Weaving the Fabric of Community: A Conversation with Natrina Kennedy, Founder & CEO of Women’s Health Initiative, Inc.
Natalie Graves, Director of Research & Implementation at Convergence Health, spoke with Natrina Kennedy, Founder & CEO of Women’s Health Initiative, Inc. (WHI), about how hospitals can be part of the community ecosystems that influence social drivers of health (SDOH).
Natrina is a public health entrepreneur from the South Side of Chicago with a love for community and a passion for breaking systemic barriers that lead to poor health outcomes. She has spent over 10 years bridging the gaps between community and systems by promoting public health and elevating healing.
Our conversation has been edited and condensed for clarity. You can watch the full conversation here: https://youtu.be/B5mbc5HTwIg
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Tell us a little about yourself, WHI, and your goals.
Thank you for having me. It is an honor to have an open and authentic conversation with you all today. WHI is a non-profit in Chicago dedicated to decreasing health disparities through education and supportive services. Most of our target population are Black and brown women between the ages of 15 and 45. I started this organization fresh out of undergrad at Loyola University of Chicago with the goal of increasing access to quality health care services for women.
The organization took an entirely different direction once we started working with women in the community. We found we were trying to solve problems that we thought were prominent, but those weren’t the most pressing problems that people were experiencing. They told us: “yeah, that’s not our problem. We go get our pap smears, we get our mammograms. We’ve had babies, we know what to do there.”
“We found we were trying to solve problems that we thought were prominent, but those weren’t the most pressing problems that people were experiencing.”
We’re still focused on decreasing health disparities, but through the assessment of lived experiences and storytelling. We’ve created a community network with over 350 women, primarily from the far South Side. We found that these women were having challenges with their everyday lives. They were experiencing racism, having a hard time with childcare, and felt really isolated and alone. So, we began to create spaces for them to just commune together, and what we found was that this was more popular and impactful that any of the other events or programs that we were putting on at the time.
One of my interns created what we call a storytelling session where we partner with local Black and brown owned businesses, mostly coffee shops and galleries in the community. Women and young girls from the community come into the space to learn and hear from health systems, leaders, clinicians, and each other. We’re thinking about these stories as a form of qualitative data and information we can get to create an evidence base for future programs and policies here locally.
I’m also a member of my community, I live in the community, I’m one of them. Everybody on my board also lives in our community, and they have expertise that is different from mine. Ultimately our goal is to empower individuals at the hyper local level, to really create movement in a way that bridges the gaps not just within community but externally within the systems as well.
Where do you see alignment between your goals as a nonprofit founder and community leader, and the goals of the health care system?
The short answer is I see alignment around overall health equity. We’re working toward the same goal from a different lens and with different vehicles. When I say ‘systems’ I mean healthcare payers, hospitals, agencies, etc. In my line of work at the hyperlocal level, we batch those into one conglomerate—“systems”—because we work across the different layers.
Health systems are focused on providing care, helping people create healthier lifestyles, understanding the social conditions in which patients live. Most hospitals in the United States are also nonprofits, which means they are also expected to prioritize the needs of community. I hear from a lot of people that they don’t get to spend a lot of time with their clinicians. The patients don’t understand the systems and the systems don’t understand them.
“The patients don’t understand the systems and the systems don’t understand them. We can understand deeply some of the problems that the hospital might be seeing clinically and provide an extra cushion between the community and the systems.”
Historically, we have been able to help with engagement that hospitals can’t always do in their day-to-day work. We can understand deeply some of the problems that they might be seeing clinically. We’re able to be that extra layer and cushion between the community and the systems.
Do you ever see that there is a disconnect between the goals you have and the goals of the system? What advice would you offer to someone who felt like there was a disconnect between the goals of the system and the goals of the community?
It might sound simple, but my advice is to meet people where they are and be ok if you’re not where you want to be yet. We sometimes have to pause our work and focus on simple. It might not seem impactful compared to the larger scale things that can be done, but it’s movement.
Related to the disconnect in goals, I had an example where the system was in a different place than the community-based organizations. It wasn’t because their goals were different, but because the system had a different understanding of the totality of situations that were influencing the problem they were trying to solve. We have this privilege when we work in systems. We see things from a very grass tops perspective, which may be different from what people experience.
“We have this privilege when we work in systems. We see things from a very grass tops perspective, which may be different from what people experience.”
WHI worked with a collaborative that convened all sorts of partners around a maternal and infant health challenge. We were seeing a reduction in visits for postpartum care, which was leading to postpartum complications that weren’t being addressed. When we got everyone talking around the same table, we discovered that some changes in the train and bus schedules on the Far South Side of Chicago were causing patients to be late and miss their follow up appointments. All that needed to happen to fix this was a conversation with the Chicago Transit Authority (CTA) and community-based organizations to figure out ways to support moms who don’t have access to transportation other than CTA.
