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Spotlight on Equity - All in Almeada
435 Plays1 year ago
We recently sat down with Dr. Larissa Estes White, the Executive director of All IN Alameda County. Launched in 2014, ALL IN Alameda County helps Alameda residents meet their basic needs related to food, shelter, safety, healthcare, and access to quality educational and economic empowerment opportunities that promote self-sufficiency. They do this by recognizing the role that racism and discrimination play in creating persistent poverty, especially among communities of color.
ALL IN Alameda County's primary focus has been increasing access to nutritious food. They have worked on this issue in several different ways, including:
- Leveraging healthcare to increase access to healthy foods by also addressing food insecurity and improving chronic conditions
- Creating local food farmacies
- Engaging in neighborhood-based policy and advocacy
- Developing food recovery programs.
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Transcript
Introduction to Equity Series
00:00:00
Speaker
Welcome to No Kid Hungry Center for Best Practices Spotlight on Equity Series. My name is Brianna Webster-Campbell, and I'm the Director of Education and Training for the Center for Best Practices. Today's Spotlight on Equity conversation features Dr. Larisa Estes-White from all in Alameda County.
Equitable Meal Access and Impact
00:00:20
Speaker
Throughout this country, we know that kids with access to healthy meals learn better. Unfortunately, communities of color and economically marginalized communities
00:00:29
Speaker
suffer disproportionately when it comes to food insecurity. We are highlighting equity practices and policies from school districts and organizations across our nation that are making efforts to eliminate disparities. By highlighting these districts and communities, we hope to provide a roadmap for those who are just getting started and for those who wish to do more.
Collaborative Poverty Alleviation in Alameda
00:00:53
Speaker
All in Alameda County is a wonderful example of how government and community can work hand in hand to help alleviate poverty within their own community. The first question is really just to tell me about your organization and how you all started working or how you all started kind of on your own equity journey because I think you all are probably much further along than a lot of organizations.
00:01:18
Speaker
My
Dr. Estes-White's Role and County Initiatives
00:01:19
Speaker
name is Dr. Larisa Estes-White. I am the Executive Director of All in Alameda County, which is based in Oakland, California. All in Alameda County was launched in 2014 on the anniversary of the war on poverty by Alameda County Supervisor Wilma Chan. In an effort to address issues of poverty across, in an effort to address issues of poverty across Alameda County and the focus areas for this work have been ensuring Alameda County families
00:01:49
Speaker
are able to meet their basic needs for food, shelters, safety, and health care, access to quality educational opportunities, and access to economic empowerment opportunities that promote self-sufficiency. And within that, recognizing the role that racism and discrimination have played in creating persistent poverty, particularly amongst communities of color.
00:02:18
Speaker
In the establishment of All In, it was born out of her office as a supervisor, which is county-level government, and eventually merged with a group that was working on children's health issues and moved into the county government in the county administrator's office, so the highest level of administrative government within Alameda County, California.
Policy Influence and Food Security Initiatives
00:02:46
Speaker
And what that did is it allowed us to have a dynamic where there was an opportunity to influence policy and programs coming out and being recommended by the governing body, as well as having an administrative connection to influence the administrative armaments. So what are the agencies like social services, like healthcare services doing around poverty? And we're governed by a very large 37 member committee
00:03:15
Speaker
which features representation from community residents, elected officials, nonprofit initiative, and non-county governmental leaders. And what this body really does is it explores the different areas that each organization is working on or collectively coming together to identify priorities to move forward as it means to, as it means to an end of addressing issues of poverty.
00:03:44
Speaker
So our primary focus has really been around food and access to food, food insecurity, and taking on food issues from several different perspectives, one being healthcare and leveraging the healthcare space to increase access to healthy, nutritious foods while also addressing food insecurity and chronic conditions. We've done more
00:04:13
Speaker
local food pharmacies where we stand up, work with the food bank, stand up farm stands at local clinical settings. We've also done some policy work in neighborhood advocacy. And then finally, food recovery, so where you're looking to retain food that is still consumable and redirected from waste to folks that are hungry and needed.
00:04:41
Speaker
And we've done other work around youth homelessness, early care and education access, preparing kids to be ready for kindergarten. It's been quite remarkable all the work that we've done. And we've embarked more recently on looking at a circular food economy. And so how are we promoting job access, well-paying jobs, especially out in the Bay Area, access to land,
00:05:07
Speaker
to just grow healthy food and keep that food and entrepreneurs employed and that money really circulating within the food system as well as the economy in Alameda County. That's great. That's a lot. Tell me about the award that you all, the one that I initially saw that made me realize, wait, I need to talk to her about what they're doing.
