The Ecology of Community Health: Advancing Equity Through a Tri-Level Approach
As a Stanford Public Interest Network (SPIN) Shinnyo Fellow— working with Redwood City 2020 and the John W. Gardner Center—I have become familiar with the tri-level youth development framework. Developed by Gardner Center researchers, this framework focuses on the interactions among the individual youth, his or her immediate setting (such as a school or program), and the system in which that setting is embedded (such as a community). Because changes at one level can affect other levels, applying a holistic or an ecological approach is key to advancing equity for young people and the communities in which they live. As a recent Stanford graduate with experience in health equity—working primarily with individuals in clinics—I was drawn to the opportunity to contribute at a system level to initiatives that help improve the lives of young people and their families.
The Gardner Center’s tri-level framework can be traced to Bronfenbrenner’s ecological model of human development. I first learned about Bronfenbrenner as an undergraduate studying Human Biology with a concentration in Community Health and Social Justice. Bronfenbrenner argues that taking into account the relationship between the developing person and the context in which the person lives and grows is necessary to fully understand their development, including their health (Bronfenbrenner, 1994).
A holistic approach is essential to leveling the playing field and advancing equity. If we ignore context, we miss important parts of the puzzle.
Through my studies, I understood that while ensuring equal access to health care for everyone is essential, access alone is insufficient to achieve health equity. Eliminating health disparities among different populations requires addressing all important determinants of health, which include contextual factors such as access to high-quality education, decent housing conditions, healthy foods, spaces to exercise, and job opportunities (Healthy People 2020). Disparities among racially and economically diverse groups are unjust because they are largely avoidable (Carter & Reardon 2015), and such disparities only become clear through an all-encompassing ecological lens.
Redwood City 2020 and the Gardner Center are working hard to address issues of inequality that exist for youth and families, focusing on ecological approaches. Chief among their strategies are community schools. Community schools are premised on a whole-child approach and leverage community resources and partnerships to help students and families thrive (NCCS & IEL 2014). Community schools target barriers to students’ learning and academic success, including those that result from living in poverty such as hunger. As a SPIN Shinnyo Fellow, I have supported planning efforts for the expansion and sustainability of community schools in Redwood City and North Fair Oaks—by conducting research in collaboration with key leaders and stakeholders to inform decision-making.
A holistic approach is essential to leveling the playing field and advancing equity. If we ignore context, we miss important parts of the puzzle. Learning about the Gardner Center’s tri-level youth development framework and gaining first-hand experience in applying this ecological lens to my work as a SPIN Shinnyo Fellow prepares me well as I work to improve the health and health care of underserved communities.
The SPIN Shinnyo Fellowship at Stanford University is a year-long, post-graduate fellowship sponsored by the Shinnyo-en Foundation in partnership with Redwood City 2020, the John W. Gardner Center for Youth and Their Communities, and the Stanford Public Interest Network (SPIN) fellowship program at the Haas Center for Public Service.
