Vital Village is a network of residents and organizations committed to maximizing child, family, and community well-being. Our place-based, community engagement network mobilizes collective investment from residents, community organizations and institutions to seed scalable and sustainable community change around child protection and promoting healthy social and emotional development in early childhood.
Erica Pike, MA & Renée Boynton-Jarrett,MD,ScD, discuss how the Vital Village Network uses a collective impact approach to supporting a deeper collaboration among educators, clinicians, social service providers, legal advocates and residents. This has been shown to strengthen the economic security of a community and to help understand the far reaching consequences of early life adversities and toxic stressors on child development and health.
Erica Pike, MA & Renée Boynton-Jarrett, MD, ScD
Passionate for systems-level change, Erica Pike, MA has been working in public health as a youth worker, trainer, project manager, and community advocate since 2010. Pike graduated with a Bachelor’s in Dance from Drexel University in 2013 and a Master’s in Applied Nutrition from Northeastern University in 2015. As an AmeriCorps Massachusetts Promise Fellow and young public health professional, she became committed to improving maternal & child wellbeing, reducing rates of obesity, and engaging communities to create lasting change.
Renée Boynton-Jarrett, MD is a practicing primary care pediatrician at Boston Medical Center, a social epidemiologist and the founding director of the Vital Village Community Engagement Network. Through the Vital Village Network, she is supporting the development of community-based strategies to promote child well-being in three Boston neighborhoods. She joined the faculty at Boston University School of Medicine in 2007 and is currently an Associate Professor of Pediatrics. She received her AB from Princeton University, her MD from Yale School of Medicine, ScD in Social Epidemiology from Harvard School of Public Health, and completed residency in Pediatrics at Johns Hopkins Hospital. Her work focuses on the role of early-life adversities as life course social determinants of health. She has a specific interest in the intersection of community violence, intimate partner violence, and child abuse and neglect and neighborhood characteristics that influence these patterns.
Melanie Cole (Host): Vital Village is a network of residents and organizations committed to maximizing child, family, and community well-being, and my guests in this panel discussion today are Erica Pike, she's the Communications and Policy Manager at the Vital Village Network, and Dr. Renée Boynton-Jarrett, she's a primary care pediatrician at Boston Medical Center and the Founding Director of Vital Village Network. Welcome to the show, ladies. So Dr. Boynton-Jarrett, I'd like to start with you. What do we know about the emerging understanding of these far-reaching consequences of early life adversities and toxic stressors on child development? What do we know about this?
Dr. Renée Boynton-Jarrett, MD, ScD (Guest): Thank you. So what we know is your exposures in childhood do not just affect you as a child. Living in a socially adverse environment, that's a neighborhood with concentrated disadvantage, structural racism, high degrees of systematic lack of opportunities, poor and failing schools, highly stressful family and household environments where caregivers may have a high degree of need, and the exposure to interpersonal acts of violence; physical, sexual, or emotional abuse. These are factors that can have a profound and lasting impact, not only on the child at the time of exposure, but as they grow and develop over their life course.
And this is because these experiences influence how you regulate your emotions, these experiences influence how your neuroendocrine system responds to future stressors, so it affects how you can learn in the future, and it affects your ultimate life chances. So we now know that there's an enduring effect of early life experiences on not only your health at the time that these experiences happen, but your health as you grown into adulthood. And your ultimate ability to engage socially and productively in your social world as you grow up.
Melanie: Dr. Boynton-Jarrett, I'm sticking with you for just a minute. Tell us a little bit about the Vital Village Network, and how it came about.
Dr. Boynton-Jarrett: Yeah, so this is a fantastic story. Vital Village really emerged out of a need. There was a need for caregivers and community residents to work more collaboratively and collectively with community-based institutions. So practitioners, educators, social service providers, community organizers. We were all stuck in separate silos working hard to improve child health and educational outcomes and child well-being, but working in isolation of each other.
So Vital Village really emerged from a need to work in a more aligned and collaborative way and to work in partnership with families and community members who live in the communities that we were serving. Who would be more or in a better position to help to address challenging circumstances than the members of the community that live there each day and experience it each day?
Melanie: How does the collaborative network enhance that synergy, Dr. Boynton-Jarrett, and what do you hope to achieve with this network?
Dr. Boynton-Jarrett: So we have taken our understanding of early childhood adversity and its long-term impacts on how children grow, develop, and thrive, and we've taken that understanding and we've used it to inform what we call the Trauma Informed Leg. So when we think about partnerships between schools, and clinics, and with housing developments, and with community members, we think about ways in which we are all working towards the same goals, and ways in which adverse social environments and the experience of social adversities undermine those goals fundamentally across the board. And this really motivates us to work together more collaboratively.
So there's three things we do as a network. First, we create data and share data publicly on our data dashboard to allow us to look at what neighborhoods are truly thriving beyond what we would expect, and what neighborhoods are not receiving as many resources or opportunity structures. This helps us direct our attention.
The second thing we do is really just hold a space. We have monthly network connection meetings here at BMC that are open to the entire community. We hold a space for people to learn more about what's happening and how they can become involved, how they can strategically align and partner with others that are working with the very same focus to improve outcomes for children.
And then the third thing we do is using a service learning and leadership model, we really create leadership pathways and trajectories for members of the community so that they can be leading the change within their local community, supporting their peers, and advocating for their peers and neighbors.
Melanie: Erica, as the resources for the Vital Village Network are increasing, and as the need is what stimulated this in the first place, tell us about the breastfeeding resource as an example of something that can really reach out to the community for the better and help with the health of children.