The disconnect was that we weren’t talking to each other. Everyone was trying to solve the same problems, but we all had different pieces of the puzzle. Literally all we had to do was be at the same table and do our part.
What a great example that illustrates how we can take a broader view of not, “what can a hospital do” but “what can we all do, collectively, to influence SDOH.” So often the challenges we see at the sharp end of health care are driven by these many external influences. If we come in and try to say, “oh let us fix this thing” without understanding those different factors, at worst we won’t fix the issue, at best we might spend a lot of money and waste a lot of time.
We need to get different perspectives to the table. If you’re a hospital leader, how do you start to build new partnerships and get to know those other community leaders?
To get people at the table you have to know that they exist. Then, an individual or organization can be at the table, but are they speaking? Are there power dynamics in place that prevents them from sharing their expertise and experiences?
The second thing we’ve found is that simple works best. Utilize the tools you have in a meaningful way. A lot of what we do is simple—Instagram searches, Google searches, zip code searches to figure out what organizations exist. Sometimes we don’t have a lot of experience with certain sectors of the community but we still invite them in and say, “tell us what we’re not thinking about.”
“We invite them in and say ‘tell us what we’re not thinking about.’”
What are some of the key elements that make a partnership between systems and community impactful?
Make sure that the relationship is bidirectional and fruitful for both sides in a way that impacts community and also works toward a shared goal.
Start with level setting. What is the goal? What is the purpose of the work we’re trying to do? What is the target audience? Are we all working toward the same target audience or are we working toward different populations?
One thing that can help with this is a charter, having something in writing that spells out the goals, target population, etc. I’ve been part of coalitions where you might have food depositories, schools, agencies of all kinds in one coalition and they have no idea what the other person is doing, but the charter is what keeps everyone centered and working collaboratively.
Whatever community we’re in, we can feel like we never have enough. What advice would you offer to folks who are feeling like the resources they need simply don’t exist. How do they move forward?
I would encourage them to take an asset-based approach. Especially in public health, we’re taught to do needs assessments and worry about what we don’t have. We don’t spend nearly as much time looking at the assets we do have and how we can optimize and mobilize those.
When we’re not in a state of thriving, we still have to survive. Right now, right outside my window, one of my neighbors is literally hosting a farmer’s market on his front porch in 10-degree weather. He probably reaches more people than the local shelters just because of proximity. In my community we don’t have grocery stores, so a lot of the liquor stores sell groceries, and the churches give out food. Those are assets.
“We’re taught to do needs assessments and worry about what we don’t have. We don’t spend nearly as much time looking at the assets we do have and how we can optimize and mobilize those.”
To have meaningful partnerships, we need to have community in the conversation as well. When I got out, whether it’s to a meeting with different agencies or speaking engagements, I always take a member of the community network with us. They understand the problems and solutions differently than anyone else at the table, because they experience these things in real time. They can also let us know how we can use what we have. For example, a lot of the galleries on the South side of Chicago are community owned.
“Members of the community understand the problems and solutions differently than anyone else at the table, because they experience these things in real time. They can also let us know how we can use what we have.”
How do you find out about those assets if you’re just getting started? It’s not just Googling, right? Or looking at your local 2-1-1 or FindHelp.org website, right? How do you access that network of hyperlocal resources?
We literally sit on the street corners and at bus stops, visit coffee shops, observe, and talk to people. If you sit at the bus stop all day long you’ll talk to people and find out about resources that you might not have experienced yourselves. These are people who need resources, right? If someone is on the bus it may mean they might not have a car. Why don’t they have a car? Because they choose to or because it’s too expensive? Then you start learning about economic problems and some of the health problems that are related. Some of the homeless people we talk to have the most traumatic stories, but they also have access to a lot of resources. They know about different things just because of what they’re experiencing.
What else can hospitals do to welcome in patients or community members to be part of the conversations about changes the hospital can make?
One way is to open up the space within the hospital. The second thing is stepping outside the hospital walls. Both are needed.
What I’ve found to be more impactful than hospitals physically holding space is to be in spaces with us in the community. We’ve hosted recently at least 5 different leaders, director roles or higher, and they’ve never had conversations with people in the community. We’ve literally just had coffee with them and said, “come and talk to us, be open to these spaces.”
We see the importance of having a teachable spirit. There’s a level of humility that comes with saying, “I don’t have the answer and I’m willing to just go and get it.” We’ve seen hospitals doing it here in Chicago, expanding in ways that are very impactful to our community. Many of those solutions came out of listening sessions and some of their community-based work.