Over the past decade, Global to Local has successfully applied lessons from global health to serve residents of South King County. While we’re committed to that work for the long term, we’re also excited to share what we’ve learned with others throughout Washington state and beyond!

Last December, we kicked off a seven-month effort to identify lessons from global health that might assist in overcoming barriers to health in rural Washington communities. Under a contract with the Washington Department of Health, we collaborated with groups in five counties in Central, Northeast, and Southeast Washington to explore how global learning might enhance ongoing community health improvement work.

A key principle of G2L’s model is that communities are experts in the barriers to health that they face, so we started by studying health data collected by the communities, and by listening to community residents. These conversations were facilitated by the Kittitas Community Health Network in Kittitas County, the Healthy Ferry County Coalition in Northeast Washington, and the Southeast Washington Health Partnership in Garfield, Whitman, and Asotin counties.

After identifying key health concerns, we scanned the global health literature for approaches to reduce health disparities in rural Washington. We used a strategic framework from a landscape assessment and literature review of global health interventions that we commissioned from PATH, a Seattle-based global health innovation organization, in 2017. We also partnered with the Strategic Analysis, Research & Training (START) Center, a research and consulting center housed in the University of Washington Department of Global Health, to help search for global health solutions.

Issues concerning access to care and financial insecurity were among the top health barriers identified across all Washington state rural communities. Other common health barriers included a lack of behavioral health services despite an increasing demand, and issues among youth such as bullying, inadequate access to childcare, and obesity.

We shared 11 global health strategies that might be of interest to rural communities. Three of these strategies emerged as the most potentially useful and transferable approaches to mitigate the impact of barriers to health identified in each community: deployment of community health workers; use of mobile health technology; and task shifting or task sharing of services typically provided by physicians, nurses, psychologists, and other highly trained health care professionals.

We shared both general ideas and examples of specific projects with each community partner, and received overwhelmingly positive feedback regarding the utility of the global health strategies.    

“I think your recommendations around Community Health Workers, task sharing, and mobile apps are spot on for our communities.”

Robin Read, Executive Director of Kittitas County Health Network

The Washington Department of Health will provide a report describing the BRIDGES work to the Washington State Legislature, which funded the effort.

Learn more

To learn more about BRIDGES, contact Alyssa Reed at alyssa@globaltolocal.org.

Since 2015, Global to Local has played a key role in facilitating Communities of Opportunity’s (COO) initiative to create greater racial, health, and economic equity in SeaTac and Tukwila. This initiative is a collaborative effort by King County, Seattle Foundation, and partners dedicated to advancing community-based priorities and shaping policies to promote racial equity.  

COO has provided funding to help the SeaTac and Tukwila communities implement projects that contribute to better health, safe and affordable housing, economic opportunity, and stronger community connections. As the local lead agency for SeaTac and Tukwila, Global to Local: convenes community-based organizations to determine local priorities and strategies; manages contracts with partner organizations that implement projects to advance community priorities; and coordinates internal and external communications for the local initiative. 

In past years, the COO initiative has supported Food Innovation Network’s food system revitalization work, Congolese Integration Network’s efforts to improve social connections and housing stability in the Congolese community, and our Community Health Workers’ physical health programs at affordable housing sites. 

Local partners

This year, six organizations are partnering to drive change in SeaTac and Tukwila with COO support: 

• Congolese Integration Network  
• Global to Local (and our Food Innovation Network program) 
• Lutheran Community Services Northwest 
• Partner in Employment 
• Somali Health Board 
• Somali Youth & Family Club 

Current work

Building on the success of our past efforts, we are collectively working to: 

• support workforce development, career pathways, and business incubation for immigrants and refugees; 
• develop leadership workshops to empower community members to address local social, economic, and political issues; 
• help community members register to vote and learn about the 2020 national census; and 
• engage in problem-solving to prevent and mitigate the impacts of displacement of residents and local businesses. 

Learn more 

• Visit the Communities of Opportunity website. 
• Contact A.J. McClure to learn about the SeaTac/Tukwila Partnership: aj@globaltolocal.org or (206) 379-6051 

Construction is underway at our Food Innovation Network’s new commercial kitchen and community hub! Tukwila Village Food Hall will be home to FIN’s Food Business Incubator, which has already helped launch 12 businesses headed by low-income South King County residents, primarily immigrants and refugees.  

