BENTON HARBOR, Mich.—What are the good things about your town? What’s working? What do you hope for?

These are the sorts of questions researchers will be asking residents of Benton Harbor and other people in the 49022 ZIP code as they seek a long-term vision of health, in all senses of the word, for the community. Coming up with such a vision in concert with community residents is part of the evaluation and research for the Center for Better Health in downtown Benton Harbor. [link to story, “Health Equity Moves into the Neighborhood.”]

Volunteers are working alongside the Spectrum Health Lakeland hospital system, the Berrien County Health Department and leaders of a project nearing its fourth year called Community Grand Rounds: Healing the Trauma of Racism.    

The person charged with measuring the work as it proceeds is evaluation consultant Corey Smith, PhD. In recent weeks Smith has been leading a team of 10 people from the community. These community research partners are working 20 hours a week to get the word out to the community about the center and to collect data about people’s needs that may be met by services offered at the center.

Come on Down, People!

Smith likened the first few weeks of door-to-door contact to a marketing and needs assessment initiative because the center — brand-new as of Nov. 2 — simply needed to be publicized. He said the essential questions were: “What do people need, and how can we get them in the door?”

Follow-up work will involve seeing if the people who said they would use the center actually showed up, whether they received support over the phone instead of in person, “or just [to] have a deeper conversation about the center’s work and to encourage them to stop in if there’s anything that they need,” he said. Researchers will also ask clients how the center can improve.

Speaking at the 3-week mark of the center, Smith estimated that 45 percent of households contacted had shown an interest in taking advantage of its services.

Flipping the Script

Smith also spoke of the longer-term vision motivating him, Lynn Todman, PhD, the leader of Community Grand Rounds, and their colleagues. Benton Harbor has long been dissected for its shortcomings. But  these researchers want to flip the prevailing narrative by asking different questions. They want to find out from residents what they think is good about their community, what can be built on, and what solutions they think are important to pursue.

“We want to start having conversations and finding out ‘What is it that they hope for their community?’” Smith said. “So it’s not as directly tied to the center, because it’s broader. It’s sort of part of our larger community engagement and community research strategy, which is, ‘What can we do together in the future to help improve Benton Harbor as a city?’

“Too often we come at that question from sort of a negative,” Smith said. “We come at it with the question of ‘What’s wrong, and what do we need to fix?’ And so we want to try and reframe it around what’s working, what are you proud of, and what are your hopes and dreams for the future of your community?’”

The overall vision the community itself comes up with “can be ultimately built into the larger health equity strategy,” Smith said. “With health as an anchor, it’s always easy to make a connection back to health, because so much around us affects our health.”

Mistrust is a Big Hurdle

Getting responses from community residents is not always easy, even for community research partners from Benton Harbor visiting the homes of other Benton Harbor residents.

Smith said he was struck by the depth of mistrust in “anything institutional,” including the local health system. Many people have refrained from answering questions of the community research partners.

Some people are afraid that answering questions might jeopardize something else in their lives—the government benefits they receive, for example, Smith said.

Smith described “the biggest challenge ahead of us,” saying, “I think we’re making good inroads in engaging with Benton Harbor residents who are maybe already amenable to that engagement, but there’s a huge swath of people who are not a part of the process and who don’t trust the process, and it’s going to take time and a lot of work to bring them into the process. It’s going to take demonstrating some success, making some gains” for many people to be open to an overture like the Center for Better Health.