Centering Community Expertise and Engagement to Decrease Heart Disease

In West Sacramento, California (pop. 53,000), one in five residents is at risk of dying from heart disease—a staggering statistic for a preventable illness. It is a rate 70 percent higher than the surrounding state of California and costs more than $200 million annually in medical expenses for the county.

The West Sacramento Accountable Community for Health (ACH) set out to save lives, curb costs, and reverse this trend. Residents were the cornerstone of this project. Often left out of the conversation entirely, community members have the expertise and lived experience to find solutions to the most challenging problems their communities face. However, community members are historically provided the smallest platform to provide input while simultaneously yoked with the most significant portions of responsibility. As a result, West Sacramento ACH was unsure how to move forward on these efforts.

PHI’s Population Health Innovation Lab (PHIL) expertise lies in convening residents in a meaningful, strength-based, community-forward way on health issues, pressing community matters, and providing training around the methods. For West Sacramento ACH, PHIL provided an Art of Hosting Training, and a customized Community of Practice centered on community engagement. Taken together, these services helped West Sacramento ACH develop a strategy focused on heart healthy opportunities.

Phase I of the PHIL process involved an Art of Hosting training focused on participatory leadership. Trainees learn how to gather, lead, and host meaningful conversations while also creating space for personal and organizational deep reflection. Participants from the West Sacramento ACH learned highly effective ways of harnessing collective wisdom, self-organizing capacity, and co-creating solutions.

Phase II included a customized Community of Practice—a structured series of workshops to improve skills and knowledge in a subject area, focused on engaging residents from a strength-based perspective. The West Sacramento ACH Community of Practice participants looked for ways to incorporate resident perspectives into strategies for heart healthy outcomes.

From this process, West Sacramento ACH participants identified that the Asset-Based Community Development (ABCD) methods was an important practice for building their resident’s interest and involvement. PHIL partnered with Ron Dwyer Voss from Pacific Community Solutions, an ABCD technical expert, to provide additional support for the West Sacramento ACH participants. PHIL’s sustainable community-driven development approach empowers residents to drive the process by identifying and mobilizing existing, unrecognized, or under-recognized assets.

Using the ABCD methods, 12 West Sacramento residents participated in a series of strategizing meetings with the West Sacramento ACH. As a result, this process uncovered more than 260 assets that could be leveraged to reduce heart disease inequities. Residents and stakeholders formed workgroups around these assets, and focused their efforts on three key focus areas to help impact rates of heart disease: access to healthy food via growing, making, and sharing; walkability in two specific neighborhoods in West Sacramento; and neighborhood connectedness.

In the end, organic, community-forward solutions emerged. Neighborhoods throughout West Sacramento hosted healthy food tastings, a mobile food truck delivered locally grown produce into the community, and storytelling was used to bring diverse ethnic groups together. Recommendations were made to city representatives about specific walkability and transportation safety concerns. These initiatives would not have been possible without the keen effort, insight, and feedback from the West Sacramento ACH in partnership with community residents.