Wanted: Big Ideas for Improving Health

Dell Med’s Center for Place-Based Initiatives looks to find local solutions to local problems, then offer those solutions to other communities that might need them.

The effort could improve health not just in Central Texas, but across America.

The concept is simple: Identify local solutions to local problems. Support them — then scale up.

The Dell Medical School’s Center for Place-Based Initiatives is issuing a call for ideas aimed at improving the health of vulnerable communities in Central Texas, especially those in Austin and other parts of Travis County. This is the first of what organizers say will be a series of twice-yearly calls to build on grass-roots innovation that creates healthier communities.

The goal is to elicit from residents, community and organizational leaders, businesses, employers, and public and private stakeholders the raw material that academics and industry experts will then use to build their agendas, working with the ideas’ originators to refine and implement innovative solutions informed by the lived experience.

“People’s social and living conditions directly impact their health,” says Paula X. Rojas, a licensed midwife and community organizer who is the Community Equity Strategy Consultant for the Department of Population Health at Dell Medical School. “That makes those living in a community some of the truest experts in the best ways to enhance the health of their community.”

The call for ideas is the first major initiative for the Center for Place-Based Initiatives, which was created through a grant from the Michael & Susan Dell Foundation. It builds on the idea that lived experience can drive health solutions that matter: In China, loosely associated groups of female retirees known as “dancing grannies” gather at twilight to square dance, exercise that mitigates organizers’ reported feelings of isolation. And in Austin, Mama Sana/Vibrant Woman — which Rojas co-founded — offers culturally specific group support, education and resources aimed at improving pregnancy and birth outcomes while supporting leadership development in communities of color.

People’s social and living conditions directly impact their health. That makes those living in a community some of the truest experts in the best ways to enhance the health of their community.
Paula X. Rojas
Community Strategy Team

Support for Scale

For Lourdes J. Rodríguez, DrPH, giving voice to grass-roots experts isn’t just a job. It’s a passion project.

“Fixing something that’s broken is a lot more expensive than nurturing it so that it doesn’t break,” says Rodríguez, DrPH, who directs the Center for Place-Based Initiatives, part of the Department of Population Health. “I want to invest in nurturing health, and that’s going to take more than just the input of physicians and nurses and other health practitioners. That’s something that we all do together.”

Early in her career, Rodríguez worked on the Northern Manhattan Community Voices Collaborative, a partnership of 30-plus institutions, community-based organizations and local healthcare providers. The group strove to improve health in northern Manhattan by addressing the problems of uninsured and underinsured people. Initiatives included building a pediatric asthma support system, combatting the “twin epidemic” of obesity and diabetes, and making more healthcare resources available online. As its name suggests, the effort relied on community voices and collaborative methods to inform its approach.

But Community Voices didn’t have the institutional support it needed to sustain this model of improving local health first and foremost, Rodríguez says.

Creating solutions that are scalable — that are informed by the life experience of people in Central Texas — is a central goal of the Center for Place-Based Initiatives and the medical school as a whole. Dell Med is one of only a handful of medical schools in the country with a department dedicated to population health. Its creation reflects both the responsibility and the opportunity that the people of Travis County created in 2012, when they voted to increase property taxes in order to support better health (and, by extension, the medical school).

“We were birthed by the taxpayers of Travis County, and that makes this community a key part of our DNA,” says Dell Med Dean Clay Johnston, MD, PhD. “It gives us a responsibility to help create a vital, inclusive health ecosystem here. With that also comes an opportunity to create really innovative models in community partnership that can act as an example everywhere.”

Lourdes J. Rodríguez, Director of the Center for Place-Based Initiatives, in her office on the University of Texas campus. In the foreground, submissions in response to the center’s call for ideas are tracked on a poster. They are represented as leaves on a tree — a deliberate choice that Rodríguez says represents the number of ideas she hopes to receive.

Finding Direction

Bill Tierney, MD and Dell Med’s chair of Population Health, says the call for ideas will help define the initial direction of the center. The department is taking responsibility for the health of the county, Tierney says, and the initiative is one of several initiatives he envisions to improve it.

“What we’re doing is opening up a channel to identify and legitimize ideas that come from people other than the ones that are typically heard: researchers and clinicians,” he says.

The idea is to match those ideas to data that suggests pressure points in a population’s health, in hopes of addressing those issues that drag on the health of communities. It’s an egalitarian process — everyone who submits an idea gets feedback, regardless of whether a proposal is selected for additional support.

Carmen Llanes Pulido, community director for GO Austin/VAMOS Austin in the city’s Dove Springs neighborhood and a member of the Community Strategy Team, emphasizes the vital role that individuals play in helping to make their communities healthier.

“Voicing ideas through this process demonstrates that residents are indeed the experts of their communities. They possess the knowledge, lived experience and concrete insight into ways of improving health, and the Dell Medical School can potentially provide resources to bring their ideas to fruition,” she says. “This is an opportunity to show that not only nonprofits and established institutions, but also organized neighbors and families, can design change and leverage resources from institutions like the medical school for the common interest in working upstream for community health.”

Lourdes J. Rodríguez, Director of the Center for Place-Based Initiatives, and Community Strategy Team member Carmen Llanes Pulido participate in GO Austin/VAMOS Austin’s event in Dove Springs to encourage physical activity and better nutrition.

Ofelia Zapata, a resident of Austin’s Dove Springs neighborhood who works with Austin Interfaith, is organizing a team to respond to the call for ideas. Zapata, who is blind, is president of the Parent Teacher Student Association at Eastside Memorial High School, where she says a lack of access to care keeps students facing health challenges out of class. Sometimes, it delays their graduation. Sometimes, it blocks it altogether. 

“We need our students and their families to have access to health care,” Zapata says. “That access will improve student learning — and the graduation rate. Healthier kids mean a better future.”

She pauses, then adds, “I can’t physically see, but I do have a vision.”