, once having learned English, doesn’t this child and similar others offer our region some competitive advantages within the globalized economy in which we live?

Greater language facility means greater capacity to understand foreign markets, more ability to communicate with customers in different countries. It means that we can work more efficiently, with fewer errors and greater productivity, in endeavors that require collaboration among people on different parts of the globe.

Speaking two languages, some research suggests, can enhance the “executive function” of children’s brains – that is, the higher level abilities that influence other critical processes such as attention, memory, and motor skills. Executive function enables human beings to initiate and stop actions, to plan for the future, to adapt behavior to changing circumstances, and to form concepts and think abstractly.

Research has shown that students who speak two languages can more accurately solve problems involving misleading cues. In addition, research has indicated that people who know how to use multiple languages, and therefore must manipulate their minds to bring one language to the fore, depending on the situation, develop skills that can support other mental processes and social interaction. Evidence suggests that they can better resolve conflicts; they can more perceptively monitor their environment. A recent study in the Journal of Neuroscience even suggests that speaking two languages might prevent Alzheimer’s and other age-related declines in “neural efficiency for cognitive control processes.”

So, the Mayor may have some good insight. Perhaps all of us should pick up another language, if we want to stay healthy and live longer. And, we should appreciate the collective potential of a multi-lingual Twin Cities, as we move forward in the twenty-first century.

I once printed as many words as I could find in a couple of hours one morning, for the word “peace.” I will print them again:

Paix (French)

Paz (Spanish)

Frieden (German)

ειρήνη (Greek)

和平 (Chinese)

Vrede (Dutch)

Vrede (Afrikaans)

Pace (Italian)

平和 (Japanese)

평화 (Korean)

Paz (Portuguese)

мир (Russian)

أمان (طمأنينة) (Arabic)

Mir (Croatian)

ukuthula (Zulu)

àlàáfíà (Yoruba)

kev sib haum xeeb (Hmong)

nabad (Somali)

Happy New Year, and Thanks, from Wilder Research!

Many of you gave us assistance, support, and advice during 2012. Together, we tried to answer challenging questions about the best ways to meet community needs. We addressed tough issues – racial and income gaps in education and health, increasing access to good child care, addressing homelessness, and other topics. We collaborated with you to improve the effectiveness of individual agencies and of the nonprofit and government sectors as a whole.

We did all of this in pursuit of our mission to improve the lives of individuals, families and communities through research.

One blog post can tell just part of the story. Wilder Research staff worked on 200+ projects last year, directly serving hundreds of organizations who share our desire to transform lives and improve everyone's quality of life. We produced about 3 reports per week, with many of them posted on our website and the websites of others. During our last complete fiscal year, more than 4,100 people attend our presentations; the media mentioned us 215 times; 24,000+ visits were recorded on our Wilder Research web pages; and YouTube tallied 7,650 views of our videos.

Some of our 2012 highlights appear here – which I share out of appreciation for you, our supporters, clients, funders, donors, collaborators, and friends who enabled us to accomplish all of this and much more. (To see the specific information produced by our 2012 research efforts, along with details on who requested, funded, and collaborated on this work, visit our website.)

Improve access to early learning opportunities. Regarding this critical issue for the future:

• A Wilder Research report identified trends and gaps in access to early learning opportunities for the 156,000 low-income children age 5 and younger in Minnesota and described the effectiveness of four approaches to expand access. In April 2012, we held a forum to highlight the policy implications of study findings.

• Wilder Research completed an economic analysis of the value of investing in healthy development and school readiness.
• Both of these studies have supported early childhood funders and advocates in their collective efforts to improve access to early learning opportunities for low-income children. The work of Wilder Research on this topic led to securing a national 3 year grant from the Kellogg Foundation.

