What’s Going On: Winona Well-being Collaborative addresses non-clinical issues that impact health

For nearly 125 years, Winona Health has been devoted to improving the health and well-being of our community. Increasingly, research has shown that a person’s health is, to a great extent, determined by factors outside a healthcare system. By various estimates, only 10-20% of a person’s health status is related to the healthcare system, the remaining 80-90% is impacted by factors known as social determinants of health. Social determinants of health are factors that influence how people are born, grow, live, work and age and include categories such as education, economic stability (job status), genetics, behavioral factors, and social connections.

Because we cannot separate these factors from an individual’s health status we have been developing ways to expand and incorporate, through partnerships, other community resources in order to improve health and well-being. One example of this is the Winona Well-being Collaborative (WWC), a collaborative of Winona area non-profits.

Our first project was to conduct a Community Health Needs Assessment (CHNA). The results were used to provide focus on pressing issues in Winona. Winona’s CHNA revealed that 14% of the standardized population and 56% of the immigrant and refugee population worry about food running out. At least 33% of children at each of our schools are on free and reduced lunch, with some schools as high as 53% and 71%. Here is a sample of the qualitative listening session findings:

• Residents are overwhelmed and don’t know how to navigate the system or where to go for help.
• Residents mentioned the stigma they feel when using services.
• Residents feel that assistance paperwork is cumbersome and confusing; navigating the system is challenging; providing as a single parent is difficult; other social determinants of health (food, housing, rent, utilities, transportation) are factors.

The WWC decided their first initiative would address pediatric food insecurity and obesity. Food insecurity encompasses both the feeling of hunger and the compensatory action of avoiding hunger. With lack of access to or education about nutritious food, people may rely on calorie rich but nutritionally poor foods, which can lead to or intensify chronic health conditions.

It’s also important to go beyond the numbers to examine the issue of food insecurity from multiple perspectives in an unbiased way. Overcoming stigma surrounding food insecurity is a challenging but important aspect of this work. Working together, we believe we can connect food insecure community members, and other community members experiencing the greatest health inequities, with resources that support a life of well-being.

Challenges for working in this type of collaborative include determining a leadership structure, accountability for the work, funding and communication among the partners. It’s also important to not operate under the assumption that the first solution is going to garner the intended results, so using continuous improvement methods facilitates ongoing learning and innovation to address how we work together to address community needs.

In addition to decreasing food insecurity and childhood obesity in our community, WWC’s goal is to develop a repeatable process that can be used for other social determinates negatively impacting the health of our community members.

WWC partners are Winona Health, Live Well Winona, Project FINE (Focus on Integrating Newcomers through Education), Winona Area Public Schools, Miller Mentoring, Bluff Country Co-op, Winona Volunteer Services and the University of Minnesota Extension SNAP-Ed (Supplemental Nutrition Assistance Program Education).

Rachelle Schultz, EdD President/CEO

Through this digital column, I hope to shine a light on what we’re working on both internally and beyond our walls in collaboration with other community-focused organizations.