Promoting well-being and a better sense of belonging in the North Sound region | Opinion

When Alex was in middle school, a teacher asked each student where they saw themselves later in life.

“Prison,” answered Alex.

With a long list of relatives and neighbors who were incarcerated, it’s where Alex thought he belonged. The gravitational pull of belonging is so strong that it sometimes leads people to act against their best interest, and it affects a person’s entire life. In class that day, Alex was looking for an adult role model to reassure him there was an alternative. He didn’t get it.

Not surprisingly, Alex spent years in the criminal legal system; that sense of belonging kept pulling him back to the people and communities that fueled his cycle of incarceration. But today, he’s building a better kind of belonging among people coming out of prison and the communities that can support ending recidivism and help build well-being.

The connection between belonging and general well-being and health is well established, as one recent study from the National Institutes of Health reported: “A sense of belonging — the subjective feeling of deep connection with social groups, physical places, and individual and collective experiences — is a fundamental human need that predicts numerous mental, physical, social, economic and behavioral outcomes.”

That’s why North Sound Accountable Community of Health (ACH) in Washington state is using an innovative Medicaid waiver program recently granted to the state to provide a $350,000 grant to fund Alex’s work as the lead re-entry navigator at nonprofit Underground Ministries. States have increasingly used Medicaid waiver dollars to support work traditionally seen as supportive of health — like nutrition and housing — but the effort in Washington to support things like re-entry and building belonging smartly pushes the envelope for how we should see and support a broader definition of health and well-being.

North Sound ACH, which was created to advance health and well-being among residents in the North Sound region of the state, recognizes that most of what makes us healthy — or sick — happens outside the walls of a medical office. To that end, we focus on funding efforts to advance the vital conditions necessary for well-being.

Vital conditions are those things that all people need for health and well-being. This includes basic needs for health and safety, a thriving natural world, humane housing, meaningful work and wealth, lifelong learning, reliable transportation, and, central to all, belonging and civic muscle that enable everyday community members to shape their futures and live healthier, happier lives. The idea of improving health by focusing on the vital conditions was developed by health system transformation thought leaders, like The Rippel Foundation.

Over the past two years, North Sound ACH has provided more than $3.5 million to support building vital conditions for people living in Island, San Juan, Snohomish, Skagit and Whatcom counties, funding efforts that address belonging and improve education, food access, housing, and other vital conditions that advance health equity and well-being. Our work supports individuals coming out of prison, refugees, longstanding residents, including members of the nine tribes in the region, and more. But everyone in the community benefits; rising tides do lift all boats.

Washington state has been a leader in improving health and well-being among residents. In a national survey, the state ranked seventh in the overall health and well-being of the state’s population. But the survey also identified challenges, including among populations in rural areas such as the Northwest region where North Sound ACH is based. Particularly in those areas, and similar areas across the country, we need to center belonging and the other vital conditions in our efforts to improve health outcomes for all people, with no exceptions.

We commit to doing more, but it will take a larger effort to improve health and well-being among all our residents. We hope more entities join us in the movement to advance vital conditions and help everyone thrive by focusing on building belonging among all our residents.

Liz Baxter is CEO of North Sound ACH, one of nine ACHs that cover Washington state. You can learn more at www.CoalitionofACHs.org.