How a Big County and a Small Village Solved a Major Health Problem
Lincoln Heights, Ohio's turnaround may be a model for other troubled areas.
During World War II, the Valley Homes in Lincoln Heights, Ohio, a village of 4,100 just north of Cincinnati, were constructed as residences for African-American engineers supporting the war effort at a nearby aeronautical plant. For years, living in the housing complex reflected a certain level of prestige, remembers Tonya Key, who was born in the village in 1972. “That area was always vibrant when I grew up,” Key says. “It almost came with a sense of status. If you lived there, you were considered someone who came from a good family.”
But as the decades passed, the Valley Homes began to erode. In 1998, the Hamilton County Public Health Department began filing complaints about loose trash, animal infestations, sewer damage and unsafe structures. More than half the homes were abandoned. This former centerpiece of the community, 300-plus homes that had reflected its admirable roots, was slowly becoming a blight. By 2005, Hamilton County officials say complaints had become incessant. Crime and drug activity were rampant. Key, who moved back to Lincoln Heights around that time, says she didn’t feel safe letting her young children walk to school near the complex.
By 2007, village and county officials agreed that drastic action was needed. There was some resistance: the mostly elderly population that resided in the Valley Homes didn’t want to leave, and others in the community were hesitant to overhaul a neighborhood that had been a foundation of the village. But through a strategic partnership between the Hamilton County Public Health Department, which oversees public health issues for a population of more than 450,000, and this community of a few thousand, a solution was found. The Valley Homes have been condemned, demolished and rebuilt as the Villas of the Valley and, after years as an eye sore, this former point of pride has been restored as “a beacon of the community,” Key says. (See the video below for a before-and-after look at the complex).
Encouraged by that transformation, Lincoln Heights has launched a village-wide initiative, part of the county’s “We Thrive” program, to restore its community to health and prosperity. Through a comprehensive effort, this community—which in the last decade had a low birth weight average triple the national trends, a rate of communicable disease infection double the county average and a soaring number of deaths from heart disease—is taking back control of its well-being.
All this progress has been possible, Lincoln Heights officials say, because a big county health department took an active interest in one of its smaller constituencies. “This development would not have happened without the county and their insistence,” says LaVerne Mitchell, who grew up in the Valley Homes and was the village’s mayor when the redevelopment process got underway. “They could have focused elsewhere, but they knew we had the greatest need.”
As the saying goes, it takes a village—and sometimes, a county. There were a lot of complicating factors that led Hamilton County officials to get involved in Lincoln Heights. Action had stalled in previous years because one of the several government agencies that needed to approve it, whether it was the Hamilton County Community Development office or the Lincoln Heights Zoning Commission, had rejected plans to move forward at least in part because of pressure from some village residents. “Some people just really didn’t want to see anything done,” says Key. “We didn’t know what we could do.”
But when a local trash disposal company said in 2006 it would stop serving the Valley Homes because the complex had become so decrepit, adding a sense of urgency to the issue from a public health perspective, Tim Ingram, the Hamilton County public health commissioner, decided something had to be done.
“That was the door that allowed me to bring many parties to the table to address this,” Ingram says. “You can do all the individual health care you want, but if you’re putting people back into an unsafe housing situation, they’re going to go right back into the system. This is one of those things that public health has to do.”
Ingram convened a workgroup of public health officials, community development authorities, the county prosecutor’s office, the Lincoln Heights Village Council and members of the community to find a solution to the Valley Homes problem. To some, the answer seemed obvious: tear it down and start fresh. But that would require the more than 100 individuals living there to be relocated. It was a delicate balance, says Ingram, but through patience and cooperation, county and village officials reached an agreement on what needed to be done. Temporary housing was secured for the complex’s residents, and plans were put in motion to transform the area into something new.
In 2009, Hamilton County Public Health condemned more than 50 of the obsolete houses at the Valley Homes—Ingram says it was the largest condemnation that he’s ever overseen in more than 30 years as a public health official. That cleared the way for ModelGroup, a homebuilding contractor, to raze and rebuild. The whole project, funded through a combination of federal, state and private money, cost about $10 million. By the end of 2011, more than 75 new housing units had been constructed, along with a 2,400-square foot community center. In the place of decaying structures built more than 50 years ago are state-of-the-art, brightly colored cottages that will serve as home for hundreds of Lincoln Heights residents.
“What I see now is exactly how it was when I grew up,” says Mitchell, who remains on the village council. “It has that sense of pride. This has changed the face of Lincoln Heights. It has made people feel good about where they live.”
While the Valley Homes restoration took shape, county officials saw an opening to address other public health problems in the village, which is 98 percent African-American and where the average household income is below $20,000. Stacy Wegley, Hamilton County Public Health’s director of health promotion and education, says—as with the housing project—some of their initial efforts were rebuffed. She recalls members of her team attending community events and being asked to leave. But with a little persistence, and recognition by some members of the Lincoln Heights community that change was necessary, a movement began to take place.
In the last few years, the village has engaged in almost every community initiative promoted by national public health advocates. A convenience store has been transformed into a healthy foods market, supplied by a local farmer, its candy rack replaced by fresh bananas and green beans. Six school-based gardens are being planted and tended. A new playground for Lincoln Heights children has been constructed on an abandoned recreational field. The village has entered into a shared-use agreement with a local church to use its facilities for senior exercise classes. Hamilton County used part of nearly $10 million in funding from the Centers for Disease Control and Prevention as financial support.
“Our zip code is a stronger determinant of our lifespan than our genetic code. Formal and informal policies, and our physical surroundings, should make it easier to make a healthy choice,” Wegley says. “It used to be that we’d do individual programs, and then we’d be gone. But the nature of this work is much more sustainable.”
How have these efforts impacted life in Lincoln Heights? Hamilton County officials caution it's still early, but some early signs suggest improvement. The death rate has fallen from an average of 11.3 deaths per 1,000 people between 2006 and 2008 to 8 in 2009. The infant mortality average dropped from two to one over the same period. Wegley and others hope that, as this health-minded approach becomes the norm, other indicators will continue to improve.
But it’s more than that, says Key, who has since joined the village council. There is a tangible sense of ownership and community, in both the Villas of the Valley complex and in general health of the village, that wasn’t there before Lincoln Heights and Hamilton County put their heads together and went to work. The transformation of the Valley Homes seems to have led to a fundamental rethinking of what the community can do.
“People thought: ‘If we can do that, what else can we do?’. There shouldn’t be anything that stops us from moving forward to better our entire community,” she says. “We know now that there is nothing too big for us to do.”
This story has been updated to clarify some of the epidemiological data.
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