June 16, 2017
Elizabeth Myung Sook Krause, ScM, Senior Program Officer,The St. David’s Foundation
2012 Terrance Keenan Fellow
“So where exactly are the healthiest communities?” I asked during a strategic planning session last fall. The vision of St. David’s Foundation and the beacon for our new strategic plan is to help Central Texas build the healthiest community in the world. It is a big, big vision and my swirling mind wanted to anchor it in an actual archetype.
“The blue zones,” a colleague responded.
That made sense. I had just moved to Austin to join the St. David’s Foundation after 11 years with the Connecticut Health Foundation. Throughout my career, I had consumed a steady diet of national health rankings. I was acutely aware that Massachusetts, Minnesota, Hawai’i—blue states—typically scored highest. But true as that was—and as much as I had consciously disciplined myself to listen without preconceived notions—in that moment I committed the fallacy of the sunbelt transplant. Blue zones are not blue states. Check your assumptions, y’all.
The blue zones are the areas of the world—like Okinawa, Sardinia, and Loma Linda—where people live longer, healthier lives. Several bestselling books about blue zones are available a click away. I must have been on a fiction kick when they made their splash.
Do we aspire to be the healthiest community in the state? Think bigger. Do we aspire to be the healthiest community in the nation? Keep going. Some days I ask myself if it is grandiose to hold a pie-in-the-sky vision during changing, uncertain times. Most days I ask myself, “who are we not to have a big vision?” I wake up each morning motivated to get us one step closer. It is through our big vision that we lead and inspire collaborators. And in return, this vision serves us in rather practical ways, as we shift into our new strategic plan.
Our big vision serves the way we communicate. I have daily opportunities to share this vision and I do so with a glint in my eye. One does not need a degree from the Lyndon B. Johnson School of Public Affairs at the University of Texas to understand. It disarms and then invites. Whether it is an executive director or a new neighbor, people quickly grasp the value proposition of our vision and either see themselves as actors or stakeholders in it. That is when we shift to listening for how they want to contribute.
Our big vision serves the way we allocate community investments. In order to be the healthiest community in the world, we invest in the healthiest care, healthiest places, and healthiest people. As a foundation with a history of supporting access in a state with entrenched barriers, health care will remain part of our legacy. Yet, we know we simply cannot make strides toward heathiest community status without shifting more of our resources to fund what it takes to keep people healthy. An omnipresent conscience whispers “80 percent of health status is determined outside the clinic,” in our ears and our vision helps us grapple with the dissonance.
Our big vision serves the way we advance equity. While it may be generations away for some of our communities, others enjoy superb health today. The data bears this out and ground truthing bears it out. Let me tell you, being new has reminded me how useful a listening tool ground truthing is. I regret not using it more when I was seasoned. Come stroll with me along the trails of Lady Bird Lake (breakfast tacos and green juice are on me) from Austin’s affluent west side to its historically underserved east side and see for yourself.
Austin’s success story has been widely told (see U.S. News & World Report and Forbes #1 place to live 2017), but there is another truth. Poverty is becoming suburbanized as the city grows unaffordable. We are losing longtime Black residents. There are rural communities 50 miles away in which only half the population has access to exercise opportunities and one in four adults is uninsured. Because St. David’s Foundation believes good health returns great benefits to the community, we are bolstering health assets in the areas where our neighbors need them most.
Something St. David’s Foundation shares with other GIH Funding Partners is that we are all working to help make our communities healthy. However, there can only be one healthiest community in the world. With time, my bet is on Central Texas. Is this a throw down to other funders? I’m not saying it’s not.