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Is climate change the newest social determinant of health?

Environment, Health

Shamar-Bibbins_QA_HealthySpacesbyDesignAs Senior Program Officer for Environment at The Kresge Foundation, Shamar Bibbins is responsible for grant making that helps communities build resilience in the face of climate change. This includes managing Kresge’s Climate Change, Health & Equity initiative, a multi-year effort that seeks to mobilize a strong constituency for equitable climate action within health care institutions, among health practitioners, and among community-based advocates in a way that is responsive to the needs and priorities of low-income, urban communities.

Sarah Strunk, strategic advisor for Healthy Places by Design, talks with Shamar about her commitment to health, equity, and the environment, and how they’re inextricably linked. Read on for highlights from their conversation.

We’ve learned more and more about the social determinants of health and their impact on quality and length of life. David Fukuzawa, managing director of Kresge’s Health Program, recently said “climate change is the newest—and arguably most important—social determinant of health.” Could you elaborate?

Climate change is a threat multiplier. It’s impacting people in real ways—right now. Extreme heat, more frequent and extreme weather events, and rising sea levels degrade air and water quality, threaten food supplies, and put homes in danger. All of these factors contribute to diminished health and well-being. On top of this, a long legacy of segregation means people of color and people with low incomes disproportionately bear the impact of climate change. As we work to create solutions, it’s critically important that we acknowledge and address how climate change exacerbates social, economic, and health inequities.

Your commitment to helping communities build capacity to become more resilient is notable. Why is it important for communities to be resilient, and what are some of the key ingredients?

Resilience is often viewed as the ability to “bounce back” from a disaster. Instead, we like to think about building resilience so communities can bounce forward. A resilient community puts relationships front and center. Neighborhoods—even less affluent ones—recover faster when neighbors know each other and can use those connections to help one another. Empowered neighbors with strong relationships can more effectively influence decision makers. Our work at Kresge is unique because we build capacity among a range of leaders, from community-based grassroots leaders to local government staff. Community members most impacted by climate change know what their needs are, and they have the solutions. So it’s critical to build leadership to ensure their voices and priorities are central when it comes to decision making. At the same time, we’re helping city staff, such as sustainability directors and water utility managers, become more adept at addressing climate change and equity.

Like you, we at Healthy Places by Design know that grassroots leadership is essential for communities to address their biggest challenges—especially for an issue as complex as climate change. But people in formal positions of authority can be reluctant to share power. Can you offer a bright spot from your experience?

Some of the most exciting work I’ve seen is when community advocates and local governments build together. For example, through Kresge’s partnership with the Urban Sustainability Directors Network and Movement Strategy Center, we convened 13 city-based teams for all-day workshops designed to increase collaboration between community-based organizations and local governments for more equitable and effective climate-resilience planning. Our goal was to accelerate the implementation of solutions that meet the needs and visions of impacted communities. The community organizations and local government staff had to submit a joint application, so there was already a desire to deepen collaboration. They also had to be willing to “roll up their sleeves” and dive deep into their cities’ challenges and opportunities. Many participants said they accomplished more during those workshops than in months of work at home.

Kresge’s Climate Resilience and Urban Opportunity Initiative (CRUO) was a pioneering investment that helped communities shift local, regional, and state climate policy and planning efforts. What were some of the biggest challenges and lessons learned?

We launched CRUO in 2014. It was a five-year, $29 million effort that prioritized work led by advocates and organizers in urban communities facing disproportionate environmental burdens. We began with one central question: Would cities adopt better policies and practices to advance climate resilience if organizations deeply committed to equity were given the resources to fully participate in the policy-formation process?

We are releasing the evaluation report by December 13 (be sure to check our website!), but here are a few of our key insights:

  • First, the evaluation affirmed the value that community-based organizations grounded in equity bring to climate-change work. The organizations achieved meaningful policy wins in their local communities, regions, and at the state level. So, we’re pleased about our role in supporting these amazing organizations.
  • However, the time-limited nature of grant initiatives doesn’t always align with the time required for systems changes. (I was new to philanthropy in 2014, and that’s been a hard reality!)
  • Climate affects everything: health, housing, education, economics, and more. We’ve had to expand our focus of what constitutes “climate work” as communities identify their priorities.
  • We need to be flexible and adaptive. We came into the work with a theory of change, but then the work itself changes. For example, midway through the grant period, many of our communities were struggling with deportation threats, so we had to adjust accordingly.
  • Policy change is just the first step. There’s so much work to be done after policies are passed to ensure they’re equitably implemented.

Like many philanthropies and nonprofits (including Healthy Places by Design), the Kresge Foundation is transforming its policies, programs, and practices to actively advance equity. In addition to the initiatives we’ve discussed, what else are you working on?

Within the Environment team, we launched a Racial Equity Learning Pilot Program in 2018 for our grantees. The focus was on strengthening capacities to help individuals become agents of change to advance their equity and climate-resilience work. This touched hundreds of people, and it’s been very well received. Organizationally, Kresge is on an amazing journey to deepen our diversity, equity, and inclusion (DEI) work. We are deeply exploring the relationship between equity, particularly racial equity, and the Foundation’s Urban Opportunity Frame. Each of our teams had expressed equity to various degrees within their program strategies for several years, but there was no shared analysis across the Foundation. We worked with Race Forward, which provided training for the entire staff, including our executive team. We’re deepening our conversations through all-staff retreats, workshops, and film screenings. We created KORE (Kresge Operationalizing Racial Equity), a group of employees who are responsible for implementing equity-focused pilot projects in areas such as procurement and grant making. We’re also normalizing conversations about race and racism. This hasn’t been easy, but it’s important work that is changing our culture!

How can all of us do better?

Don’t let perfect be the enemy of good. Start wherever makes sense, and continue to push to have conversations. Equity is an ongoing process. You can’t just check the box. Then, add the accountability needed to move from talk to action. Finally, don’t be afraid to ask for help. While everyone may be starting from a different placewe all should approach this work from a learning stance with patience, empathy, and humility.

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