Healthy Together

Healthy Together: Creating Community with New Americans is a grantmaking initiative designed to reduce health inequities for immigrants and improve the health and vitality of the entire community. The foundation awards grants to projects that foster exchanges and interactions between newcomers and the receiving community, strengthen the capacity of immigrant-led organizations and their attention to health, and address social adjustment and mental health.

The health of all Minnesotans, including our newest neighbors, is a product of many interrelated factors. Social, economic and environmental factors such as culture, education and income often play a significant and decisive role in health status. Research demonstrates that social connectedness is a key determinant of health:

• Social ties play a significant role in maintaining psychological well-being
• Social networks and social supports influence mental health
• Social connectedness allows individuals through their social networks to build trust and foster a level of comfort with exchanges that are important to individuals and civic life

Through Healthy Together, the Blue Cross Foundation explores, implements and evaluates strategies at the intersection of health, social connectedness and immigrant integration. It builds on the foundation’s grantmaking experience associated with helping people with unique cultural needs navigate the health care system.

Immigrant integration, which results in mutual responsibility, mutual change and mutual benefits, depends on a combination of individual human capital and social capital. Often measured by indicators related to socioeconomic status and language acquisition, it is influenced by the actions of organizations and institutions that shape the policy and practices in which integration occurs.

Funding guidelines

Healthy Together is a guideline-based grantmaking initiative that bridges our former funding priority, which helped people with unique cultural needs navigate the complex health care system, and our new focus on social determinants of health. Applicants may propose projects related to one of the initiative’s three objectives below. Please note that Healthy Together is entering its final year of commitment and is undergoing an evaluation process.  Therefore, funding in 2010-2011 will be available for implementation grants only.  No planning grants will be available.

Examples of grants for each of the following objectives are listed under the Grantees tab above.

1) Foster facilitated exchanges between immigrants and the receiving community, leading to greater social connectedness, healthier communities and increased opportunities available for all.

The Blue Cross Foundation invites letters of inquiry for one-year implementation grants of up to $50,000 for community, regional or statewide efforts.  Implementation grants will be considered only from organizations that have received a previous planning grant from the foundation.

This funding strategy represents the most “upstream” component of the Healthy Together program. It focuses on promoting and facilitating exchanges among and between newcomers and the community-at-large. We define exchanges as interactions that encourage on-going transactions, engagement and relationships sustained over time. The foundation supports positive interactions between immigrant-led organizations, community and civic groups, as well as institutions representing community development, neighborhood improvement, education, faith traditions, business, culture, law enforcement, government agencies and others. Bringing together newcomers and the larger community builds knowledge and relationships that can promote opportunities for social connectedness and foster a true “two-way” integration, leading to more vital communities,better health and opportunities for all.

The foundation also supports opportunities for collaborative engagement among recent immigrants and established neighbors around issues of common interest, enlisting all parties to work together equally to create a diverse, cohesive community that reflects social connectedness and promotes healthy living conditions.

This strategy includes efforts to build trust among new immigrants and social institutions. It also supports projects that enable immigrants to learn skills and acquire tools that help them fully participate in community life. Exchanges among immigrant groups build bonds around shared experiences and help those involved learn about and value skills, languages, cultures and transnational ties, thereby enriching the social and cultural fabric of the larger community.

Healthy Together supports projects that have created community partnerships that encourage two-way learning and engagement.

Desired outcomes:

• New or expanded relationship(s) between immigrants and established residents and institutions
• Increased capacity (knowledge, skills, commitment, relationships) on the part of grantees, their participants and partners to identify and work toward common goals across cultures and ethnic groups
• Visible community improvements, physical or systemic, resulting from exchange projects
• An intentionally more cohesive community of newcomers and long-time Minnesotans that is sustainable over time

2) Build the capacity and viability of immigrant-led organizations.

The foundation invites letters of inquiry for one-year organizational development grants of up to $10,000.

The foundation helps increase the organizational capacity of groups or agencies that serve as bridging institutions between immigrant communities and the resident community. Newer mutual assistance associations and immigrant-led organizations tend to reflect the mission and cultural practices of their founders. Those in leadership roles often hold positions of great respect in their communities. At the same time, boards and executive directors may face challenges associated with organizational growth, fund development and management, changing regulations and unfamiliar nonprofit requirements and practices.