Close the achievement gap. Our collaborative research efforts to improve education at the classroom, school, district, and state levels have included:

• A study of Response to Intervention (RtI), an evidence-based framework to identify children’s learning issues and intervene early
• Ongoing evaluation of Project Early Kindergarten, a program in the Saint Paul Schools to improve school readiness among English language learners and low-income children
• Ongoing evaluation of the Positive Behavioral Interventions and Supports initiative which trains schools around the state on evidence-based approaches to improve school safety and climate
• An evaluation of a Saint Paul charter school that is one of the first case studies to document how a school with a predominantly low-income, East African student population addresses challenges posed by being a high-poverty school
• A longitudinal study of STARBASE Minnesota, aimed at increasing low-income students’ interest in science, technology, engineering and math. This study received national attention during 2012.

Identify health inequities and address health system improvements. Several new studies focused on this topic, including:

• Research showing that poorer health outcomes continue to result from both poverty and lower levels of education. The results of this study will help to address the underlying causes that contribute to racial and income health inequities.
• A study which identified health care needs of American Indians living in the Twin Cities area.
• An assessment which documented the role of community health workers to reach Native American, African-American and other underserved populations, and demonstrated the economic value of investing in community health workers.

Integrate mental health and substance abuse prevention systems

• Wilder Research staff serve as the lead assessment and evaluation experts for a federally-funded statewide strategic planning effort to align substance abuse prevention, mental health, and primary care.

Improve the mental health system of care

• Wilder Research manages MN Kids Database, a collaborative, web-based integrated data management system to improve school-based mental health services.
• We have begun a project to explore social indicators of children’s mental health.
• Wilder Research is also developing metrics related to adult mental health services/access in the east metro, and is working to help hospitals conduct mandated community health assessments.

Engage diverse voices to build corridors of opportunity around transportation lines

• Wilder Research undertook research on several projects related to Corridors of Opportunity, working to ensure strong, vibrant communities around seven-major transportation corridors under development in the Twin Cities Region.

Ensure a strong nonprofit sector

A new study on nonprofit mergers by Wilder Research and Map for Nonprofits received attention in July at a Greater Twin Cities United Way Leadership Forum, attended by nearly 600 organization leaders and board members, and philanthropists. This first-of-its-kind study identified concrete ingredients for success, if agencies feel that by merging they can increase their community impacts.

Minnesota Compass: Measuring progress, inspiring action

Supported by a collaboration of private Minnesota foundations, this quality-of-life initiative has become the go-to resource for organizations and concerned citizens throughout the state to inform them about community issues. During 2012, we witnessed the value of a new and comprehensive set of Saint Paul and Minneapolis Neighborhood Profiles, for grassroots and neighborhoods groups working to improve their communities. The profiles, which provide neighborhood-level measures including demographics, housing, education, and workforce, have been accessed more than 7000 times.

 

Also in 2012, Compass accepted a national award from the Community Indicators Consortium and received recognition as “the model others around the world look to” for developing user-friendly community indicators.

Improve early childhood development in the African-American community.

Wilder Research worked closely with the African-American Babies Project, finding a number of risk-factors, including inadequate prenatal care, low-birth weight, and teen pregnancy to be much higher for African-American babies than for other babies born in the metro area. The initiative intends to bring education and services to parents, child care providers, and community members in an accessible, applicable, and culturally relevant way.

Moving forward in 2013

Two events occurred near the end of 2012; you will hear much more about them in 2013: 

• With a statewide group of 1,000 + volunteers, we interviewed more than 5,000 homeless people. Findings will become available during the coming months.
• We initiated the “Speaking for Ourselves” project. About 80 representatives of immigrant and refugee ethnic communities and of the organizations serving those communities joined us to plan a study which will learn more about how immigrants and refugees fare in the Twin Cities. 

Never before has research had such importance – for increasing the effectiveness of organizations serving our communities, and for improving community quality of life. We look forward to continuing our work with you – understanding trends, measuring and improving effectiveness, and empowering all of us to meet our aspirations to do good for the community.