Building Community Resilience:
DC-Maryland-Virginia (DMV) Region
"Although there is a wealth of opportunity for advancement here in the nation's capital, many of these resources do not reach the communities that need it most. Through the support of Building Community Resilience, we have been able to garner insight into the lives of our patients beyond what we can gather in our usual 15-minute office visit. Through this enlightening process, our team has learned how we can best support the communities we serve to continue to thrive amidst adversity."
—— Dr. Nia Imani Bodrick, Community Pediatrician, Children's National Health System
The DMV Network Partners
- Center for Urban Families
- Fairfax County Health Department
- Ward 8 Health Council
- The Center for Health and Health Care in Schools at The George Washington University
- The Rodham Institute at The George Washington University
- Martha’s Table
- ROOT (Reaching Out to Others Together)
- Good Foods Market
- Trinity Washington University
- Early Childhood Innovation Network (ECIN)
- Children's National at THEARC
- Resilient DC, Office of the City Administrator
- The Office of Neighborhood Safety and Engagement
- The Office of Victims Services and Justice Grants
- The Office of East of the River Services in the Executive Office of the Mayor
- The Office of the Attorney General
The Community Context
In recent years, the Washington, DC region has seen rapid growth – in population, development, investment, and property values – but not all residents are prospering. Stark inequities, fueled in part by the District’s status as the U.S. city with the highest ‘intensity’ of gentrification – has seen more than 35,000 African American residents displaced 2000- 2019 in DC alone – according to a recent study. In Wards 7 and 8, nearly 40 and 50 percent of children live in households below the poverty line, respectively. Rates of chronic disease are twice as high in these wards compared to the city as a whole and life expectancy is 17 years less in comparison to the wealthiest Wards. As with national trends, opioid overdose deaths have increasingly become a public health priority in the region. In 2017, Washington, DC had the third highest rate of overdose deaths in the country, with neighboring Maryland having a rate nearly twice the national average. As a region, community violence continues to cause concern among residents and policymakers. In Baltimore, the District, and Northern Virginia, black males are disproportionately the victims of gun-related violence. After the civil unrest that took place in Baltimore in the aftermath of the death of Freddie Gray while in police custody in April 2015, the city has experience more than 300 homicides every year—the most violent period in Baltimore’s history. With the exception of 2012, there have been at least 100 homicides in DC every year since 1999. In addition, many residents across the region have limited employment opportunities, and other structural barriers to health. In DC’s Wards 7 and 8, residents face inadequate public transportation and a significant “grocery gap,” with just three stores for more than 150,000 residents compared to 50 in the rest of the city. Closure of the obstetrics ward at United Medical Center has also significantly decreased access to maternal and prenatal healthcare east of the river. Communities across the region are also some of the most diverse in the country. In 2017 nearly 14% of Washington, D.C.'s residents were born in another country, many of them from El Salvador, Guatemala and Honduras. Over 30% of Fairfax County residents were born outside of the U.S. and nearly 40% of households speak a language other than English at home.
Despite structural and systemic adversity, community members have many assets to draw upon, including strong family and community networks, access to high-quality, community-based services, relatively high rates of health insurance coverage and expanded preschool options for 3 and 4-year-old children in DC and Maryland.
Adapting & Growing Through the BCR Process
To address the Pair of ACEs, the DMV BCR network approaches its work through an equity lens, collaborating with partners across a range of sectors that impact child, family, community health and safety, and policy outcomes. The network engages partners in the medical community, community-based organizations, multiple universities, and government – including departments that manage health and education, early learning centers and juvenile justice.
Policy Engagement as a Means to Address the Pair of ACEs
The BCR national team, in partnership with the broader DC BCR team, engages with local policymakers in city council, as well as in the Executive Office of the Mayor, the Office of the Attorney General and government agencies to educate them on the Pair of ACEs and support trauma-informed policy, practice and programs for children and families. In partnership with longstanding local partner, GW’s Center for Health and Healthcare in Schools, the national BCR team is supporting a policy task force and local policy agenda, including priorities around DC Council’s sustained funding for trauma-informed policies, specifically, the Birth to Three for All DC law and recommendations of the Coordinating Council on School Mental Health.