Specifically, this strategy is intended to support immigrant-led organizations — often the first and most trusted sources of assistance for new Americans — by enabling them to strengthen their governance, management and finances; increase their ability to work effectively in partnership with others; and build their capacity and infrastructure to sustain mission-driven work over the long term. We define immigrant- and refugee-led organizations as those with at least 51 percent immigrant and/or refugee representation on their board of directors.

Under this funding strategy, immigrant-led organizations may request up to one-year grants for capacity building in one or more of the following areas:

• Strategic planning
• Organizational assessment
• Board development
• Financial management and fund development (e.g. bookkeeping and accounting systems)
• Human resources including management and direct service staff development, recruitment, retention and/or succession planning
• Business plan development
• Volunteer recruitment
• Strategic alliance development and mergers among interested partners at the organizational level
• Capacity building for greater focus on health

Organizations receiving capacity-building grants will participate in a learning network hosted by the foundation to promote peer education and shared learning. The foundation will also offer one-to-one coaching with an organizational development consultant on a case-by-case basis.  Grantees will also use a 100-point assessment tool to identify areas to focus their work and measure progress.

Desired outcomes:

• Strong organizations that serve as “bridging” institutions between immigrants and the larger community, including partnerships with other organizations to maximize program effectiveness and efficiency
• Increased capacity at the governance, management and/or program staff level to engage of the immigrant community, partner with other organizations and to sustain programs and operations over time
• New or expanded focus on immigrant health

3) Promote the mental health and social adjustment of new Americans.

The Blue Cross Foundation invites letters of inquiry for one-year implementation grants of up to $50,000 for up to one year for community, regional or statewide efforts.

Studies in immigrant social adjustment indicate that the process of adapting to a new community takes time and is shaped by individual experience and access to social support systems. Although immigrants may benefit from protective factors such as spirituality and strong family support, many face enormous social and economic factors that expose them to higher levels of stress and disadvantage due to poverty, unemployment, lack of English proficiency, discrimination and the trauma associated with the immigrant experience.

The cultural contexts in which people live influence the way they define and experience mental health and mental illness. Cultural factors can influence whether people seek care for their symptoms, what kinds of care they seek, and where they seek care (e.g., primary care providers, mental health providers, traditional healers and/or family members). Cultural factors can also influence how symptoms are reported as people express them in culturally based ways.

Immigrant communities are diverse, and each group has its own history, language, cultural norms and religious beliefs as well as perception of health and illness. This growing diversity challenges the mental health system and its providers to adopt culturally competent approaches to prevention, diagnosis, and treatment and to address barriers to appropriate and timely mental health services for members of immigrant communities.

This funding strategy supports planning and program grants to eligible organizations that propose to:

• Provide social adjustment and mental health approaches that reduce isolation, improve problem solving capacity and strengthen circles of support
• Build the capacity and cultural competence of the mental health system to serve immigrants through partnerships with immigrant-led organizations
• Reduce barriers to mental health treatment through culturally and linguistically appropriate mental health services and programs
• Demonstrate the effective use of community health workers (CHWs) to facilitate healthy social adjustment, social connectedness and access to and use of mental health services

Desired outcomes:

• Increased access to culturally and linguistically appropriate mental health services for immigrants of all ages
• Increased resources to foster the healthy social adjustment of new immigrants through the use of CHWs
• Prevention and early detection of mental health and social adjustment problems, especially through community-level programs

Evaluation

Grantees will be part of an initiative level evaluation conducted by Touchstone Center for Collaborative Inquiry, which the Blue Cross Foundation has selected as its evaluation partner. The purpose of evaluation is to document results, generate lessons for improved effectiveness and show progress toward the desired outcomes related to health, immigrant integration and social connectedness. Results will be shared with grantees, the foundation and other practitioners, funders and policy-makers. The evaluation will be operated on collaborative and participatory principles, providing opportunities for grantees and foundation staff to learn along the way through engagement in evaluation design, data collection and interpretation, and peer reflection. The foundation will organize joint learning opportunities on participatory evaluation in consultation with Touchstone.