The IAF Northwest Health Equity Organizing initiative works with health clinics, residency programs, and students to use community organizing tools and practices to address the social determinants of health - the conditions in our community where we work, live, and play, that have been demonstrated to influence our health far more than medical care. There is immense interest within the healthcare world to address the social determinants, but direct services to individual patients (e.g., housing referrals, food vouchers, resume workshops) are not enough to address community-level issues like unstable housing, food insecurity, unemployment.
In 2009, the IAF Northwest began working with students in the health sciences schools at the University of Washington (UW) to build an organization that would provide a vehicle for them to learn about and apply IAF community organizing practices to address the social determinates of health. Health Equity Circle (HEC) now has over 500 members at UW and chapters in Spokane and Portland. Together, HEC and the Sound and Spokane Alliances developed a class on "Health Equity and Community Organizing" that is offered for credit at the UW and on the WSU Spokane campus. Through HEC or their local Alliance, the students have carried out successful campaigns to protect funding for medical interpreters, expand free clinic care, increase services to the homeless and reduce immigrant detention.
Recently, the IAF Northwest expanded its health equity organizing initiative into work with residency programs and community clinics, beginning with the OHSU (Portland) and Swedish Cherry Hill (Seattle) Family Medicine Residency programs. At Swedish, for example, residents receive 4 hours of training per month equipping them to apply relational community organizing practices to engage patients in their clinics and build “power with” them to identify and address the barriers they experience in realizing positive health comes. The clinics - Cherry Hill, Seattle Indian Health Board, Sea Mar, ICHS and Carolyn Downs - all serve very diverse populations, including the most at-risk populations in the region. At OHSU, clinic organizing efforts are underway at the Richmond and Scappoose sites.
The clinic-based work engages and supports patients in high disparity communities to become active agents in taking more control of their health. It draws on best practices in community organizing and clinical/public health in exercising “power with” to address disparities, starting will engagement campaigns that help patients learn about the range of factors that contribute to health outcomes. Centered on the patients, the whole clinic community then identifies the barriers that they feel have the most impact on their health (and/or that of their loved ones) and makes individual and collective commitments to address the most important and/or most achievable of them.
In addition to the individual or clinic/neighborhood focused action, patients are also equipped to address the larger social determinates of health by developing and/or participating in campaigns through its membership in their local Alliance.