“The State of Health in Needham”

On Thursday, September 15th, the Needham Resilience Network met in Powers Hall at Needham Town Hall. Upon entering the room, members were asked to reflect on a summer experience that influenced their understanding of someone from a different background.  

While we will continue to ground our work in the concepts of Belonging and Othering (see the short video on these concepts by john a. powell at the end of this newsletter), we will now begin applying this frame as we consider “The State of Needham.” We launched this work by focusing on “The State of Health in Needham”. 



NRN ROADMAP

We reviewed the work of the past 5 months, and the work of our next two Trimesters.


Where Have We Been? 

Trimester 1: March - August 2022

In the first trimester, the Network came to know each other as individuals and not just representatives or liaisons to groups. We also learned together.

Collectively, we learned about othering and belonging and the benefits of being open to ideas that differ from ours. We built skills around communication, such as: how to “flip the switch” from persuasion to listening when we realize that a conversation will benefit from it, and how to engage in deep listening (SAVE–stories, action, values, emotion). Lastly, we built a communications protocol (our guide for approaching conversations that entail different perspectives – to be referenced in the case that the agreement is breached, by way of “calling-in” and seeking to repair a harm, if there is one). Of course, knowing is not doing: These skills are like muscles that grow stronger with use. We initially practiced using them in short dialogues, and we will continue to practice them over the coming months.


Where Are We Going?

Trimester 2: “Deep Dive into the State of Needham,”
September 2022 - January 2023

Our goal from September - January will be to examine the “State of Needham” as it relates to equity in health, safety (from discrimination or violence) and belonging. We will use the following as data sources: 

  • The pre-Network member survey (illustrating differences in perceptions before we began, even among the leaders)

  • Stories of our lived experiences, from each other and from our sub-networks

  • Thematic statistics on local satisfaction, housing, food scarcity, public safety, education, etc., presented by the Town, hospital, school, and police (enabling an understanding of what data is officially gathered, and if/where there are inequities) 

  • The Network’s own Community Cohesion Survey (Aug-Oct 2022) 

At the end of the trimester, the Network will identify a set of priorities to be addressed over the coming year (Feb 2023-January 2024). Also, this trimester: After the Community Cohesion Survey closes on October 3, the Network will “go public”- first with a press release, and then through outreach to our collective networks.


Trimester 3: “Rapid Response and Prevention,”
February - June 2023

Our main goal in Trimester 3 will be the co-creation of a protocol for responding to hate incidents and other impactful local events. This will entail:
 
  • learning about the role and function of rapid response and best practices in how it's done

  • carrying out 3-4 simulations based on the most prevalent hate incident scenarios from Needham 

  • using the simulations to prepare communications and event protocols, as well as an operational protocol delineating how decision-making can quickly and efficiently unfold 
 
Network liaisons and their subnetworks will be asked to provide feedback on, and vote on, the protocol. In addition to the protocol, the NRN will develop two committees:

  • A Rapid Response sub-committee, to enact protocols and work with community members if/when warranted

  • A Prevention Team, to work with the Human Rights Committee’s complaint process when individuals at risk of hate or violence are identified. 


Year 2: “Prevention & Social Cohesion,”
Co-created Network Projects, July - Feb 2024

The remaining eight months of Year 2 will focus on prevention activities and collaborations. These activities will be based on the priorities chosen by the NRN in January or February 2023. In the event of a local crisis, regular programming will be paused to hold a structured discussion about that event. 



INTERACTIVE LEARNING                    


One foundational tenet of our work at the NRN is that physical, mental and social well-being are intertwined. It is through this lens that we are examining the "State of Needham". We are grateful to Jennifer Pinto, the Trotman Director of Behavioral Health at Beth Israeli Deaconess Medical Center - Needham, for launching our inquiry with a presentation focused on health.
While her full presentation can be found in the PPT slides, we recap some of her major insights here: 


  • The determinants of health extend far beyond the health care setting. They include trauma, and social and economic disparities (e.g., access to healthcare, resources, education, chronic stress, education levels), which themselves often lead to situations of trauma.

  • Trauma is more pervasive than we once thought, with implications for brain processing, how we perceive/live in the world after the stressor/s, and how we relate to one another. Trauma can be interpersonal or collective (experienced by a group, e.g., discrimination or oppression), and in addition to being prompted by an intense, acute event it can be experienced vicariously (witnessing something that happens to another), chronically (exposure to repeated harms), etc. In the realm of health, trauma is related to use/abuse of substances and behavioral disorders; in terms of social interactions, it can affect our ability to trust others and sustain healthy attachments.

  • The impact of hardship/trauma in childhood is long-lasting, and it can be “invisible” to the outside world in real time. Kaiser Permanente did a major study years ago showing that childhood trauma - captured in the Adverse Childhood Events (ACEs) questionnaire – are linked to disrupted neurodevelopment; social, emotional, and cognitive impairment; adoption of risk behaviors; disease, disability and social problems; and early death. The ACEs questionnaire asks about neglect; emotional abuse, physical abuse, sexual abuse; divorce; having enough money for food or clothing; whether a family member is in jail or uses a lot of drugs/alcohol; etc. 

  • In Needham, since March 2020 (e.g., Covid), behavioral health related instances have increased x 4, making them 15% of all visits. There are high rates of physical visits that have mental/behavioral health components (the most frequent issues to present at BID-N hospital prior to Covid were related to geriatric psychiatry and alcohol.) 