Erica Pike (Guest): Thank you, yes as Renee mentioned, we know deeply that no one individual or social service program can change the fabric of a community that really supports healthy outcomes for children and families, but we all need to be collectively responsible. And an example that comes to mind is back in 2014 at our annual leadership summit where a Mattapan resident came to our event with a solution that just- all it needed was a little bit more support and encouragement from other neighbors and residents. By the end of the day, she had filled a cross-sector team, had learned some valuable quality improvement skills, and just within three months, her team made connections to community-based organizations, further developed their idea, and launched the first breastfeeding support group in Mattapan.
This group staffed by peer breastfeeding counselors is now the most popular support group in the city. The Mattapan Breastfeeding Support Group also inspired more people to get involved in this mission to increase access to breastfeeding support through a peer leadership model, like Renee mentioned, and in 2016 the Breastfeeding Coalition for the City of Boston formed. There are now nine support groups that are peer-led across Boston that use simple measurement tools that track the impact and outcome. The groups are based at community organizations such as the Children's Museum, different community health centers across the city, and libraries where people are going, where families are, peer scholars meet them.
The scale has shown real community-driven solutions are powerful. Over 1,000 caregivers and children have been reached. Forty-five community leaders have been trained as peer counselors and are on the trajectory to becoming certified lactation counselors or internationally board certified lactation consultants or IBCLCs. And these peers have volunteered their time, they're dedicated to this work because maybe they themselves have experienced a hard time receiving access to breastfeeding support in their own community.
We also see that this model has been replicated. Brigham and Women's Hospital has now since adopted our model after participating in the Breastfeeding Coalition.
Melanie: That is so cool, and what a wonderful opportunity for community members to serve as peer lactation support providers and getting involved, because in this case, it really does take a village, and that seems to be, to me, what you are doing there. So Erica, how does this address what you see as the inequities that persist in communities? Are women just not aware of the benefits of breastfeeding? Or if they have issues or problems, they don't know where to turn? Is that how this all sort of came together?
Erica: Yes, exactly. So when you are in a support group talking with other members who look like you, who speak your language, you are more able to be in a trusting relationship and ask the questions that may go unasked in a patient / provider environment. These support groups are in the community, so they are in places where families frequent, and are in those spaces that trust and relationship building thrives. So our support groups really have space for relationship building, for talking, for socializing, but also for really asking those tough questions.
Dr. Boynton-Jarrett: This is Renee, and I would like to add, just as Erica shared, this is the heart of the work we do as a network, and why it was so important to form as a network. We take a solution finding orientation. You may look at certain communities in Boston and see them with more of a deficit lens. They have high needs and high issues; however we take the opposite orientation. We look for the assets and the resources within the community, and one of the biggest assets and greatest resources in every community in America is the people. The people and the abundance of their willingness to give and help their neighbors. And we have leveraged that very abundance of that willingness to help your other peers to really have a huge impact on health and well-being in a very proactive, sustainable, and scalable model.
Melanie: Before we wrap up, Erica, I'd like to give you this last point to make as the Communications and Policy Manager. How are you setting policy as far as whether you're building civic capacity and community members or peer advocacy even for legal strategies? How are you going about getting all these people ramped up and involved?
Erica: This is really where our network is going. We really create the space for innovation and connections to be made which helps these solutions that Renee mentioned because the people in their community, they know what the community needs. Creating that space for innovation and connection really helps those solutions thrive.
Specifically with the Boston Breastfeeding Coalition, we have upcoming signature advocacy events celebrating Black Breastfeeding Week which are co-hosted by various community-based organizations and resident leaders. Raising awareness, bringing the research and voices, stories from the community to the table where decisions are being made is a real next level strategy that we'll be using in the Boston Breastfeeding Coalition and with the Vital Village Network.
We really encourage your listeners to join us in celebrating Breastfeeding Month this August, and to check out ongoing policy advocacy and connection activities happening throughout the Vital Village Network on our calendar page. As always, our events are open, and we encourage various partners and community members to join.
Melanie: Dr. Boynton-Jarrett, the last word to you here. Tell us how Vital Village Network and Boston Medical Center working together are maximizing child, family, and community well-being. What do you want the listeners to take away from this segment to know about all the great things that you are doing there?
Dr. Boynton-Jarrett: I'll just share very personally, I came to Boston Medical Center as a primary care pediatrician, which I have loved being, and I've loved the opportunity to work with patients and families. However, partnering with schools, clinics around the city, organizations such as the Boston Children's Museum, community organizers, partnering with parents has actually completely changed my understanding of how we create environment where children thrive.
So rather than responding to challenges and issues that are identified medically, we are really supporting the creation of communities that have opportunity structures for social support, for access to resources, for access to peer support. This is an investment in health that every member of the community is making for children, and that's a huge, huge abundance of resources that could never be produced by an independent hospital medical center alone.
This helps achieve not only Vital Village Network's vision, but the BMC vision to be exceptional and provide exceptional care for every person, and also to help make Boston the healthiest city in the country.
Melanie: What a wonderful wrap-up. Thank you, ladies, so much, and thank you for all of the great work that you're doing on behalf of the community. It's such important work, and it's wonderful to see people coming together in this collaborative network to help each other. We certainly need more of it, so thank you so much for being with us today.
This is Boston MedTalks with Boston Medical Center. For more information on the Vital Village Network, you can go to www.VitalVillage.org. That's www.VitalVillage.org. Or to hear more podcasts in this series, go to www.BMC.org. This is Melanie Cole, thanks so much for listening.