Investing in Health Equity

Grand Rapids, MI is using data to improve health and equity in their community.

ARTICLE | Oct 28, 2019

Contributors: Becky Jo Glover & Alex Melton, City of Grand Rapids and Samantha Breslin, MPA Project Coordinator, City Health Dashboard, Department of Population Health, NYU School of Medicine

Grand Rapids is one of the fastest-growing U.S. cities with economic opportunities for businesses. We’re consistently ranked among the best cities to start a business and we top national lists for best places to call home, raise a family and retire.

This does not tell the whole story, though. Communities of color struggle to thrive here. We rank among the worst large U.S. cities for African-Americans economically. Nearly 40% of African-Americans in our city live in poverty. They are three times as likely to be unemployed as whites. More than 40% of Hispanics and Latinx live in poverty, and they are more than twice as likely to be unemployed.

We knew we had to shine more light on these inequities and barriers to quality of life.

What We Did

To address these issues, we have begun to integrate an equity lens into everything we do at the City –  from fixing infrastructure to improving health and well-being. This is not simply a promise we have made to our community stakeholders – it is a commitment and deliverable that City Manager Mark Washington has deemed a priority across all levels of government. Equity is embedded in our three-year Strategic Plan. And, in a partnership with Kent County, we are beginning to implement Health in All policies. This is an effort to integrate health, well-being and equity into the development and implementation of policy and programs not traditionally health-related.

As one of the 500 most populous cities in the U.S., we were selected as a City Health Dashboard community. Launched in 2018, the City Health Dashboard is an online resource that provides city- and neighborhood-level data on more than 35 measures that address health, such as diabetes and frequent mental distress rates, and the conditions that shape health, such as housing affordability and unemployment, for the country’s 500 largest cities. This easy-to-use and feature-rich website displays its measures through interactive maps, tables and charts with the goal of helping communities target their resources to drive change and improve health neighborhood by neighborhood.

The data we have accessed through the City Health Dashboard has been a catalyst for integrating data-driven decision-making throughout Grand Rapids, particularly as it relates to our equity story. Dashboard data has been embedded into metrics we plan to report out on in our strategic plan to make sure we are accountable.

Data – dashboard data in particular – have been useful as we begin to bring diverse stakeholders to the table to improve health and equity throughout our city. We’re working with Invest Health, a national cross-sectoral initiative whose goal is to improve health outcomes through targeted public and private investments in underserved areas. Our project team, comprised of representatives from health care, government and community development, seeks to invest in areas where we can have the largest impact. The dashboard provides the level of granularity and visualization necessary to identify patterns, make connections between different issues and establish a shared language with diverse stakeholders about the importance of factors that shape health.

Since launching in 2018, Invest Health already has made great strides toward improving health and equity in these communities. Here are a few exciting stats:

  • Increase in low-income housing tax credits in 2018, resulting in more than $50 million worth of credits – about 30% of the state’s available credits – to projects located in Neighborhoods of Focus The Neighborhoods of Focus, identified by the W.K. Kellogg Foundation, are 17 census tracts with higher poverty, higher unemployment and lower rates of educational attainment than elsewhere in Grand Rapids
  • Spectrum Health invested $730,000 into Invest Health-related projects since the start of Grand Rapids’ involvement
  • Affordable housing partner, LINC Up, received a $500,000 grant from NeighborWorks’ Project Reinvest initiative to support affordable housing projects and efforts to connect residents with construction opportunities

These represent initiatives and data related to only one of six strategic priorities in our Strategic Plan. We knew we needed a repository to store, dynamically use and visualize both internal and external datasets. We had an open data portal, but we needed more robust functionality to track and measure the breadth of performance metrics developed in the Strategic Plan. Through interdepartmental partnerships, we procured Socrata to provide us with the functionality and transparency to carry out the Strategic Plan. The GR Digital Team has developed out all the metrics and is working on projects to integrate more datasets from City departments and partner organizations.

Lessons Learned

We would not be where we are today if we had ventured to do this work alone. Our idea only materialized because we had developed internal buy-in from leadership. We did this by eventually integrating the importance of data in the Strategic Plan. But it started by sharing the story of data’s power. We visualized individual department’s data to show them the possibilities – how to simplify, make processes work for humans, save time and tell their story. We developed the data groundwork to build on our data story and develop buy-in from leadership. 

Looking beyond City Hall, we developed partnerships with various organizations and coalitions to build connections across datasets and make more meaningful analyses and more effectively impact the root of the issues our city faces. These partnerships are vital to expanding the possibilities of what we can achieve for Grand Rapids. When we are inclusive, we expand the capacity for us all to leverage diverse expertise toward solving tough challenges. In Grand Rapids, this has made all the difference.

Organizational Strategy, Culture’s Role

Our organization has been in a state of shift over the past year. We have a new City Manager and we’ve adopted the City’s first Strategic Plan of its kind. The Strategic Plan has developed a new depth of performance management tracking across the organization and opened an opportunity to further embed data-driven decision-making across the organization. Leadership has tasked the organization with disaggregating all performance metrics by demographics to embed equity in everything we do. The timing is ripe for change, and we’ve heeded the call by also launching an Innovation Team (iTeam). The iTeam seeks to uplift, advocate for and act on the City’s value of innovation across operations by developing a culture of innovation.

We’re in the absorption stage now – absorbing everything we can learn from others who do innovation well.  As we take in these findings, we’ve begun making connections on how to interpret and transpose these learnings to fit the needs of various City departments and initiatives. By shifting the organization’s culture even further, our goal is to adequately assess and address the work needed to address the inequities and barriers to quality of life in our community.

 

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