MIYO Case Studies: Making Health Our Own

Located in the northwestern-most corner of Washington, Whatcom County has approximately 193,000 residents. In January 2007, some of those residents attended a meeting held by the Whatcom County Health Advisory Board to brainstorm a process for establishing a county-wide comprehensive health plan.

But what would happen next? Susan Sloan and Regina Delahunt thought that what should happen next was involving residents in determining which health issues were most pressing and implementing action plans that would help create a healthier community over the long term. To that end, their project, Making Health Our Own (MHOO), began planning activities that would “establish an ongoing citizen-driven process” ensuring all residents have “the opportunity to mold a community vision for health.”

The MIYO grant award process came along at the right time for the group, which was planning to hold community conversations in conjunction with partners across the county. The goal of these meetings was for groups of residents—including those with “very divergent views”—to identify health issues of importance to Whatcom County residents.

With MIYO support, the group held ten such “Health Counts Community Conversations,” all of which used Open Space Technology. Susan Sloan says:

Using Open Space was a truly citizen-centered approach,” says Susan Sloan, “because it assumed that people are first and foremost capable, and that when given responsibility and a safe environment in which to work they would also become energized and achieve innovative solutions.”

MHOO also held more than 20 focus groups (each of which included various stakeholder populations) and 33 individual interviews with health experts. The result was an exhaustive list of health-related issues, as well as a compelling vision of what a healthy Whatcom county would look like. The plan had buy-in from a wide swath of residents, as well as from leaders of key health and community groups, government officials, and businesses—almost 700 people.

To spur faster action, MHOO adopted a sense of urgency and partnered with several other community organizations already working on specific health issues. It discovered there wasn’t a lot of public interested in communicable disease, which had been the traditional role of the public health department, so this brought other topics to the fore, among them, child health, health promotion, and health and the built environment.

As a next step, MHOO worked with its numerous organizational partners and resident participants to host a Future Search Conference—an effort also supported by the MIYO grant. “We were able to get the whole community in the room,” Sloan notes, “to work on the identified issue of child health—specifically to address the needs of children and youth with special health care needs. This issue was selected in large part because there was the will and energy on the part of many community members to move forward in taking action on this particular issue.”

It also helped that collaborations “were already seen as a good approach to problem-solving in our county,” Sloan says. “We know that new partnerships had emerged from the MHOO process and we wanted to honor the will of the people.”

In spring 2009, MHOO held a successful three-day Future Search Conference to develop an actionable vision for improving supports and service provision for children and youth with special health care needs [CYSHCN]. Conference participants came from education, government, social services, public health, medicine, psychology, non-profits, and youth and families. Out of this conference, Taking Action for CYSHCN was formed and has been moving forward ever since in the form of four action groups, a development team, and a coordinating council. Sloan says that:

The best part of Taking Action is that it truly represents the embodiment of a citizen-driven process.

What have they learned? “Early on, we spent too much money on facilitators,” Sloan notes. “In hindsight, we wouldn’t bring in a professional facilitator until much later in the process, when we are much clearer about what issue we were specifically ready to move forward.” She adds that there is still work to do around getting people to understand what citizen-centered efforts are, because:

...people are still so fixated on top management. The real innovators are grassroots people, not bigwigs!

A partner agency director agrees:

We were so excited to hear about MHOO and its focus on citizen-centered processes because it completely fits what we do and because the health care system now is anything but citizen-centered. Public processes around this issue and system are set up in ways that exclude citizens, and public input comes too late. Now, we’re seeing early listening and a public voice when the question requires more than a yes or no!