Health Equity Award and Food as Medicine
00:05:34
Speaker
Yeah, so the award was from the Alameda Health System Foundation. And it's a health equity award for the work that we were doing for Food is Medicine or a recipe for health initiative. So Food is Medicine is a clinically integrated food security health outcome model.
00:05:56
Speaker
um, work with federally qualified health centers, um, train up their physician in clinical staff on Buddhist medicine strategies. And we work with them to then, uh, do food prescriptions that previously families used to have to go pick up in the clinic. Now we do doorstep delivery thing and, you know, an innovation, thanks to COVID, um, where they receive
00:06:22
Speaker
up to 16 weeks, 16 servings of fresh produce for up to 16 weeks. There's another component of it though, that's called the behavioral pharmacy, which is a space and it was a physical space now it's virtual, where people learn how to, that are enrolled in the food prescriptions, learn how to eat better, be more physically active,
00:06:49
Speaker
um, self-regulate or co-regulate. So the stress reduction and then, um, social engagement. So avoiding social isolation. And, um, you know, when you are told by your doctor, you need to lose weight, you need to exercise more. That's all the doctor says. And so whatever you're in a position like, um, living in a low income neighborhood where you don't feel safe outside walking.
00:07:13
Speaker
For whatever reason, you don't have a sidewalk. There are no streetlights. Your neighborhood doesn't feel safe. I don't have access to fresh produce in the same way. And so it's like, how do we package that? And this is done by an organization called Open Source Wellness. How do we package that in a way that people can come to a physical or a virtual space and get that knowledge as to this is how you can be physically active in your home.
00:07:41
Speaker
Like let's talk about meditation and self-regulation. Let's talk about, you know, let's engage with each other to avoid the social isolation that the pandemic especially has brought on. And those have been the behavioral pharmacy we feel has been kind of the secret sauce that has helped lead to decreases in emergency department visits as well as hospitalizations. We've seen decreases in systolic blood pressure, decreases in depression and anxiety scores.
00:08:10
Speaker
And I do want to acknowledge this has been for adults specifically. I was going to ask, yeah. We are exploring looking at pediatric populations.
Medicaid and Food Coverage Efforts
00:08:19
Speaker
Probably the most, so we have gone to five clinics total in Alameda County. Okay. All federally qualified health centers, all with high percentages of diverse populations. But the biggest innovation was we were able to successfully advocate
00:08:37
Speaker
for food to become a covered benefit under our state Medicaid waiver. So the food prescriptions, as well as the behavioral pharmacy, which is like nutrition education and counseling and support wraparound services, as well as the physician training has all been wrapped up into a single cost that we are going to be working with a managed care organization
00:09:04
Speaker
to reimburse for under the Medicaid waiver. So food will be covered for those who get food prescriptions through this program. And our hope is that we can scale it across the region and across the state, but even more so, we've been actively engaged in conversations with Congresswoman Barbara Lee's office, HHS Secretary Javier Becerra, as well as other leaders
00:09:33
Speaker
uh, in Congress on like the white house conference on hunger and really trying to elevate how a clinically integrated approach like this can support and how you can actually pay for it using Medicaid dollars so that you are increasing fruit and vegetable servings, but you're also addressing some of these downstream health issues that are costing the system so much more. And if you look at the cost differential between a bag of groceries versus a prescription, the impact is huge. Yeah.
00:10:03
Speaker
and it's all about access. Yeah, that is great.
Economic Shifts and Poverty in Diverse Communities
00:10:07
Speaker
Congratulations on that. Yeah, so can you speak a little bit about the specific communities that your programs are serving? Sure, so Alameda County is across the Bay from San Francisco and you often see a huge, I guess, social economic status of folks and that has now shifted as people
00:10:33
Speaker
San Francisco got very expensive. People start moving east, which moves into Oakland, Hayward, San Leandro, and even further east. We've got families that are even being pushed out as far as Stockton, so your Central Valley, Stockton, Fresno, due to just the huge influx of money from tech. And many of the neighborhoods that we serve are neighborhoods of concentrated poverty.
