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5 Questions for...Karen McNeil-Miller, President, Kate B. Reynolds Charitable Trust

April 07, 2015

They are communities which nurtured many of us and to which many of us return when we want to recharge and reconnect. The fact that they are rural and removed from the economic dynamism driving the revitalization of urban areas across the country also means they often lack the capital  financial and human – needed to improve the circumstances of people who call them home. That organized philanthropy, like much of corporate America, finds it relatively easy to overlook such communities further complicates the situation.

One foundation looking to change that dynamic is the Kate B. Reynolds Charitable Trust, a philanthropy established in 1946 by Kate Gertrude Bitting Reynolds, the wife of William Neal Reynolds, chairman of the R.J. Reynolds Tobacco Company, to improve the health and wellness of low-income residents of North Carolina. In March, PND spoke with Karen McNeil-Miller, the trust’s president, about Healthy Places North Carolina, a new place-based initiative focused on rural areas of the state.

Headshot_karen_mcneil-millerPhilanthropy News Digest:  The Reynolds Charitable Trust has always supported efforts to improve the health of North Carolinians. What's new about Healthy Places NC?

Karen McNeil-Miller: Well, for us, almost everything. For instance, we're not leading with money, which is a huge thing. We're not going into these communities saying, "Here's our agenda, apply for a grant." We're going into these communities and, essentially, are trying to help them organize themselves. In a way, we're leading from behind instead of leading from in front. The trust is deferring its goals to the goals of the community; we want the community to determine what it needs or what it would like to change, and then we'll bring our resources to bear to help them achieve those goals.

PND:  Beyond a lack of resources, what are some of the challenges unique to rural communities that you aim to address through the initiative?

KMM: Well, one of the things we want to address is the building of human capacity. These days, it's hard to get folks to move to rural communities, which means if you want to help these communities thrive, you have to build the leadership capacity of the people who are already there. 

We also want to help them, where we can, with access to care. In so many rural communities, you may have a primary care physician or two, but hospitals and specialty care are much less common. So, through the initiative, we've been helping community-based organi­zations invest in tele-health infrastructure, whether it's tele-psychology, or tele-therapy, or even tele-osteo­pathic medicine. 

Of course, one of the most plentiful assets in rural communities is land. So helping communities make the best use of their land assets, whether it's through building an amenity like a playground, or bike or walking trails, or any of the other things that make communities more livable and healthy, is something we're interested in.

What's harder to address is job creation. But if we can help local people see the connection between physical and mental health and economic health and help them build their capacity to partner with local government to create the kinds of amenities that help attract jobs and improve quality of life for everyone, that will be big. We want everybody to start thinking that health is their business, not just the purview of healthcare institutions. It's about broadening the conversation to people who don't normally see themselves in the health business, to people in law enforcement, to people in the educational system, to business and industry, and bringing them all together to talk about what they can do to make their community the healthiest community possible. 

PND:  You've awarded about $20 million in grants to projects in half a dozen counties. Can you give us an example of a project that has met or exceeded your expectations?

KMM:  Sure. We're partnering with a national organization called KaBOOM! whose vision is an America in which every child has a playground within a mile of their home. Now the physical playground is important in and of itself, but it's not the only benefit of what KaBOOM! does. When KaBOOM! builds a playground in a community, it involves the community from the get-go, working with community members to decide where the playground should be, involving local kids in the design of the playground, requiring the community to generate some of the funds for playground construction, and enlisting community members in the actual building of the playground.  A play­ground is the tangible result at the end of the process, and we see and know that those playgrounds are being used, not just by children but by parents and grandparents who are coming out with their children and grand­children and building social capital with their neighbors and people they see around town but may not necessarily know or talk to. We're also seeing the tangible results of kids having a safe place to play in their neighbor­hoods and being more active.

Another example is communities adopting the Nurse-Family Partnership model, an intensive home-visitation program that works with first-time low-income moms starting at about the eighteenth week of pregnancy right up through the child’s second birth­day. Research on the model shows that moms in the program tend to delay their second pregnancy more than non-participants, that the birth weight of babies born to moms in the program is better, that the develop­mental milestones children need to meet are achieved on time, that more moms return to school, and that moms are in a better position to parent their children because they have a better understanding of the critical role they play in the development of their kids. So we're excited about those initiatives as well.

PND:  You've announced that you plan to invest a total of $100 million in the Healthy Places initiative over the next decade. Does that mean you'll be expanding the number of communities involved, awarding follow-up grants to some or all of the projects that have already received grants, or both?

KMM:  All three. We plan to expand the init­iative to ten to twelve of the most economically and health dis­tressed rural counties in North Carolina and expect to have all counties up and running by the end of 2017. Including what we've spent since 2014, it's going to be a $100 million, maybe even $150 million investment of our re­sources in programs, services, and capacity building that communities say they want. And we will continue to invest in all those communities over at least the next ten years.

PND:  Are you open to collaborating with other funders from North Carolina, or even large national funders?

KMM:  Absolutely. In fact, we're counting on that. We're counting on that because we don't have the resources to do it alone. So we're counting on local funders, we're counting on the state to join us as a funding partner, we're counting on regional funders, on national funders, we're counting on the communities themselves. We are looking to bring any and all like-minded institutions who want to help these rural communities lift themselves up and create better health outcomes for their residents. We want everybody at the table.

You know, one of the things we've learned about rural communities is that they tend to be tight knit. We can't just come in and expect people to defer to us. In many communities, the folks don't know who we are and don't particularly care who we are. We don't have the kind of credibility and name recognition that you might in a more urban setting that has lots of nonprofit infrastructure. That means we've got to build relationships, we've got to engage with people in a real, significant way; we've got to give them agency, give them a voice. Otherwise, we're just another group coming in to try to fix them. And, believe me, most of these communities don't see themselves as needing to be fixed.

– Mitch Nauffts 

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