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Bob's Blog: Why This Strategic Direction?
Wednesday, March 5, 2008 | 2:44 PM
Robert K. Ross, M.D.
Our Board of Directors, management team, staff and consultants spent the better part of a year methodically
examining evaluation reports, environmental scans and data trends on a broad range of health issues facing
California. So there is a fair amount of intellectual rigor and logic that underlies our decision to land on
a decade-long "Building Healthy Communities" strategic framework.
But I wanted fill you on the other half of the decision equation here that can't be found in an environmental
scan report: our passion for this work.
At the height of our planning and analyzing period last summer, I grew weary of reviewing charts, graphs and
data trends, and hearing from consultants. I decided that we really needed a dose of authentic voices - from
folks who are struggling on a daily basis with the realities of life in an underserved community.
I called Carla Sanger, the irrepressible executive director of the LA’s BEST after-school program, and asked
her to set up a conversation with a group of parents of kids at an East L.A. elementary school. Over plates
of rice, beans and chicken, I asked a dozen mostly Latino and Latina parents what they needed for their
children to be healthy. For nearly three hours, they spoke of the barriers to optimal health for their kids.
What I heard: The local park was overrun by alcoholic men during the day and drug dealers at night. The streets
were unsafe for the kids to play and get exercise. The city’s parks and rec programs were beginning to charge a
fee for the summer program that used to be free. Graffiti was abundant. The tagging (graffiti) crews were
aggressively recruiting middle-school boys, and these were the "farm teams" for the hard core gangs.
One mother, who I will not forget, told me how she and her husband have managed to steer their three boys - thus
far - away from gangs and "la vida loca". But her middle son was beaten at school by boys from a tagging crew he
steadfastly refused to join. I felt her frustration as she wept: Her son was physically assaulted for bravely
doing the right thing.
We also provide grant support to an equally terrific organization serving at-risk youth called
Youth Uprising in
Oakland. They produced a video entitled "What is a healthy community?" that provided an opportunity for six or
seven adolescents, mostly African-American, to offer their thoughts about what a healthy community means to them.
Several of them described a healthy community as a place where bullets don’t fly, and their friends are not buried
prematurely. Others discussed the sheer lack of positive activities for young people to engage in. A young lady
described the preponderance of liquor-deli stores in the community, where healthy foods are impossible to find.
The strategic direction we have adopted is driven by two forces. The first is the realization that we must hold
ourselves accountable for doing better on behalf of the young people and parents described above - and many more just
like them. Secondly, we are moved and inspired by the community leaders and organizations that are demonstrating
"hope in action" for children and young people in impoverished communities across our state.
California must do better by these young people and their families. And our nation must and can do better.
 We are passionate and hopeful about the positive impact that
so many of our grantees around the state have by working with our youth. Along with parents and community leaders,
they are helping so many young people beat the odds while growing up in distressed and unhealthy communities. But while
heroic tales of "beating the odds" are certainly inspiring, this is not a sustainable reality for the future of our state.
To paraphrase Geoffrey Canada, president and CEO of
Harlem Children's Zone: We need to work to change the odds. And this is what a sizable portion of our "Building Healthy
Communities" strategy is about.
From our colleagues at PolicyLink and the
Prevention Institute we have learned a great deal about the impact of
"place" on health status. We already know from a credible body of public health research more than two-thirds of
what determines health status has nothing to do with the provision of health care services. The key contributors
are what we recognize as the "social determinants" of health: poverty, racism and hopelessness. These factors
feed the heavy burden of disease and despair in low-income communities, and these disease conditions are largely
preventable. But less than 5 percent of our nation’s health spending is invested in prevention.
So with our eyes open, we have decided to stop dipping our feet and jump into the pool on the matter of these
social determinants of health. In the coming decade we will invest in and work with local leaders to transform
distressed communities into healthy ones. Our Board of Directors is willing to commit the lion’s share of our
resources to get this done.
The core strategy here is simple in concept. We will select a limited number of communities for deep and
comprehensive investments in prevention-oriented partnerships. We will help link the leaders and residents of
these communities, and the creativity and lessons they produce, for the purposes of driving a statewide vision
for Building Healthy Communities.
None of this is groundbreaking or innovative as a core strategy. But we have come to grips with the reality that
finding innovation is not the central challenge in our field of philanthropy. Rather, we must be more purposeful
and intentional about how to "scale up" the beauty of an effective idea when we find it. We will rely upon the
lessons we have learned in supporting policy, systems change and advocacy work in our first decade as a foundation.
On behalf of our Board and our staff, we welcome your comments, questions and feedback about our chosen path. This
10-year plan represents our Board’s commitment to challenging, and joining, leaders in California who believe that
a new generation of children in our state must be healthy, safe and ready to learn.
We hope you can appreciate our logic - and our passion - for moving in this direction.
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