Racial Equity Impact Analysis (REIA)

The Racial Equity Impact Analysis helps the City consider racial equity outcomes when shaping policies, practices, programs and budgets.

Public Health Regenerative Leadership Synergy (PHEARLESS) grant - REIA

Section 1: Background
Public Safety No
Housing Yes
Economic Development No
Public Services No
Environmental Justice No
Built Environment & Transportation No
Public Health Yes
Arts & Culture No
Workforce Yes
Spending No
Data No
Community Engagement No
The Minneapolis Health Department (MHD) and Minneapolis Public Housing Authority (MPHA) have been accepted to the Public Health Regenerative Leadership Synergy (PHEARLESS) – a one-year leadership training program made up of 15 teams across the United States. The purpose of PHEARLESS is to advance the public’s health by developing the leadership competencies necessary to design systems that promote thriving for all. MHD and MPHA applied for this initiative through their joint work with the Highrise Health Alliance (HHA). The HHA’s purpose is to improve health outcomes for MPHA’s 5,300 high-rise residents by making it easier and more efficient for them to get the care they need. Through PHEARLESS, MHD and MPHA will develop four leaders who will collectively enhance the HHA and its community health improvement efforts. Two MHD staff, one MPHA staff, and one MPHA resident are participating. MHD will serve as the fiscal agent and receive $100,000 to design and implement a capstone project improving community health for MPHA high-rise residents. PHEARLESS also includes four, 4-day learning modules; travel and expenses for 1-2 in-person convenings paid directly by the University of South Florida (USF); and $9,000 stipends (taxable income) disbursed directly from USF to eligible community participants. PHEARLESS runs from September 2023 through May 2024, with an ongoing alumni network. PHEARLESS is led by the University of South Florida; supported by the Association of State and Territorial Health Officials, Big Cities Health Coalition, National Association of County and City Health Officials; and funded by The Kresge Foundation, the deBeaumont Foundation, and the Robert Wood Johnson Foundation.
Jennie Meinz, Manager, Healthy Living Initiative
Section 2: Data
This project will impact residents living in the 42 MPHA high rise buildings across the city. MPHA’s high rise buildings are comprised of residents representing Minneapolis populations facing the greatest health disparities. More than three quarters of residents are African American/Black, 57% are foreign-born (primarily from East African countries), and 86% are elderly and/or disabled. Only 16% of high-rise residents have employment income (MPHA Strategic Plan 2023-2027: https://mphaonline.org/wp-content/uploads/2023/01/23-27-Strategic-Plan_FINAL.pdf).  
While the direct outcome of this program is leadership competencies and collaboration for four individuals affiliated with two agencies, the capstone project and $100,000 aim to improve health outcomes for 5,300 MPHA residents. Many MPHA residents have limited access to community resources such as transportation or food, which exacerbates unmanaged chronic physical and mental health conditions. Department of Human Services data indicate the top three chronic condition diagnoses among high rise residents in 2020 were hypertension,diabetes and injury. Behavioral health and substance use were not included in the data; however mental health needs and social isolation increased throughout the pandemic. MPHA residents also have 183% more emergency room visits and 23% more inpatient hospitalizations compared to other Medicaid recipients who are over age 65 and/or living with disabilities. The Highrise Health Alliance works to improve health outcomes for MPHA residents.
While much data is available, health status data for communities with the highest health disparities is often difficult to obtain. The capstone project designed through this funding will use both qualitative and quantitative methods to measure success. This is a learning and planning grant, so specific data collection and evaluation plans have not been developed.
Section 3: Community Engagement
Inform Yes
Consult Yes
Involve Yes
Collaborate Yes
Empower No

The Highrise Health Alliance was formed during the COVID-19 pandemic and built a system to coordinate on-site vaccination clinics in all 42 high rise buildings. In 2021 the HHA identified six health improvement priorities and has coordinated pilot projects including Community Health Worker infrastructure, behavioral health, medication support and access to pharmacy services. 

Engagement with MPHA residents is done through the Minneapolis Highrise Representative Council. Two residents serve on the HHA Leadership Team, pilot projects are reviewed by Resident Councils in relevant buildings, resident voices and solutions are featured in quarterly Highrise Lowdown newsletter inserts. One of the PHEARLESS leaders is an MPHA resident from Northeast Minneapolis. Through this leadership training program and capstone project we will empower and partner with her.

We have learned that communication with residents needs to be done in multiple languages and in a variety of culturally inclusive formats. We have also learned that having MHD staff who speak additional languages (e.g. Somali) and spend time building trust with residents is key. Another PHEARLESS participant and MHD staff member speaks Somali and leads resident engagement across MPHA properties.

The HHA continues to pilot health initiatives, but the past 1.5 years brought significant staff transition among member organizations including new leaders at MHD, MPHA and Volunteers of America. PHEARLESS supports a clear leadership group that can dedicate time to redesign systems and expand services.
Section 4: Analysis

Developing trust and investing in four diverse leaders from MHD and MPHA is one way to build trust and increase cross-sector collaboration. This grant invests time, education and money in a team who cares about health, housing, race and equity. The PHEARLESS learning modules and capstone project will be directed to support better community health outcomes for MPHA’s 5,300 residents.

MPHA’s high rise buildings are comprised of residents representing Minneapolis populations facing the greatest health disparities. More than three quarters of residents are African American/ Black, 57% are foreign-born (primarily from East African countries), and 86% are elderly and/or disabled. Only 16% of high-rise residents have employment income (MPHA Strategic Plan 2023-2027: https://mphaonline.org/wp-content/uploads/2023/01/23-27-Strategic-Plan_FINAL.pdf).  Many residents have limited access to outside resources given chronic health conditions and/or limited mobility and limited transportation access.
Section 5: Evaluation
Success indicators for the PHEARLESS learning and capstone grant include:
-Four leaders complete all four learning modules
-Four leaders work with a national public health mentor to design a meaningful and feasible community health project valued at $100,000
-Project is implemented and evaluated with relevant health improvement measures
-PHEARLESS leaders work with and report progress to the Highrise Health Alliance
-The HHA has stronger leadership to interpret data, identify health priorities and align sustainable resident systems and services.
PHEARLESS leaders will present to the Highrise Health Alliance, write a newsletter article in the Highrise Lowdown, present as needed to Resident Councils and resident leadership.
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