Food businesses have traditionally been a way for many striving immigrants and low-income families to make a living. However, skyrocketing real estate and rental rates are making it difficult for these entrepreneurs to access commercial kitchen and restaurant spaces in South King County. Tukwila Village Food Hall will provide the space and support to help entrepreneurs launch and scale to successful local businesses. The Food Hall will also provide a community hub—a space where people can gather to learn about and celebrate the community’s rich food traditions. 

The facility

The 2,900-square-foot facility will include a commercial kitchen with four cook stations, five food retail stalls (including one stall designated for pop-ups and cooking demos), and a community dining area. The space will accommodate 20 food businesses, including eight that will rent stalls in the public Food Hall. Other businesses will use the kitchen for off-site sales, such as catering and farmers markets. 

The Food Hall will be in Tukwila Village, a mixed development project with 400 new affordable and market-rate apartments. Construction began in late 2018, and the Food Hall will be ready for operations next spring. 

State and community support  

Building out the facility and installing kitchen equipment will cost $850,000. Thanks to our local funding partners and the State of Washington, we’ve already raised more than half of this amount!  

Communities of Opportunity and the Port of Seattle have provided support in the pilot testing, pre-construction needs, and program expansion.  

The State of Washington has appropriated $400,000 in its capital budget to support the project; the budget request was sponsored by Sen. Bob Hasegawa, and supported by dozens of local businesses, nonprofit organizations, and community leaders. 

We continue to seek sponsors, and have launched a capital campaign to help raise the remaining funds. You can help open Tukwila Village Food Hall by contributing online and joining our crowdfunding campaign!  

Learn more 

• Subscribe to FIN’s email updates to receive news about Tukwila Village Food Hall and FIN programs and events.  
• Visit FIN’s website to read more about Tukwila Village Food Hall and the Food Business Incubator, and watch our video featuring Incubator participants:

Global to Local’s leadership and community mobilization initiatives strive to improve health by building community power. As part of this effort, our Community Connectors programs recruit and support individuals who serve as liaisons between their diverse communities and the cities of Tukwila and Burien.

Earlier this year, our website featured Tukwila Connector Rinny Tun. Now we are excited to spotlight Burien Connector Martha Molina. Read on for our Q&A with this community leader!

How did you learn about the Community Connectors program? Why did you decide to join?
My friend told me about it. I thought it was a great opportunity for me to learn more about local government and how to connect the community with the city.

What are some of the most urgent or greatest needs you see in your community?
The biggest needs I see are: getting more families involved in community events and meetings; regular child care for families who want to attend meetings but can’t because of children; and more languages offered for interpretation in meetings/events.  

What activities have you done as a Connector?
I took a City 101 training, helped review and give out surveys, and learned about city resources and who to call for help. I attended a City of Burien budget meeting, and have done some outreach work by passing out fliers and by reaching out to friends and family through social media to share events and information. I also attended a King County Council meeting in Seattle, which I never had done, so that was exciting and different.

What are some of the most important things you’ve learned as a Connector?
The biggest thing I have learned is how powerful word of mouth can be. The Latinx community, especially older folks who don’t use social media as regularly, rely heavily on word of mouth from their close friends and family. I can’t begin to say how many times I’ve been told that someone learned of an event through a mom from school or through a next-door neighbor. Another important thing I have learned is that anyone has the power to speak up, and everyone’s voice truly matters, no matter how small or unimportant you feel.

What’s something you’ve accomplished as a Connector that you feel proud of?
I know there is still a lot for me to learn, but I am proud that I have introduced the idea of attending events and learning about city politics to some of my friends and family, and hope I have made them consider attending more often — because if I can, they can, too.

What is your hope for your community?
I hope for a community that welcomes diversity and accepts differences. A community in which neighbors know each other and reach out to each other. They participate in events that impact them, and are able to understand the content in their language if it’s not English. An inclusive community that works together and listens to the needs of one another. Anyone feels safe to be a leader and has the support to get there.

Is there anything else you’d like to share?
I’m so grateful for the support I have been given during my participation in the program. I know I can always reach out for questions or any other support, and don’t feel ashamed for asking too many questions. I know I am appreciated, and that feels so great.

Learn more about our Community Connectors programs

Contact G2L Deputy Director A.J. McClure: aj@globaltolocal.org or (206) 379-6051.

When Foster High School senior Rinny Tun learned about the Tukwila Community Connectors program, he jumped at the chance to join. 

Connectors serve as liaisons between city staff and Tukwila’s diverse communities, helping the city build toward more equitable community engagement. 