  • Are there differences in health outcomes between demographic groups in Needham? In terms of behavioral health (e.g., substance abuse, mental illness) and race/ethnicity, the answer appears to be no: In the past 12 months, 82% of all behavioral health related hospital visits by Needham residents had “Caucasian” identified as race. Since Needham’s Caucasian population is slightly higher than this (83-85%), it appears that the rate of non-Caucasian hospital visits (for behavioral health issues) is only slightly higher - and perhaps not even statistically different. This is news to celebrate! That said, data is not currently tracked by socio-economic status. Over the next year+, BID-N is focused on outreach to diverse communities to help with access and social determinants of health, among other areas. 

NRN would like to once again acknowledge Beth Israel Deaconess Needham and the Crimson Lion Lavine Family Foundation for their generous support and partnership! 



SMALL GROUP EXERCISE:


Reflecting on the Health Data

Reflecting on the data shared by Jen Pinto, small groups of 4 considered:

  • “What sort of social determinants, traumas, or adverse childhood events are relevant to our communities in Needham?

  • Where might there be disparities in these things?”

Members agreed that the issues of trauma and economic stress are relevant to Needham in the following ways:

  • Families on the cusp: There are residents on the cusp that may be struggling, yet make too much money to qualify for assistance. Since COVID, the number of families that need to access food pantries in Needham has doubled. Some families have lost jobs/health insurance, which means they also lost access to mental health resources. 

  • Children: There is an increase of children being neglected because parents are working from home and are unable to afford extra childcare. Children take on the stress of their parents and caregivers – so Needham children are getting stressed out because their parents are stressed out. In addition, Needham has a reputation of being affluent, which means that issues facing the lower middle class can get overlooked. Kids facing hardships may thus suffer in silence and isolation, at times feeling hopelessness or experiencing suicidality. 

  • Mental Health Services – Capacity: Even in a town rich in resources, access to mental health resources is limited. Covid complicated this with increased external stressors (food insecurity, deaths of caregivers, parental work challenges with children schooling at home for an extended period, etc.). Mental health issues have increased for students while they are waiting for mental health services (because demand exceeds current capacity). 

  • Increase in substance abuse: Police are also seeing an increase in local substance abuse cases, a finding that complements the hospital data

At the end of this trimester, we will return to consider recommendations for monitoring of health disparities and for consideration of ways in which NRN can support work on health in the community.  


Important Health Care Data Next Steps

It would be useful to see a greater number of health outcomes by race and ethnicity as a percentage of Needham (per capita) to best understand the disparities in trauma presentation, healthcare access, chronic disease, mental/ behavioral health, and in other social determinants of health, such as food scarcity, housing challenges and parental duress.



GROUP BIOS


Democratic Town Committee

Michael Diener, the Chair of the Needham Town Democratic Committee, shared about the mission, values, membership and activities of the group. The DTC aims to build a party open to all to move forward agendas such as healthcare, education, climate, choice, organized labor, gender and racial equity, LGBTQ and immigrant rights. He reviewed the processes of forming and sustaining local political committees, and statistics regarding Massachusetts’ Democratic majority (see attached slides). Compared to what we see at the national level or even other communities nearby, Michael noted that “toxic” left-right polarization has really not been an issue in Needham. All are welcome to join the DTC mailing list and can do so by contacting needhamdems@gmail.com.


Needham Interfaith Clergy Association;
First Parish Unitarian Universalist

Reverend Catie Scudera of First Parish Unitarian Universalist Church is currently co-chairing the Needham Interfaith Clergy Association. Most communities do not have an interfaith clergy association, so this really is a strength of Needam. NICA is dedicated to serving each other as clergy, as well as their collective faith communities and the greater Needham community as a whole. Needham’s faith leaders - clergy and lay - are committed to partnering with community organizations and to participating and lending spiritual inspiration at large town events, including the annual Martin Luther King Day program, Needham Diversity Initiative Summits, rallies and vigils for human rights and loss, as well as at their own Interfaith Thanksgiving Service. Members of the NRN thanked the NICA for its participation in Needham’s vigils in recent years.


                              
UPDATES & NEXT STEPS


In the next few weeks liaisons will: 

  • Receive a reminder that can be forwarded to their subgroups encouraging participation in the Needham Community Cohesion Survey, the deadline of which will be extended to Oct. 3rd, just following the Needham Harvest Fair.

  • Introduce their subnetworks to the NRN and begin to collect stories and reflections on lived experiences in Needham. These critical, anonymous narratives will be brought back to NRN for discussion and consideration of action. 

  • This fall will mark our ‘coming out’ via social media, the NRN Website, and a press release via local news. Network members will be reviewing their own information in the next days in preparation for a website launch!

  • We will be beginning to explore the creation of an information NRN video. 



RESOURCES


What We Are Reading/Watching/Listening to:


  • The Sum of Us by Heather McGee. McGHee’s book is an invitation to consider letting go of this country’s ‘zero sum game’ lens where one group has to be depleted and disempowered for another to be strengthened; instead, we can be richer, and stronger together. Wealth and impoverishment, Education and Healthcare. Climate and Housing are viewed through the lens of race, with the suggestion that the pooling versus division of resources can enrich us all. https://www.npr.org/2021/02/17/968638759/sum-of-us-examines-the-hidden-cost-of-racism-for-everyone  


  • Suzie Wise has a fabulous book on belonging, replete with ideas and exercises for local application. Check out Design for Belonging



Onward!
Beth & Nichole (NRN Co-Directors)