Interrupting the Cycle of Intergenerational Poverty at the Border of Texas
Challenge

For those who live alongside the border and south of Texas, generational poverty is a norm. 29 million people live in colonias, settlements that often lack basics like running water, electricity, and internet. 2/3 of adults and 90% of youth who live in these communities are US citizens–yet experience a lack of access to the vital condition everyone needs to thrive that results in generational poverty–conditions like access to meaningful work and wealth, humane housing, lifelong learning, broadband, and more. People who live in the colonias are resourceful and entrepreneurial and have a strong sense of belonging and community.

Why Does this Challenge Exist?

Since the colonization of America by Spaniards, indigenous people at the border of Texas were considered to be “heathens”, and were forced to become slaves and to identify as Hispanic or be killed.  Hispanic people at the border of Texas have lived a life of second class citizens for generations.  While over 90% of those living in substandard settlements called the colonias are US born citizens, they live in communities without running water, electricity, access to schools, internet etc.  This systemic disinvestment has led to generational poverty across vital conditions.  For more information, read this report from the Dallas Federal Reserve.

Who Came Together?

Methodist Healthcare Ministries (MHM) of South Texas has a mission to advance well-being for those who are “least served” in 74 counties in the southern tip of Texas. MHM runs a foundation and a health care system that work together to achieving its mission. MHM has a long history of investing in its communities, but outside of health care, its investments would often be short-term and reactive. MHM had learned that lack of access to these upstream vital conditions were compromising well-being in their communities and wanted to shift their environment to create greater well-being.

The Role of WE in the World

WE in the World engaged with MHM in a process of strategic planning and accompaniment to help MHM invest in addressing upstream community conditions and root causes.

What Changed

The health system engaged in its own equity journey, and developed language and frame to talk about how race, class, immigration status influenced outcomes for employees and for the community.

Philanthropic and community arm shifted from emergency response or community events to long-term investment in civic capacity to build communities of solutions. They launched Prosperimos Juntos, which brought together community coalitions to meet the needs of their communities.

Outcomes

  • Shifted grantmaking to make long-term investments in building community of solutions, led by the ideas of communities experiencing inequities
  • Invested in a strategic pipeline to interrupt the cycle of generational poverty.  This included investments in:
    • shifting the narrative
    • investments in the Census to improve social determinant investments
    • investments in education together with school districts
    • investments in broadband infrastructure, internet access and digital access to improve access to health, education, and jobs
    • access to capital through the Family Independence Initiative and Mayor’s guaranteed income initiatives for families to develop their own solutions
    • investments in anchor strategies and the food system
    • investments in policy change supported by local community organizers to improve access to immediate needs while creating long-term policy change for an equitable economy

How We Did It

Approach & Building Blocks

Used Pathways to Population Health Equity to develop a balanced strategy

Communities of Solutions framework

Key Insight

Real change takes time and work inside and outside the organization to shift mindsets and outcomes. It was important to develop and align transformation processes and structure with existing operational structures. Partnerships in the community and with other sectors proved to be key to abundance.

LESSONS LEARNED

And Failings Forward

They didn’t need to go it alone. There were many partners and assets in the community

The health system had much more power–and many more levers for change than they initially imagined. Once they let go of clinical care as their only role and leaned into partnerships, they could create a much deeper and more impactful portfolio of change.

There was a strong need to invest in internal culture change to advance well-being and equity. This required investment in staff training to deepen literacy and mindsets and the expansion of staff who could hold a transformational frame.

“The focus has sharpened to more intentionally advance health equity. We are now working with our communities at a deeper level to focus on social determinants, or gaps that are necessary to overcome to help their communities thrive.”

– Jaime Wesolwski, President & CEO Methodist Healthcare Ministries

THE RESOURCES LIBRARY

Framework and tools to strategically advance health equity for public health change agents