“Learning about the government is interesting,” Rinny said. “I thought it was important to get myself to do that, and then to help other kids like me connect with civic engagement.” 

Having served as a Connector for a year and a half, Rinny has accomplished his goal of serving as a bridge between the city and his community. 

“Meeting with city officials was very interesting because it gave me that network, and the resources to utilize in my own community,” he said. “Connecting with human services staff was especially good, because when I know community members are going through something, I can connect them with the right person.” 

Another benefit of the program has been building his own advocacy and leadership abilities. Niesha Brooks, Global to Local’s leadership and engagement manager, mentors the Connectors, and also has helped Rinny find additional opportunities to grow his skills and network. She encouraged him to join a three-day leadership development training with the Healthy King County Coalition that he found particularly impactful.  

“That’s how you connect with people. For leadership, that’s important. I used to be a little shy kid. Now I’m almost outspoken. I’m on my way,” he said with a laugh. 

A future in community service 

With high school graduation around the corner, Rinny has his future on his mind.  

“I want to go to college. And I want to hopefully be able to take on more tasks from the community.” 

Rinny is considering a career in medicine, with aspirations to “open a private clinic and help low-income families.” Or, inspired by his volunteer work with FIGHT – Formerly Incarcerated Group Healing Together, he might advocate full-time for criminal justice system reform. 

Whatever path he chooses, Rinny is committed to using his skills and energy to lift up community members who have been underrepresented — particularly Southeast Asians, refugees, youth, and people with low incomes. 

“I want to do something transformative. Helping people grow — go from low-income to middle class, get resources they need, overcome barriers, like language barriers — that’s a big thing,” he said. 

Learn more about our Community Connectors programs 

Contact G2L Deputy Director A.J. McClure: aj@globaltolocal.org or (206) 379-6051. 

The Trump administration has proposed changes to immigration rules that many experts believe could put the health of millions of families at risk. The proposed changes would expand the “public charge” rule so immigrants could be denied admission to the U.S. or permanent residency if they or their dependents use certain health, food, and housing programs. These changes could increase poverty, stress, and fear among immigrant communities.

These proposed changes have not yet been implemented. Public comment can have an impact on whether the changes are made.

What you can do:

1. Make a comment in the federal register. Because the government must take all comments into account before finalizing the rule, you have the opportunity to affect the outcome. Advocates have come together to create an easy-to-use comment portal at ProtectingImmigrantFamilies.org. Using this portal, you can let the government know how this rule would affect you, your family, your community, and our country. If you do not want to include any personal information, a friend or representative can submit a comment for you. You have until Dec. 10 to submit comments.
2. Make a comment on behalf of someone you know. You can submit multiple comments on behalf of friends, clients, or anyone who doesn’t want to disclose their personal information. This FAQ shares information about submitting comments on behalf of others, as well as submitting comments that have been translated into English.
3. Share this information with your networks, and encourage them to speak out.

More information:

• FAQ explaining how and why to make public comments about this rule change from the Center for Law and Social Policy
• FAQ on the “public charge” rule from Protecting Immigrant Families and Moms Rising
• Article about the negative health impacts of the proposed rule change from Health Affairs

Research shows that financial wellbeing is linked to physical health. For this reason, it’s no surprise that when G2L asked our SeaTac and Tukwila communities what stood between them and better health, the top answers were connected to economic security.

To start to address this issue, G2L examined how global health approaches economic development. Our research found that interventions tend to focus on improving access to income-generating opportunities and financial services.

Alongside many partners, we launched the Food Innovation Network to create economic development opportunities for low-income community members by helping aspiring entrepreneurs start food businesses.

More recently, we began work to improve access to financial services among community members who participate in our physical fitness classes, with the idea that, when our community health workers (CHWs) integrate financial and health education, we can improve outcomes in both areas.

Connecting the dots between wealth and health

With support from Northwest Area Foundation, we partnered with the Seattle-based nonprofit The Prosperity Agenda to train Somali and Latina CHWs to lead financial awareness classes. Those CHWs then invited their physical fitness class participants to join them for financial education.

“This program has been a need, and it’s been very helpful for the Latina community,” said CHW Monica Davalos, who leads classes in Spanish.

When Monica asked participants what they thought about their financial situation, she heard a wide range of responses. Some women managed their family’s finances and had a good handle on how financial services work. Others said that because their partners dealt with money, they didn’t know the basics. One participant said that when her 15-year-old daughter had asked her what “credit” meant, she didn’t know the answer.