Throughout 2018-2019, DC BCR partners provided expert guidance to DC City Council in crafting legislation to expand and support ACEs work in the District, with a focus on linking ongoing violence prevention work with trauma-informed interventions and supports that promote family well-being and resilience. In early 2019, the DC BCR partner network was presented with the opportunity to collectively develop legislation to scale and coordinate promising practices to address ACEs and reduce community violence. The legislation developed by the group is expected to be considered by the City Council later in 2019. This local policy expertise is also leveraged within the broader DMV region as well. With the addition of Baltimore to the network, BCR national team members have connected with members of the Baltimore City Council to identify policy opportunities connected to trauma-informed care and cross-sector partnerships. BCR has also provided support in efforts to move state-level legislation to make the Maryland Child Support system more equitable for low-income families, particularly families with an incarcerated or returning citizen parent. In 2019 the expanded DMV network partners have also begun work to further map and identify targets for policy change and advocacy. In identifying opportunities, partners are looking to model policies from other communities to develop substantive policy recommendations to apply locally in jurisdictions across the region.
Identifying Community Stressors & Development of the Root Causes Project
In DC, the Root Causes Community Dialogue Project was born in 2017 as an outgrowth of focus groups conducted by BCR to understand the community perspective of barriers to health and wellbeing. Initial focus groups conducted at Unity Health Care – a neutral, trusted community resource and BCR partner – with patients living east of the Anacostia River (Wards 7 and 8) revealed that tension between community and metropolitan police is a stressor felt daily in interactions with police officers on community streets and compounded by community violence. As a result, the national BCR team created the Root Causes project to begin to understand these community-police dynamics, as well as potential solutions to reduce tensions and build community resilience. Throughout 2018, the BCR National team developed partnerships with Reaching Out to Others (ROOT), a longstanding and trusted community-based organization, the DC Metropolitan Police, and the National Office of Black Law Enforcement Executives. In 2019, five focus groups were conducted with youth aged 16 to 21 and separately with metropolitan police officers in collaboration with key staff at the DC Department of Parks and Recreation at Bald Eagle Recreation Center in Ward 8. Following up on Root Causes momentum, BCR convened a group of key partners and stakeholders in mid-October to discuss how to support and align work across critical government agencies, including the Office of Victim Services, Office of Neighborhood Safety and Engagement, East of the River Services, and the Office of the Attorney General, to address community violence with the DC BCR partners.
The Early Childhood Innovation Network
The Early Childhood Innovation Network (ECIN) (www.ecin.org), which focuses on families from pregnancy through children up to age five, continues to be a critical partner to ensure adults in the caregiver role—parents, family members, educators, and health providers—have the knowledge and resources to improve outcomes for their children. To address exposure to the Pair of ACEs, ECIN is implementing trauma-informed approaches to engage families, community organizations, and the broader ‘system of care’, and push for systemic change to improve early childhood health, developmental and learning outcomes. Through collaboration with Children’s Law Center and ZERO TO THREE, a national early childhood organization, ECIN also has advocated for federal funding of early childhood and maternal mental health programs. HealthySteps Program and Expansion HealthySteps DC embeds an early childhood mental health specialist and family service associate in Children’s Health Centers in Ward 8. HealthySteps supports families through parenting guidance, support between visits, screening and referrals to community resources, and care coordination – all tailored to each family’s needs. Since launching HealthySteps DC almost three years ago, the HealthySteps team has served approximately 1,500 children. ECIN implements an enhanced version of the national model by providing parents and caregivers with brief clinical sessions on parent mental health, child behavior, sleep hygiene, grief and loss, and positive parenting practices.
Throughout all of its work, the DC team is focused on establishing long-term sustainability, working to align and connect existing services and to support capacity building, and also to advance policy, practice and program change that supports resilience and equity.
Tiffany Williams, MA
President & CEO, Martha's Table
Cynthia Greer, PhD
Associate Professor of Counseling, Trinity Washington University
Sarah Barclay Hoffman, MPP
Assistant Director, Early Childhood Innovation Network
Rev. Kim Lagree, LHA
Executive Director, Healing City Baltimore
Director, Center for Community Resilience
George Washington University