By Katherine Schaff, Alameda County Public Health Department; Robbie Clark, Causa Justa::Just Cause; Alexandra Desautels, Alameda County Public Health Department; Tammy Lee, Alameda County Public Health Department; Tram Nguyen, Alameda County Public Health Department; and Muntu Davis, Alameda County Public Health Department
The Alameda County (CA) Public Health Department (ACPHD) strives to ensure the optimal health and well-being of all people. However, staggering inequities in health continue along lines of place, race, and class.1
As an example, by 2006, subprime loans generated one trillion dollars for the banking industry, while people of color experienced a loss in wealth of an estimated $164 to $213 billion from 2000 to 2008—the greatest loss of wealth to communities of color in modern U.S. history.13 This massive redistribution of wealth portends poorer health for current and future generations.
ACPHD built partnerships with community-based organizations (CBOs) to address local housing and foreclosure policies as one strategy to achieve health equity. This article exemplifies how local health departments (LHDs) and CBOs and residents can influence and draw attention to larger issues that generate health inequities.
Coming Together to Rebuild Neighborhoods, Restore Health
Given the disproportionate impact subprime loans and the foreclosure crisis had in African-American and Latino communities,2,3,4 Causa Justa::Just Cause (CJJC), a multi-racial grassroots organization working to achieve justice for low-income San Francisco and Oakland residents, began holding Tenant Rights Clinics to fight illegal evictions and utility shutoffs. ACPHD recognized utility shutoffs would directly affect health and partnered with CJJC on the issue.
From this initial collaboration, CJJC and ACPHD released Rebuilding Neighborhoods, Restoring Health: A Report on the Impact of Foreclosures on Public Health. Combining primary data collection and stories from community members, the report exposed both individual and community-level health impacts of foreclosure and amplified the voices of residents negatively impacted by foreclosures.5,6
Ongoing Partnering for Success
CJJC and ACPHD sent the report to key allies and policymakers at the local, county, state, and federal levels and coordinated events to draw media attention to the impact foreclosure has on health. The report included 11 policy recommendations that helped guide continued joint work. At the same time, ACPHD launched its “Place Matters” initiative, building staff capacity and infrastructure to address policy.7 CJJC and ACPHD stayed connected through the Place Matters Housing and Economics Workgroups even when there was not funding for a specific collaborative project.
This partnership led to several significant outcomes:
Local and State Policy on Utility Shutoffs Rentals account for a substantial number of properties facing foreclosure.8
Because landlords and banks stopped making water payments on foreclosed properties, tenants faced water shutoffs. CJJC organized advocacy efforts and ACPHD provided testimony and letters to policymakers, helping enact a local resolution to prevent water shutoffs. CJJC used the report to support organizing at the state level, helping pass SB 1035 in 2010, which supported an end to utility shutoffs by allowing utility companies to place liens on properties for delinquent bills, holding landlords and banks accountable.9
Vacant Property Registration
The Place Matters Housing Workgroup, CJJC, and other partners collaborated to ensure passage of Oakland’s Vacant Property Registration Ordinance, which netted the city over $1.6 million in its first 18 months and helped reduce blight by mandating that banks register and maintain foreclosed properties.
Linked Banking Ordinance
CJJC and the Place Matters Economics workgroup collaborated with the City of Oakland to update its Linked Banking Ordinance to include requirements that banks disclose detailed lending data, including any ties to predatory financial services located in Oakland. To highlight the links among banking, foreclosure, and health, ACPHD’s Health Officer and Director, Dr. Muntu Davis, wrote an op-ed about responsible banking and health in the Oakland Tribune.10
Virtual Blight and Habitability Tour
In May 2013, CJJC led a “Virtual Blight and Habitability Tour” in front of Oakland City Hall, using ACPHD data and tenant testimonies to highlight the need for resources for housing code enforcement. CJJC, the Place Matters Housing Workgroup, and many partners also released the report Housing, Health & Habitability in Oakland: A Factsheet for 2011–12, with recommendations for stabilizing Oakland’s neighborhoods, preserving a healthy housing stock, and ensuring better city services for the residents made most vulnerable by institutional decisions related to foreclosure and banking policy.11
Building Partnerships for Health Equity
Staff from both organizations describe several lessons learned and benefits from the continued partnership to address housing and economic issues that affect health.
Partnerships
LHDs can partner with CBOs to conduct research and advocate for change to address the social issues that affect health.
Robbie Clark from CJJC states, “It has been good to use our different positions as organizations to advance things from areas of strength.” CJJC brought people power, campaign knowledge, and a deep understanding of housing issues. Engaging local residents to take collective action is essential for moving policy solutions forward, and CBOs, free from the restrictions placed on government, may be better equipped and have more experience in this area.
ACPHD staff have data and policy analysis skills, and the health lens brings a sense of objectivity, credibility, and urgency to issues. To engage in partnerships that include policy change and community organizing, LHDs need to develop internal infrastructure and staffing support, including reliable points of contact, clearly stated priorities, and individual relationships with partners.
Building Trust and Transparency
Partnerships are most likely to succeed when built on trust, mutual respect, and power sharing. Communicating about capacity and process is an important aspect of strong partnerships.
