March 24, 2017
The San Joaquin Valley is a testament to the troubling social, environmental, economic, and health divides that exist between individuals and communities living within relatively close proximity to one another. A mere three-hour drive from California's prosperous coastal communities, the Valley is home to a multi-billion-dollar agricultural industry, but many of the children who live there go hungry. And while the need for food assistance varies across the state, it is highest in the Valley. Data in our recently released report, California's San Joaquin Valley: A Region and Its Children Under Stress (32 pages, PDF), show that eight of the counties in the Valley are among the top nine agricultural producers in the state, and that seven of these same counties are among the ten counties with the highest child poverty rates. What's more, in six of the Valley's nine counties, over 40 percent of residents are enrolled in Medi-Cal, the state's health insurance program, while one in four schools do not have access to clean drinking water.
California also is home to more than two million undocumented immigrants, 10 percent of whom live in the region. Immigrants make up 42 percent of the agricultural workforce and 11 percent of the region's overall workforce, and emerging evidence shows that recent policy efforts have placed their safety, health, and emotional well-being at risk. In combination, these inequities place residents of the Valley at greater risk for negative, often preventable health outcomes such as childhood asthma, diabetes, depression, cancer, and trauma.
While California has provided leadership on some of the nation's most pressing health and racial equity issues, the San Joaquin Valley has been left behind. In fact, the Federal Reserve Bank has called the region "the Appalachia of the West." To address the complicated mix of challenges facing Valley communities, Sierra Health Foundation launched the San Joaquin Valley Health Fund (the Fund) to build and support a network of community organizations committed to promoting resident voices, ideas, and agency aimed at driving policy and systems change at a regional level. With an initial investment from Sierra Health Foundation and The California Endowment, the Fund is managed by The Center, a nonprofit created by Sierra Health Foundation to bring people, ideas, infrastructure, and resources to bear on the challenge of eradicating health inequities across the state. Among other things, The Center helps communities access proven practices, tap their existing knowledge and creativity, and act collectively to create the political will necessary to put their ideas into action. The investment fund is now a partnership of nine local, regional, state, and national funders, including The California Wellness, Rosenberg, W. K. Kellogg, Blue Shield of California, Wallace H. Coulter, Dignity Health, and Tides foundations.
To date, the Fund has announced grant commitments totaling more than $4.5 million to support local community organizations. This year, the Fund will support a network of sixty-eight organizations with investments totaling nearly $3 million, but there remain many worthy organizations whose participation we are unable to support.
The Fund's model brings grantees into a "learning community" cohort where organizations develop solutions to address inequities through a policy and systems change lens. Through the Fund, our nonprofit partners receive modest grants to strengthen their capacity to engage in collective advocacy while building relationships, receiving technical assistance, and sharing best practices. As a result, the fifty-eight nonprofits currently working with the Fund have agreed to support a regional policy platform that employs a social-determinants-of-health approach focused on access to health coverage, early childhood investment, affordable housing, environmental health, and employment.
In our model, grantees are equal partners who contribute to the Fund's goal by agreeing to be mutually supportive and civically active. A powerful example of what this looks like on the ground occurred last month with Equity on the Mall, a day of advocacy at the California State Capitol. Despite heavy rain, more than a thousand San Joaquin Valley residents traveled to Sacramento to make their case for what it is needed to make California a "Golden State for All." The bipartisan list of speakers included Senate president pro tem Kevin de León, Assemblyman Devon Mathis, California secretary of health and human services Diana Dooley, and Michael Tubbs, the first African-American and youngest person elected mayor of Stockton. Community residents presented their multi-strategy policy platform to state leadership, putting their elected leaders on notice that "Valley communities are mobilizing and will no longer be overlooked, marginalized, or behave as though they have no ability to exert political influence."
Through the Fund, we are learning new lessons about the power of organizing to make meaningful and sustainable change at scale. And we are shining a light on inequity in the health, social, and economic outcomes of different regions within our great state, while contributing to solutions designed to address them. Our goal is simple: to ensure that our community partners are at the forefront of efforts to identify and lead on the issues that will require political support and systemic changes to be implemented. We have been heartened by the response of our partners who say the approach of the Fund is significantly different from that of other funders, who have come to the Valley with their own agenda rather than listening to the priorities of residents. The Fund's model works for and with residents, with a shared vision of a healthy San Joaquin Valley for all.
This work continues to evolve, but it is well positioned to inform similar strategies in other under-resourced and overburdened regions. We encourage others to join with us to expand our impact in the Valley and, by doing so, create new models for addressing inequity and inequality across the country.
Chet P. Hewitt is president and CEO of Sierra Health Foundation and The Center, an independent nonprofit developed and supported by the foundation. To get involved or to learn more about the San Joaquin Valley Health Fund, see www.shfcenter.org/sjvhealthfund.