00:10:59
Speaker
West Oakland, West and North Oakland, which were very prominent in the 60s and 70s with the establishment of the Black Panther Party. Deep East Oakland, which has been historically black. Ashland and Cherryland, which is an unincorporated area of the county where the county is the safety net, has the highest poverty rates hovering between 17 and 20 percent.
00:11:27
Speaker
There are other pockets of poverty throughout the county, and so you have this huge dynamic where there's so much money flowing in the Bay Area, but yet you have these very large areas of concentrated poverty. And so much of our work is going directly to the neighborhoods and working directly with neighborhood residents and community-based organizations in building their own capacity and supporting them in serving and addressing issues of poverty.
00:11:58
Speaker
Dynamics are the demographics vary. Some areas are heavy Latinx, Latino, other areas, Asian, as well as African-American. And so there's a huge swath of folks that are in need of support that we work with specific CBOs with to address. Do you think that there are any populations or community members that your
00:12:28
Speaker
programs are currently missing right now? Oh, completely. I think about the Pacific Islander population, which is often looped into Asian Asian-American, and they're often a lost population in the numbers. And we've worked really closely with the Pacific Islander Regional Task Force to ensure that they're connected into a lot of the programs that often miss them through the pandemic. And if you look at
00:12:58
Speaker
income, when they're looped in there, they look like they're doing well with other Asian populations. But when you tease them out and they're, they've been really intentional about demonstrating the data when you start teasing out the different Pacific Islander populations, really what the impact is and the disproportionality and outcomes when it comes to health and poverty. Can you share a little bit about your own staff and whether or not you all represent the communities that you're working with?
00:13:27
Speaker
I would definitely say we represent are the communities we serve. I mean, there is a level of, there is a power dynamic given that we are government employees, you know, at some level have a level of education. I do have a position on my staff, but we are racially and ethnically diverse, which is a,
00:13:56
Speaker
a compliment to what you often don't see. We have an ability, and I think this is an important piece, to be present and listen first to community. We don't have a lens of, arrogance isn't the word, but we don't have the expectation that community just meets government or government wants them to meet them, but the importance of going to community.
00:14:26
Speaker
I encourage my staff that when you have an opportunity to be on the ground, to see and to feel what other people are experiencing it because experiencing, because being in just a meeting and hearing about it, it isn't the same as seeing it. Absolutely. Can you share what you would say are, have been some of your most successful strategies that you've used to ensure that especially children are accessing the nutritious meals that they need?
00:14:56
Speaker
Yeah. There are a couple of ways that we've done that. And I think for me, the most successful story was really early on in the pandemic. Prior to the pandemic, we were an administrative lead for an entity called the San Antonio Family Resource Center, which was an initiative to support kindergarten readiness within a local neighborhood.
00:15:24
Speaker
That partnership featured all in and a couple of other local community-based organizations was really focused on play groups, adult support and learning wraparound services, connecting adults to services in support of their children. And so when the pandemic hit, there was this massive need for food.
00:15:50
Speaker
and a variety of resources. Everything shut down. Nobody knew what was going on. And one of the community-based organizations, the funder for the initiative actually pivoted the funding that was initially going to support this
00:16:09
Speaker
kindergarten readiness initiative, and they actually started seeding those resource centers with funding to be able to work with the food bank and other food entities to get food distribution, as well as other resources stood up. And so pretty quickly within like two or three weeks, maybe even less than that, it was probably 10 days, now that I'm saying this all out, they were able to stand up large points of distribution for food, for
00:16:38
Speaker
uh, you know, kits for kids since school had closed and nobody knew what was going to happen there. Some of the schools, um, we launched a partnership with a world central kitchen and, um, they worked with small entrepreneurs to prepare meals that then were distributed from school, um, points of distribution so that kids could actually have access to meals. But with this large distribution network that was established, what we did,
00:17:07
Speaker
was we recognize the different federal funding sources that were coming down the pike. And when you're working with CBOs, often CBOs are so used to struggling that they kind of ask for what they think they can get and not what they actually need. And so we actually spent a lot of time in March and April of the pandemic when we knew this funding was eventually coming down the pike to say, what is it that you need?
00:17:36
Speaker
Like, like, let's talk about need, not what you think you can get, but what do you need? And so we were able to support them in really developing out budget requests that went from organizations having budgets of maybe like $200,000 to like a total of $21 million over two years to do work that they were all pretty like scrambling to do. But it was an important lesson in
00:18:06
Speaker
needing to ask for what you want and need, needing to think ahead. So what are the things that you can leverage around federal dollars that aren't something that'll just come in and leave? So it's like, do you need a pallet jack and things I've learned about like, you know, a refrigerated van? You know, how do you pay staff a living wage?