“Even if you aren’t in charge of your family’s finances, this is important to know. Your kids will learn from you,” Monica told participants.

Peer learning plays a key role in G2L’s financial awareness classes.

Monica covered a variety of topics, from how to open a checking account, to retirement planning. Through a combination of facilitated activities and peer learning, the participants enhanced their understanding of financial services, money management, and how economic wellbeing relates to their health.

In CHW Roda Sugulle’s sessions, Somali women also discussed the connections between financial and physical health, as well as barriers they face to economic stability. They shared that they not only support their families here in the U.S., but also loved ones who are still in Africa.

“There’s always someone else in need back home,” said program participant Amina, a mother of four who came to the Tukwila area from Somalia about 15 years ago. Taking care of these contingencies not only makes it hard to save, but also creates stress.

Roda encouraged participants to record their financial goals on their cell phones.

“If you have a plan, you can reduce your stress. When emergencies happen, you have a safety net,” Roda told participants.

Amina had always actively managed her finances, but hadn’t written down her thoughts. She reported that learning how to create a budget was the most useful takeaway from the sessions.

“Budgeting has helped me better understand how I spend money,” Amina said.

Roda also led discussions about credit cards, and checking and savings accounts. She heard that participants wanted savings accounts, but were wary of opening them because most accrue interest by default, and Islamic law prohibits paying or collecting interest. Language and cultural barriers to banking, as well as a lack of trust in the institutions, has kept them from opening accounts.

Looking forward

Aisha Dahir, who manages our CHW program, says it will take improved cultural competency at the financial institutions to fully break down these barriers to financial services. Our program partners are working with banks and credit unions to improve community members’ access.

Aisha noted that, outside of those established institutions, community members have developed their own informal systems of banking, including lending circles.

“We’re learning about these communities’ assets, such as informal banking, and the fact that there’s not much debt. We know these assets are what we need to build on as we move into the future,” Aisha said.

G2L will continue to refine our financial education program in partnership with our community. After a few rounds of classes, our approach already looks very different from other financial coaching programs.

“We’re seeing the community from a different angle, looking at how the social determinants of health, including economic factors, affect lives,” Aisha said.

And as important as financial education is, we know it’s only one small part of what’s needed to improve economic security and advance health equity. We’ll continue to advocate for systemic change to address the growing income inequality and other barriers that prevent community members from living healthy, prosperous lives.

Jonathan Sugarman, MD, MPH will join Global to Local next week as our CEO. With over three decades of experience improving health both domestically and internationally, Jonathan is well suited to build on Global to Local’s success in demonstrating how global health strategies can advance health equity in the United States. Communities around the country are interested in adapting the innovative programs we’ve piloted in SeaTac and Tukwila, from a smartphone app that helps patients control diabetes, to culturally appropriate fitness classes. Jonathan brings an ideal skill set to support the development of similar programs nationwide, starting with our upcoming projects in Cle Elum and Spokane.

Jonathan began his work leading health improvement efforts as an Indian Health Service physician on the Navajo Nation. He served as president and CEO of Qualis Health for nearly 20 years, guiding the Seattle-based nonprofit to national recognition as a leader in improving population health, particularly among vulnerable populations. He has held leadership roles in numerous local, state, and national associations, including the Washington Academy of Family Physicians, the American Academy of Family Physicians, and the Physicians Consortium for Performance Improvement. He is a technical facilitator for the Joint Learning Network for Universal Healthcare (JLN) People-Centered Integrated Care Collaborative. The JLN is an innovative, country-driven network of practitioners and policymakers from over 30 nations who co-develop global knowledge products that help bridge the gap between theory and practice to improve the health of more than 3 billion people.

Jonathan is a graduate of Harvard College, the Albert Einstein College of Medicine, and the University of Washington School of Public Health and Community Medicine. He serves as a clinical professor in the Department of Family Medicine at the University of Washington, and as a lecturer in the Department of Global Health and Social Medicine at Harvard Medical School.

In an announcement message, Global to Local Board Chair Lisa Cohen wrote:

“Given these credentials, it is clear why Jonathan emerged as the most outstanding candidate during our five-month nationwide search to replace our founding executive director, Adam Taylor, whom we can’t thank enough for establishing Global to Local as a model for improving community health. We’re also grateful to A.J. McClure, who stepped in as interim executive director following Adam’s departure this summer. As deputy director, A.J. will continue to oversee our King County programs.

