This month, Mid-Iowa Health Foundation welcomed Dr. Nalo Johnson as President and CEO. In this introductory interview, she shares what she’s looking forward to in this philanthropic leadership role and how her public health lens aligns with and can help further the Foundation’s vision for children and families in our community.
I believe strongly in the community wealth model—that partnership between the public sector, private sector, nonprofits, and philanthropic organizations—in order to address community needs. I have spent most of my career in the public sector and am very familiar with the levers and resources available to try and affect community change. Coming to the Foundation provides me an opportunity to see how the philanthropic sector works. I'm excited about what additional levers or resources may be available to bring to the table to address community health needs. I imagine that it's not only from a funding standpoint, to be able to invest in initiatives, but also from a network standpoint, bringing partners together around an issue to learn and problem-solve together, as well as having access to other resources you wouldn’t necessarily have in the public sector.
As a public health professional, I feel I greatly align with the Foundation because I really view its framework as a public health framework. Its strategic vision talks about applying a health equity lens to addressing a broad spectrum of barriers and social determinants of health with an emphasis on systems-change work. This is how I have practiced public health. The question we need to be asking is: What does health equity look like? I view health equity as taking a health-disparities reducing approach to the work. I think the Foundation already invests in this, particularly through the HealthConnect Fellowship with the broad spectrum of organizations and areas of focus represented through this opportunity.
From the internal perspective, I would say I am proud of the professional development strategy I fostered with our team. Having a 100-person team overseeing many programs means you have a lot of different work going on. Everybody is busy and focused on their own areas of interest and expertise. I was proud that we brought everyone together to create a common language and understanding around things like the “10 Essential Public Health Services”, “health equity,” and “social determinants of health.” This not only increased our capacity as public health professionals but also built a better understanding of the work that's going on in one another's programs, so that we could be more collaborative in reducing health disparities within the populations we serve.
From the external standpoint, I'm most proud of standing up community-based systems-change models that aren't necessarily the norm for the state health department. This includes how we developed and implemented projects by being in conversation with community members and organizations that are serving health disparate populations.
A good example is the project we are working on with Oakridge Neighborhood to develop and conduct a community health and well-being needs assessment. The project will use the assessment findings to connect residents to the department's current chronic disease, health promotion, nutrition, and physical activity resources. What I really love about this project is that it came about because, earlier this year, Oakridge CEO Teree Caldwell-Johnson explained that she had interest in doing a well-being assessment for the Oakridge community. When I later saw a CDC funding opportunity with a similar goal, I contacted her, and we were able to work with the Polk County Health Department, United Way of Central Iowa, and The Director’s Council to bring the project into being. This project built off the Director’s Council One Economy Report that identified the Black community in Polk County experiences disproportionately greater disparities across the broad spectrum of the social determinants of health. Our project focuses specifically on the Oakridge Neighborhood population to see what we can learn and then will use that information and experience to make further connections for the broader Polk County population. This approach is much more targeted in helping people get the resources that truly help improve their health and well-being.
Another example of this community-based, systems-change approach is with our Title V Community-Based Doula Project for African American/Black families. Looking at our maternal health data, we saw disproportionate health outcomes in maternal mortality and morbidity for Black-identified birthing people. We worked with local Black maternal health professionals, including certified doulas, Certified Nurse Midwives, and evaluation specialists, to develop a culturally congruent, community-based doula program to offer to our Black-identified Title V participants. This project, of which Mid-Iowa Health Foundation supported, not only seeks to reduce maternal health disparities in our state, but also diversify our perinatal workforce by supporting Black women going through the doula certification process as well as certified lactation specialist process. Most importantly, it seeks to use the project findings to build the case for Medicaid and private insurer reimbursement for doula services, thus positively impacting ALL birthing persons in Iowa.
I feel like the Oakridge Neighborhood Project and the Title V Doula Project are standing up models for the state health department for how they can do community-based work in a way that they haven't really explored before.
One of the things that really attracted me to the Foundation was its language around systems change. You can't truly address your community needs without systems change. With a commitment to systems change, I think the organization is stating that it’s not here to just fund one-time opportunities that make everybody feel good, but to invest in efforts to actually change people's lives in our community. So that's very exciting to me.
As a public health practitioner, I bring a data-driven understanding of the picture of health in a community: Who is disproportionately impacted and what can we identify as being connected to causing that disproportionate impact? It also means that I'm looking at evidence-based and promising-practices strategies for solutions. It’s being intentional about where it makes sense to put investments, but then also what those investments should look like to be able to evaluate impact. Those are all things that I think are useful to supporting that broader systems-change goal, because you're identifying through data where the needs exist and then identifying the evidence base, so we know what type of solutions can provide us the most impact. It’s easy to create greater collaborative buy-in to an effort – across political, social, and economic lines – following that type of public health approach.
It’s also critical that in order to be successful in addressing community health needs, we need to involve community members who are experiencing the disproportionate impact in every stage of our process – in the problem identification, the solution development, the intervention implementation, and discussions of outcome or impact of any effort.
I grew up in Des Moines, but I've been gone for a very long time. I was very excited to come back because I wanted my kids to be introduced to all the things that I loved growing up in the area. And of course, we've been here through COVID, which has definitely impeded my ability to go out and introduce myself in all the ways that I normally used to do. I'm really excited about this role, because I think it's going to allow me to catch up after the past two years under the COVID experience. I am very much looking forward to being in community with folks again!
Teenagers in jumpsuits lying on yoga mats, their eyes closed, their bodies still. This is the image Megan Hoxhalli describes as remarkable for juvenile detention, a place where youth arrive shaken, dysregulated, and scared about their future.