00:18:31
Speaker
And that was the other side of it is while we were ensuring that kids and their families have access to nutritious foods. And what they did was they gave them three weeks worth of canned goods. And then as they could, they would supplement fresh produce. And other times, so people wouldn't have to leave. They provided diapers, formula. Eventually, they did laptops and hotspots, so kids could go back to learning or get back to learning.
00:19:01
Speaker
created an economy in its own right within the neighborhood where people that weren't doing anything that were on the, you know, just on the block and starting to get employed. And they started to have valuable experiences in working with others. And they were able to pass off a dollar to somebody else who, you know, and so it kept the money circulating in the community. People were employed, people were eating.
00:19:28
Speaker
and people had access and it was just, it was a beautiful demonstration of what it can look like when government gets out of the way. Yeah, absolutely. That's a great story.
Community Engagement Challenges
00:19:44
Speaker
Have you all sought to really get input from kids, families, you know, the actual communities that you're working with and serving?
00:19:55
Speaker
Yeah, early on in Allin's history, we did a series of community listening sessions where we provided small grants to community organizations to inform, you know, like what are the priorities for communities? And we did this for like three years. And the last one was done right before I took over leadership as the executive director. And when I looked back at the reports, they were still saying nothing had changed.
00:20:25
Speaker
And so it's important to include an engaged community, but if community has told you what their priorities are time and time again, and you haven't responded and they don't feel like you have responded or listened, like it becomes very laborious to continue to go back to them and not be responsive. And so, you know, I've been very protective of how we go to community. Yeah.
00:20:54
Speaker
because I don't want to set them up to think that they're going to get something that the government isn't ready to address or provide. And so we have in some ways, we've developed a parent action team with our family resource center to work with the families in the community, kind of say like, what are your priority needs around employment, housing, other community supports. And so we have tapped in.
00:21:22
Speaker
But we have to be very, very careful because I think we have this tendency to ask community for what they need and what they want and never quite deliver on what they're asking for. And that's really, it's painful to see. And especially when we're asking them to do this on their time and we're like, we're paid to do it. Like I'm paid to show up. I'm paid X number of dollars per hour. And you're asking them and we're going to give them a $10 gift card to go get, you know, a Subway sandwich. Like that's inappropriate.
00:21:52
Speaker
It also in repeating kind of, these are my challenges in my day-to-day life, whether it's access to food, keeping the lights on, employment, like that's traumatizing as well. And so what are we doing to also create safe environments for people to be able to share? But it's that responsiveness that still remains really important. Yeah, I mean, and I'm sure that when organizations continue to go back and ask, but like you said, don't deliver, just erodes trust. So they're going to be a lot less likely to
00:22:22
Speaker
volunteer to give their feedback, you know, the next time. And I'm watching it play out in a couple of different settings where we even engaged community-based organizations around food systems and, you know, trying to get them to wanting them to be involved in a circular food economy, but the government wasn't willing or isn't necessarily willing to change how they procure contracts and distribute funds.
00:22:52
Speaker
And so while we were trying to do this more equitable and inclusive approach, the government was like, yeah, but we're going to continue to do contracts this way. So it didn't end up really. And as somebody said, like they were all brought to the table, but not everybody got to eat. Yeah. And there's an expectation to stay at the table because you're afraid you're going to miss a bite. Right. But when the meal is on one side of the table and you're just getting the crumbs, like what does that really mean?
00:23:22
Speaker
And so I'm watching this dynamic play out with community organizations. So, so there has to be a parallel between not just engaging community and residents and the organizations, but it's like, what are you willing? What are your parameters as an organization or as a government that you're willing to be flexible in? And I think that's what the pandemic has brought us is this opportunity to be more flexible. And there's this desire to return to this norm, which we talked about around
00:23:51
Speaker
going back to the office, and normal didn't work for us then. And normal didn't work for families that were hungry then. It just brought a brighter light to what people have been experiencing in the dark. So as government, we really have to be open, or just as large entities with levels of power and influence, have to be willing to change ourselves.
Strategic Planning and Accountability Measures
00:24:19
Speaker
Absolutely.