Both LHDs and CBOs adhere to internal decision-making processes. LHDs will also have processes for taking a position on a policy, testifying, or speaking to the media. Clark shared that CJJC understands that such processes are part of working with a governmental organization and that ACPHD staff are clear about the processes and ensure that they do not delay action. In addition, coming to consensus about the goal of a collectively created tool or report is an essential step in role clarification.
Building Staff Capacity and Leadership Support
LHD staff need to be politically savvy to navigate difficult situations and bureaucratic constraints. LHDs can hire staff experienced in or build staff capacity for campaigns and advocacy, policy analysis, community organizing, and social justice work. ACPHD benefitted by having a framework12 that includes analysis of the role of power in driving social and health inequities; such frameworks align with those used by many CBOs that are engaged in community organizing, racial justice, and policy change. Having support at a high level within ACPHD has also given validity to the work and helped advance agendas through bureaucratic processes.
Broadening the Lens
A health lens can broaden the political dialogue and create opportunities to advocate for change from a new, powerful perspective. Clark states that there are “widely held beliefs around health and people’s right to health, as well as the responsibility of our local government and politicians of protecting the health of residents.” Partnering with CJJC has given ACPHD powerful allies who can advocate for the important local government role in addressing health inequities, increasing much needed political support for this type of initiative.
Advancing Goals
CJJC and ACPHD create opportunities to advance both organizations’ goals with joint projects; for example, door-to-door surveys can mobilize and engage residents. In collecting primary data for the report, ACPHD developed a sampling plan that emphasized rigorous scientific standards and provided an opportunity for CJJC to advance its goals while connecting with residents.
Conclusion
LHDs are charged with examining, maintaining, and protecting the public’s health and safety. While the context for each LHD will differ, foreclosure has emerged as a threat to public health in communities across the country. For ACPHD, partnering with local organizations like CJJC to explore and address foreclosure and housing through multiple and connected strategies of community organizing, policy change, and strong partnerships has meant winning real policy successes, informing the public of the health impacts of banking decisions, and thereby increasing capacity to tackle health inequities.
References
1. Beyers, M., Brown, J., Cho, S., et al. (2008). Life and death from unnatural causes: Health and social inequity in Alameda County. Oakland, CA: Alameda County Public Health Department.
2. Rugh, J.S., & Massey, D.S. (2010). Racial segregation and the American foreclosure crisis. Am Sociol Rev, 75(5):629–651. doi:10.1177/0003122410380868.
3. Foote, C.L., Gerardi, K., Goette, L., & Willen, P.S. (2008). Subprime facts: What (we think) we know about the subprime crisis and what we don’t. Federal Reserve Bank of Boston. Retrieved April 1, 2013, from //ideas.repec.org/p/fip/fedbpp/08-2.html
4. Tatom, J. (2008). The U.S. foreclosure crisis: A two-pronged assault on the U.S. economy. Rochester, NY: Social Science Research Network. Retrieved April 1, 2013, from //papers.ssrn.com/abstract=1194975
5. Phillips, D., Clark, R., Lee, T., & Desautels, A. (2009). Rebuilding neighborhoods, restoring health: A report on the impact of foreclosures on public health—preliminary report. Oakland, CA: Causa Justa::Just Cause, Alameda County Public Health Department. Available at //www.acphd.org/data-reports/reports-by-topic/social-and-health-equity.aspx
6. Phillips, D., Clark, R., Lee, T., & Desautels, A. (2010). Rebuilding neighborhoods, restoring health: A report on the impact of foreclosure on public health. Oakland, CA: Causa Justa::Just Cause, Alameda County Public Health Department. Available at //www.acphd.org/data-reports/reports-by-topic/social-and-health-equity.aspx
7. Alameda County Public Health Department. Place matters. Retrieved Nov. 28, 2013, from at //www.acphd.org/social-and-health-equity/policy-change/place-matters.aspx
8. Pelletiere, D. (2008). Renters in foreclosure: Defining the problem, identifying solutions. Washington, DC: National Low Income Housing Coalition. Retrieved Dec. 7, 2013, from //www2398.ssldomain.com/nlihc/doc/patchwork.pdf
9. Causa Justa::Just Cause. New state law keeps water on for East Bay tenants in foreclosed properties. Retrieved Nov. 27, 2013, from //cjjc.org/en/news/51-housing-justice/150-new-state-law-keeps-water-on-for-east-bay-tenants-in-foreclosed-properties
10. Davis, M. (July 26, 2012). My word: Council amendment helps city select the best-performing bank. Oakland Tribune. Retrieved Dec. 16, 2013, from //www.insidebayarea.com/argus/ci_21168983
11. Causa Justa::Just Cause. (2013). Health & habitability report 2013: Housing, health, & habitability in Oakland. Oakland, CA: Causa Justa::Just Cause. Retrieved Dec. 16, 2013, from //www.cjjc.org/en/news/51-housing-justice/532-health-habitability-report-2013
12. Alameda County Public Health Department. Framework for health equity. Retrieved Dec. 12, 2013, from //www.acphd.org/media/46517/barhii_chart_20080903.pdf
13. Rivera, A., Cotto-Escalera, B., Desai, A., Huezo, J., & Muhammad, D. (2008). Foreclosed: State of the dream 2008. Boston: United for a Fair Economy. Retrieved Dec. 6, 2013, from www.faireconomy.org/files/stateofdream_01_16_08_web.pdf