Five perspectives
This article was published as part of the Healthcare Forum's "Healthier Communities Action Kits"
International Copyright 1994 Joe Flower All Rights Reserved
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Phil Newbold, CEO, Memorial Health System, South Bend, Indiana:
Community assessment can be the greatest stalling technique. People say,
"Let's go collect some data." It sounds sensible, but that saps all the energy
and enthusiasm, and two years from now, you're still pushing the numbers
around.
It really doesn't make that much difference what it is you do. If you've been living here five years, and you don't know what the health problems are, you don't need a bunch of consultants to tell you.
And meanwhile the kids are dying. Just pick something and do it. If you want a better handle on what the problems are, talk to the county prosecutor, talk to the ministers, talk to the Welfare Department, but don't spend a couple of years studying and prioritizing.
One raw unvarnished experience with a real human being is worth all the market data in the world. It gets people excited to just go do it, to serve a meal at the soup kitchen or take a shift at a clinic.
We do "plunges," orchestrated for our board members, and other people that we would like to get involved. We target a spot and go down to the area. We get some neighborhood people on the bus. They point out the vacant lots, where they live, the Meals On Wheels, the churches, the Partnership Center, point out here's a prostitute, there's a drug addict. Someone says, "We ought to build a park, get a play structure up, some kind of rec center." And the neighborhood people say, "You want to see a park? Driver, take a left here. Nicest park in the city. No one's used it for two years. The drug guys hang out in it."
That kind of experience is worth all the community assessment and data collection in the world.
Hazel Henderson, economist and author: I can hear where Phil's heart is coming from. We do have to get out there and organize and be active. But there's two things that need saying. First, there's no reason why you can't do both at once, get some projects going and establish a way of measuring how well your community is doing, and where you can improve it. Second: none of it is rocket science. Most of these indicators are already there, the information is around, you just have to identify and use the indicators that have already been done. If you want to know the amount of park space per capita, ask the Parks Department. It need not take that long, and it doesn't have to involve expensive consultants.
Clem Bezold, Institute for Alternative Futures: What this field needs is a sensitive evaluation to help establish what difference these efforts have made, what has worked, to help us make the case. No one has really done that. What we have so far is a wonderful collection of vignettes and anecdotes, and a real sense of process. It would help if we had quantified results to show.
Sean Sullivan, National Business Coalition: Our society lives and dies by statistics. Unfortunately, the results of community building have not been quantified. There has not been good enough evidence that it paid off. Without the numbers, business people have trouble justifying spending money on it
So business people sign on to various kinds of good work in the community, but what they do isn't a piece of a larger, continuing, consistent, well-thought out strategy. They just chip away at the problem
If business could help put together the assessment, they could then use that as a basis for a budget to coordinate private efforts. The place to start is to ask what results you want.
It would behoove us to find the success stories and quantify them. We're trying to do that in our coalition movement, but mostly we hear the negative costs of not doing it. We can quantify the medical costs of gunshot wounds, smoking, alcohol abuse, and so forth, after the fact. If we could quantify a few success stories, we could grab some attention.
Leland Kaiser, Kaiser and Associates: In one of the targeted areas where one hospital is working right now, they have reduced crime by 50 percent. They put in a free clinic, and they are working on projects that take them door to door. It's shown a quick short-term gain. For long-term positive gains we'll have to take longer longitudinal study. We do not yet have such a study.
So go for the short-term and document it, do outcomes research on it.
The cost of one Patriot missile would be a big enough budget to demonstrate the effectiveness of the Healthier Communities movement.