“We’re delighted to welcome Jonathan to our team, and look forward to his leadership – and your partnership – as we strive to advance health equity in South King County and beyond.”

Stay connected with G2L

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Gali eyed a green beverage with suspicion on a recent Friday afternoon. She’d never heard of putting spinach in a smoothie before, but she took a chance, tried a sip, and was delighted to discover a new favorite drink.

Gali and her friends had concocted the smoothie at a summer class for youth held at Global to Local. Young members of the local Somali community who joined the four-class series learned about nutrition, enjoyed physical activities, and developed their leadership skills.

Nutrition class participants, including Hassan, concentrated hard to get their smoothie recipe just right!

Global to Local offered the summer program in partnership with Food $ense to help local youth develop healthy habits. Educating young people about their health not only sets them up to make good choices for themselves, but also to positively influence their families.

Community Health Worker (CHW) Abdi Hussein coordinated the class, one of many programs that Global to Local CHWs offer to help build a healthier community here in the SeaTac/Tukwila area. CHW activities range from organizing exercise and nutrition classes, to addressing barriers that prevent residents from visiting their primary care doctors.

Community Health Worker Abdi Hussein (left) laughed along with students as they played a game to learn about the effects of caffeine.

Our CHW work is inspired by the many global health programs that train trusted community members as health workers who operate outside of clinics to provide education, referrals, and social support for health behaviors. It’s just one of four initiatives that G2L has developed to improve community health.

Continued engagement

After school starts back up, Abdi will continue to keep in touch with the students and their families, who are his neighbors. Two of the students’ parents are joining a nutrition class that Abdi’s organizing in September. And he is working to connect the families with their primary care doctors. Through G2L’s partnership with HealthPoint, Abdi and other CHWs help families make medical appointments, communicate with clinicians, and follow through with prescriptions and doctor recommendations.

Global to Local is also engaging young people through our Green Cities partnership with Forterra. We’re inviting youth to give input about where trees should be added in their community, and then get hands-on planting trees!

By the way, we suspect there are more green smoothies in Gali’s future. A few days after that summer class, she called Abdi to tell him she’d made a batch for her whole family.

An outdoor activity not only helped students burn some energy, but also taught them about teamwork as they raced the clock to make a star shape with a rope.

In a place as diverse as Tukwila, where over 80 languages are spoken, it’s not easy for the city to engage all of its residents—particularly communities who face language and cultural barriers. In 2013, the city began working with G2L and Forterra to create the Community Connectors Program to help boost civic engagement.

Through this partnership, we recruit Community Connectors from groups that the city has a difficult time reaching through traditional outreach. Tukwila Connectors include members of the African-American, Latino, Somali and Burmese communities who have deep connections in their communities, and who are committed to facilitating outreach and communications.

Connectors join “City 101” trainings where they learn about things like how the city is structured, what different departments do, how the budget is developed, and what city council does.

“Knowledge is power — especially for people who are new to the country. They need to know the processes,” said Leadership and Engagement Manager Niesha Brooks, who runs the Connectors program.

Next, G2L and the city work together with the Connectors to identify priority projects that the Connectors can support, reaching out to their communities to seek input on things like the comprehensive plan, housing, safety, and economic development. Connectors also provide guidance to city staff on how to design and undertake comprehensive and effective outreach. These efforts ensure that the priorities of previously underrepresented groups are heard and incorporated into city work.

Community leadership advances community health

The Community Connectors program is key to G2L’s efforts to advance health equity in our region. We started our work in 2010 by asking community members to describe what a healthy community looks like to them. Many talked about feeling connected to their community, being able to access and navigate systems, and having a voice.

“This program is letting the Connectors and community members know that their voices are valid,” said Niesha.

As the Connectors program builds community voice, it also invests in the capacity of individual leaders.

“We want for the Connectors to gain experience and skills,” Niesha said. “They can take what they learn here, and join task forces and boards, and take on other leadership positions.”

Learn more

• After pioneering Community Connectors in Tukwila, we partnered on a similar program with the City of Burien. Cityvision Magazine recently highlighted Burien’s Connectors program in an article on the city’s efforts to better serve its residents. You can read “A Right to Be Heard” online; the article starts on page 16.
• Read Community Connectors program descriptions on the Tukwila and Burien city websites.
• Keep visiting our website, where we’ll feature stories of Community Connectors. To receive updates about all things Global to Local, subscribe to our email newsletter.