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Guest Article by Stacey Millett: Libraries as Networked Health Equity Leaders

Over the past several years we have begun to realize that some of the most innovative approaches to leadership development are happening under our radar because they are embedded in the day to day work taking place in organizations, communities and initiatives.  I recently found myself marveling over the impact of a grants program that supported and connected library leaders committed to strengthening public health in their cities and counties. I am on the board of Blue Cross Blue Shield MN and was first inspired by this grants program as a creative strategy for furthering health equity when it was introduced by Stacey Millett, Senior Program Officer for Health Equity.  Recently I have become impressed by the leadership achievements of this program, a network of library leaders engaged in peer learning, reaching out to connect with networks in their respective communities and collaborating on a toolkit to for other public libraries leaders to help them bring a health and equity lens to their work.  I asked Stacey to share the story of this work and I invite you to listen with a leadership lens and imagine what we might borrow from this story in our own leadership thinking and practice.

“Libraries as Networked Health Equity Leaders”

 “What do libraries have to do with health?” a colleague queried when I suggested making grants to public libraries in Minnesota.  “Everything” I replied, “libraries are more than just a great place to get books.”  When joining Blue Cross and Blue Shield of Minnesota Foundation as Senior Program Officer for Health Equity I envisioned cultivating a network of local public library staff committed to strengthening local community health.  As trusted institutions they often have strong community ties.

First, let’s identify a few key drivers of health.  Although genes, behavior and access to care affect health outcomes social and economic factors matter more.  Low earnings, high stress, dangerous environments, inadequate education and limited access to healthy food have a greater influence on health outcomes. Research and reports confirm this.  The Robert Wood Johnson Foundation identified obstacles to better health Overcoming Obstacles to Build Health In 2013 and Beyond  and is now calling on everyone to play a role in building a culture of health.


Second, let’s describe what is meant by health equity. The heart of it is making sure that all people get a fair chance to live a healthy life to their full potential no matter their income, race, ethnicity, gender, sexual orientation, disability status, or geographic location. To expect less is wrong, or better stated:

“Health Inequities are differences in health which are not only unnecessary and avoidable, but in addition are considered unfair and unjust.”
     – Margaret Whitehead, World Health Organization

Place matters a lot when it comes to health equity as illustrated in the documentary series Unnatural Causes. Libraries play important roles in places across the country spanning urban and rural geographies so the leap to health makes sense.

Blue Cross and Blue Shield of Minnesota Foundation created its “Public Libraries for Health” grant program in 2012 to enlist library staff leadership in forming partnerships focused on connecting economically challenged places and people to opportunities for better health.  Applicants were asked to propose projects that  addressed one or more of the five social and economic factors, as defined by the University of Wisconsin Population Health Institute, that affect 40 percent of health outcomes: 1) education, 2) employment, 3) income, 4) family and social support, and 5) community safety.

Funded projects have ranged from offering health insurance coverage enrollment and literacy programs at branch libraries serving predominately low-income families in Duluth to a downtown Minneapolis library opening its doors early for coffee/chat sessions with 300-400 homeless patrons who visit daily.  A rural library is focused on workforce training for under and unemployed residents. Another rural library offers cooking classes to build social connections with long-time local residents and more recent immigrant arrivals.

Findings from the Foundation’s 2012 program evaluation show two key outcomes across grantees 1) Library staff expressed learning news way to engage in their communities and gain credibility as health equity agents 2) Library staff reported that a health equity lens now informs all work inside the their institutions and in the local community.

Importantly the seven public library grantees across the state have become local leaders in pursuing health equity strategies by building two types of networks; 1) bridging library staff to health-focused networks in their local communities and, 2)connecting library staff to each other across place.

Based on the emerging strength of the latter that was nurtured through joint meetings, webinars and program evaluation sharing the library grantees are working on creating a ‘Public Libraries for Health Toolkit.” This project will result in a web-based resource for sharing how public libraries in other communities can launch a “Public Libraries for Health” initiative suited for local context.

Public libraries have become a go-to place for everything from digital medical information to deep community connections that influence health. Their leadership networks are invaluable on the journey to advancing health equity.