A Minneapolis neighborhood improves health from grassroots up

Lee Younger isn't a doctor, but he makes daily rounds through the halls of his Phillips neighborhood apartment building, checking on the health of neighbors and offering help and support.

"I make sure they don't suffer from too much isolation, and encourage them to get out and walk,'' said Younger, who is 81. "It's about social cohesion and ... connectedness with other people. I probably get more out of it than they do."

Younger has been making his rounds for more than six years as a volunteer with the Backyard Initiative, a health improvement experiment in south central Minneapolis. Driven by volunteers and encompassing a wide range of activities — from exercise classes to youth mentoring — the project represents a novel strategy that redefines health and health care.

Last year, it reached more than 8,000 residents, or about 20 percent of the population in the seven neighborhoods that make up the Backyard.

Its beginning, however, was not so auspicious.

It started in 2008 as an effort by Allina Health to improve the health of residents in its "backyard'' — the neighborhoods that surround the nonprofit's corporate offices near Lake Street and Chicago Avenue. Armed with data showing high rates of chronic disease, Allina planned a series of surveys to measure resident health over time as the initiative progressed.

But it ran into opposition when Allina began talking to community members about its plans. Tensions boiled over at one key meeting attended by top Allina officials and about 70 residents.

"People were angry and distrustful of corporate leadership," said Atum Azzahir, executive director of the Cultural Wellness Center, one of the organizations that is leading the effort. "They just thought it was another corporate research project and that it wasn't going to ... benefit the residents."

Allina soon realized that to make the project work, it not only had to get the community to buy in, it had to rethink its entire approach.

"There had to be a 180 of this project," said Ellie Zuehlke, Allina's director of community benefit and engagement. "We really needed to listen to the community residents."

Allina brought in the Cultural Wellness Center, a nonprofit with deep roots in the community, to lead conversations and refocus the initiative on health projects designed and run by the residents themselves.

Known as Community Health Action Teams, these groups organize around specific topics, such as growing and distributing local vegetables or home cleaning using natural products. There's also a teen group that helps run the initiative's resource center at the Midtown Global Market and has launched a project to reduce consumption of sugary drinks.

"It was designed so that the residents were the agents of change rather than the target of change," said Ruth Olkon, manager of community programs for Allina.

Zumba, yoga, potlucks

At the heart of the initiative is a focus on building community, especially between different cultures, ending isolation and seeing health as something more than just the absence of disease.

"We all have a connection to each other,'' said Azzahir. "If we can sustain that connection we are going to feel better and we are going to take care of each other."

One team, Out in the Backyard, started as a way to reduce isolation within the gay and lesbian community, but also to forge ties to other groups. It runs a full schedule of popular and free Zumba and yoga classes, supplemented with special workshops, such as self-defense, and community potlucks.

"It is a LGBT-led group, but here we have a melding of cultures," said Minda Garcia, who was introduced to the Zumba class through her gay nephew. "This group keeps people well. It helps them physically, but also mentally and socially."

Since she started taking Zumba classes 18 months ago, the 47-year-old Garcia has lost 35 pounds and found the motivation to run several marathons.

Another participant, Polly Kellogg, 73 and a self-described "couch potato," could only sit and move her arms when she joined the class two years ago after a health scare.

"My health is better than it has been for decades," said Kellogg, who now moves to the Latin music standing up. "It has done things for my zest, my vigor and strength."

Gretchen Musicant, Minneapolis Health Commissioner who sits on two Backyard Initiative advisory panels, said the project appears to be breaking new ground.

"There are examples across the country of health systems working with community, but not in this way," she said. "It really demonstrates the idea that health is so much more than health care."

So far, Allina has invested $5 million in the initiative and has pledged another $600,000 for the next two years.

An evaluation of the initiative is being wrapped up, but so far it shows that participants in the programs report greater social connectedness and higher levels of health empowerment.

Volunteer Robert Albee leads another of the teams, a Place for Diabetics, to provide peer support for neighbors with the condition.

The group runs five weekly meetings, four of them for Somali language speakers. University of Minnesota researchers are studying health outcomes for about 100 participants of the groups to measure effectiveness of the peer approach.

Albee says the group is helping reinvent the nature of health care.

"We're not relying on doctors, nurses or certified anybody to do this," he said. "People do better when they have people who care for them. We'll care about you until you can care about yourself."

Reporting for this story was supported by a grant from the Commonwealth Fund through the Association of Health Care Journalists.

Glenn Howatt • 612-673-7192