00:24:21
Speaker
What are you all doing to really hold yourselves accountable to the type of work that you all are doing? Well, the 37 member steering committee definitely is in place to hold us accountable. But even though we've been around for eight years, we've only had a one year strategic plan in 2019. And then I did a three year strategic plan last year. OK.
00:24:49
Speaker
And we've made it a habit to check ourselves. Like, what have we done? What have we not done? Do we need to better measure ourselves? It becomes very hard to measure because the work that Alwyn does, there is some transactional where you can actually have quantitative hard counts, but much of this is relational and it's qualitative data and you can't
00:25:12
Speaker
Nobody quite understands qualitative data in the same way that they look at numbers and like, oh, we served X number of people, but you also have to think about how well did you serve them and did anything change? And so we use, in concert with the qualitative, we also use results-based accountability. And usually we talk about that a little bit, because we're, I think we and probably many other organizations are at a similar point where traditionally it's been about the numbers, but
00:25:42
Speaker
the pandemic sort of blew everything up. And now we're totally changing the way that we work. And like you said, you know, first of all, so much of this work takes time. And so I'm not gonna be able to turn around and show you a particular outcome necessarily in a year or two years, which so many of the grants have traditionally been a one or two year grant. And so we're trying to say,
00:26:11
Speaker
One, give us more time with people, you know, and then two, we're not gonna be able to show you the results in the same way. And we're really wanting to learn from organizations that still have been able to show their leadership, their board, fund their, you know, kind of like, what are we doing with the money, the time, the resources that we have? And sort of painting this picture that's just as
00:26:41
Speaker
powerful than the old numbers that we used to show all the time. Yeah. Storytelling. What I'll share with you is some storytelling that we did with some community collaboratives and how to work with community collaboratives and to encourage government and just funders to think differently. We called it a funders briefing. Think differently about how you fund community.
00:27:10
Speaker
So I'll share that reporting with you. But storytelling is really important. And I think it's more important early on before you get to the numbers because it sets the tone for which you then see the numbers. Process measures are really important because again, you can't get to the, you're not going to see we ended poverty by this date. One, because it's
00:27:39
Speaker
it's an investment of time and it was created over decades. But you aren't going to undo the damage that's been done overnight. And so you have to be able to say that out loud and tell an elected official, this is what it is. What I can give you though, are the stories that people share about the impact. I can tell you that we serve X number of people, but you will never understand what that impact is until you talk to them.
00:28:09
Speaker
And that's the kind of the how well did you do it? And did anything change part of the results based accountability? So results based accountability, how much did you do? How well did you do it? So the quality ended, did anything change? And that's kind of a long-term impact. And it's developing, you know, measures on that spectrum for like, you know, food security. Like how many people did you get fresh produce to?
00:28:37
Speaker
Did you increase the number of servings of fruits and vegetables per day? And then did anything change? Did they have better health outcomes? Were they more secure in terms of their access to food? Well, is there anything else? Thinking about our no-kit-hungry audience, is there anything that you would want them to know about your organization or community?
Addressing Hunger Through Education and Employment
00:29:06
Speaker
Yeah.
00:29:07
Speaker
I would just add that, you know, in the way that I've talked about things, you know, I've talked about just kind of singular programs, but there've been other pieces that affected together in that. And I'm just, I'm thinking and reflecting of some of our work with Children's Hospital Oakland and, you know, having a farm stand there at the hospital as well, the federally qualified health center, but then also having community and training up community residents to be able to talk about
00:29:35
Speaker
healthy eating and active living where they're doing projects directly in the community, whether it be establishing community gardens, teaching hand hygiene, providing cooking classes in schools. And so it's not just one-offs, but you have to really take a multi-sectoral approach to addressing issues around hunger. So it's one thing to provide food, but how are we teaching people about food?
00:30:01
Speaker
How are we addressing issues around the environment, around food? How are we employing people around food and ensuring that they're getting a living wage while working within the food system? And so I want to encourage folks to not just think about the food distribution side of things, but also think of the bigger picture around employment, economics, environment, learning, and what it means for kids to have access to food and the outcomes related to learning. It's just so much more bigger
00:30:31
Speaker
than just making sure somebody has a meal today. Absolutely. Thank you for listening to our Spotlight on Equity conversation with all in Alameda County. To read more conversations like this one, please check out our equity and child nutrition webpage at bestpractices.no-kidhungry.org backslash equity.