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Advancing Equity in Two Florida Communities

By Phil Bors on February 8th, 2017

A Conversation with Laureen Husband

Today’s shifting political environment has increased urgency in the struggle for equity. New federal policies will impact the resources we have to address critical community health challenges. So more than ever, we count on the helpful perspective, optimism, and wisdom of friends and colleagues who have partnered with Active Living By Design (ALBD). I was refreshed by a recent conversation with Laureen Husband, who assured me that authentic resident engagement will always be an essential practice for community health.

Laureen directed the collaborative work of Healthy Jacksonville, which the Duval County Health Department formed with many partners and became part of the Robert Wood Johnson Foundation’s 2008-2012 Healthy Kids, Healthy Communities (HKHC) initiative. Still active today, Healthy Jacksonville aspires to impact all Jacksonville residents and, in an effort to reduce health disparities, emphasizes the city’s Health Zone 1, a neighborhood distressed by high poverty, unemployment, chronic disease, heavy traffic, and other barriers to health. Healthy Jacksonville pushed for better access to recreation by opening up school grounds to the public and creating a safer, more walkable transportation system. The group also increased access to healthy food by working with farmers’ markets and child care centers and expanding community gardens and urban farming.

With varied experience and a background in education, data, and local public health, Laureen strongly believes in the value of meaningful resident and youth involvement. Laureen was born and raised in Kenya, where she became the avid runner she is today. You can learn more about her leadership development here on page 34.

Since the HKHC initiative ended, Laureen has transitioned from her job in Jacksonville to a new role as Director of Community Health Services at the Volusia County Health Department, home to Daytona Beach and 15 other municipalities. She oversees WIC (Special Supplemental Nutrition Program for Women, Infants and Children), Tobacco Free Volusia, the Community Health Assessment process, and the Community Health Improvement Plan. Laureen still lives in Jacksonville and is a devoted advocate for health equity.

What lessons should inform our work toward health and equity in communities?

The things that survive are those with the greatest community engagement. I learned this lesson even before coming to Jacksonville. It was true there and is also true in Volusia County.

For example, a local nonprofit partner called the I’M A STAR Foundation (IAS) grew from a group of passionate teens, who, after reviewing the results of the Youth Risk Behavior Survey, pushed to change health indicators for their generation. Betty Burney was the Duval County School Board Co-Chair at the time, and formed IAS to empower young people in creating the change they wanted while helping to keep them in school. The youth have decided what new issues to address, like improving the lives of homeless students and hosting the annual Let’s Move Jacksonville event.

Last year, IAS partnered with the Jacksonville Transportation Authority to set up a weekly produce market in the center of a food desert. Even the Surgeon General, Vivek Murthy, visited the youth to honor the work they’ve been doing. Right now, I’m helping them plan the opening of a new urban farm so they can sell their own produce. This is what can happen when young people are engaged and determine how to help their own community. It’s our job to support them with coaching and resources.

What are some lasting city-wide policy and environmental “imprints” left behind as a result of Healthy Jacksonville’s work?

During HKHC, Complete Streets was just an idea. Now, we have new Context Sensitive design standards and updated land use codes. We urged the city to involve stakeholders broadly. They not only got input from businesses and freight companies, but also residents who use the streets every day. One of the most important elements was to ensure that all intersections were ADA (Americans with Disabilities Act) compliant. Having wheelchair users at all planning meetings and on street audit teams was critical. Now the city has a committee that regularly advises the Jacksonville City Council, reviews policies, and pushes for implementation of the updated design standards.

And when we helped the Jacksonville Farmers’ Market get SNAP-EBT coverage for customers, our partners encouraged State Representative Reggie Fullwood and State Senator Audrey Gibson to champion healthy food access. In 2015, the Florida legislature passed a law requiring all farmers and flea markets to provide SNAP-EBT technology. We know it’s just a first step, but it has given momentum to other state initiatives, like healthy food financing, that are still a work in progress.

You made a big transition from Jacksonville to Volusia County. How have you adapted your approach?

While Volusia is not a big county, it has 16 municipalities, and the disparities from one community to the other are stark. Some neighborhoods range in average life expectancy by 20 years!

Looking at my work through an equity lens, I strongly believe in the power of community. When I first arrived in Volusia, I was responsible for facilitating the development of the Community Health Improvement Plan (CHIP). After a careful stakeholder engagement process, we are now vetting the plan with communities and organizations, and we’re accountable to communicating that we’ve heard them. My experience from HKHC in Jacksonville helped me acknowledge their priorities. For example, we are returning to a small town church, where we conducted community meetings, to share final county-wide priorities. We still try to support community priorities that don’t make it to the final CHIP.

What other new approaches have you learned that advance health for Volusia’s most vulnerable residents?

Our health officer, Patricia Boswell, encourages staff to take our services into the community. We’re seeking MOUs with community groups like churches and schools and are hiring people in immigrant communities to work as lay health advisors. Residents are excited to see this happen outside the health clinic. We recently hired two teenage girls to work in the WIC program with peers around teen pregnancy. We’re also partnering with mental health providers to help us better serve the community. I’m witnessing public health at work through local partnerships.

Internally, we are looking at how we unintentionally create barriers to residents accessing services. Through training, we help team members who interact daily with patients be better at relating to them holistically, by asking not just about their medical condition, but also about their other needs. When mothers come in for WIC, they are also asked about dental health. And when our team goes out for a well-water inspection, we can ask, are there other signs of poor health or risk, like domestic abuse or unsafe swimming pools in people’s backyards?

How have you adjusted to the shifting political environment?

I have to be vigilant for people who are most affected by the decisions of those in power. Change is a constant in our lives, but with every change, we’re also presented with opportunities. This is an exciting time to be in public health; our health means everything, and I can relate everything I do back to health. I’m still hopeful because of the work of youth and the incredible people I meet through my job every day. I have yet to encounter a problem that others haven’t helped me solve. I believe in the power of community.

Phil Bors

Senior Project Director

Community collaborator, enthusiastic brainstormer, and devotee of down time