Editor’s Note: This post is part of an ongoing series written for Health Affairs Blog by local leaders from communities honored with the annual Robert Wood Johnson Foundation Culture of Health Prize. In 2014, six winning communities were selected by RWJF from more than 250 applicants and celebrated for placing a priority on health and creating powerful partnerships to drive change. Interested communities are encouraged to apply for the 2015 RWJF Culture of Health Prize. Applications are due September 17, 2014.

Spokane County is a metro area of more than 470,000 people, yet it’s still driven by the spirit of a small town. That sense of community is an essential part of the county’s ongoing work to improve the health of all residents by focusing on education.

In 2006, Spokane Public Schools’ high school graduation rate was less than 60 percent overall, while Spokane County’s rate was 72.9 percent. Spokane County educators were increasingly concerned about the future health and well-being of the county’s children, especially the 18 percent living in poverty.

On top of the poor high school graduation rate, students who attended local colleges or technical schools often failed to obtain a degree, and adult job seekers were frequently unprepared to fill the available positions in the county’s growing biomedical, technical, and health care sectors.

To address these issues, a collaboration of business leaders, health and education organizations, and nonprofits created Priority Spokane, a local organization committed to “creating a vibrant future” for county residents. In 2009, Priority Spokane led 120 community leaders from five sectors (Education, Economic Vitality, Environment, Public Safety, and Health) through a series of meetings that resulted in a vote on the area’s most pressing problems. By an overwhelming margin, the top answer was education. One man echoed his neighbors when he said: “You say jobs [are important], I say schooling to get a job. I think to get a solid job you have to get an education.”

Soon after, the Spokane Regional Health District released a report clearly linking lack of education with poorer health and poverty. In Spokane County, Washington, 46 percent of adults older than age 24 with less than a high school education live in poverty, compared to 31 percent of those who have completed high school living in poverty.

People with more education are likely to live longer, to experience better health outcomes and to practice health promoting behaviors such as obtaining timely health care checkups and screenings. Armed with the knowledge that educated individuals live longer, healthier lives than those with less education, Spokane County went to work.

A Dramatic Turnaround

By 2013, the Spokane Public Schools’ graduation rate was 79.5 percent overall and 81 percent in Spokane County. This dramatic turnaround did not happen by accident. Resources from nearly every sector of the county—business, education, and health care—were used to create innovative approaches to educating children of all ages:

  • Teachers and childcare workers are being trained—by Dr. Kent Hoffman, founder of “Circle of Security,” a relationship-based, early intervention program designed to enhance attachment security between parents and children, and Dr. Chris Blodgett, a researcher from Washington State University—to identify, support, and mentor children who experienced traumatic events in their home during their earliest years.
  • With research showing that more than 50 percent of students who eventually drop out can be identified before entering high school, Spokane Public Schools designed an Early Warning System  to identify at-risk students and develop personalized early interventions for them.
  • Community Attendance Support Teams were created to work directly with truant students and their families to reengage them with school. This is a promising practice for resolving truancy that supports families and children, whether that means buying an alarm clock or getting a child into counseling.
  • The juvenile justice system also agreed to change the way they treat children who miss school. Instead of focusing on punishment, they hired a truancy specialist to work on solving the problem. Court administrators and educators now work on understanding what keeps kids away from school and providing support to students and their families. Spokane County Juvenile Court is a leader in the Models for Change program, which includes the hiring of a Truancy Specialist, and in the Juvenile Detention Alternatives Initiative, both of which are working for reforms in the treatment of truancy.
  • A local energy company backed an effort by four county schools to convert an old big box store into Spokane Valley Tech, a high school designed to help students build careers in the well-paying STEM fields of science, technology, engineering, and mathematics. The Spokane STEM network comprises leaders from K-12, higher education, business, and community-based organizations who are building interest in STEM disciplines and post-secondary education; promoting project-based learning; encouraging formal and non-formal educators to gain STEM-related skills and experiences; and advocating for rules, laws, and policies that enhance educational innovation.

A Life is Changed

Perhaps the best way to illustrate Spokane County’s success is to share the story of Colton Cox.

Colton was raised by his grandfather. He had trouble with school; he did not feel comfortable in a traditional high school setting and had little idea what he wanted to do after graduation. But Colton was able to enroll in Spokane Valley Tech and became immersed in hands-on learning, and soon discovered he was a skilled communicator, inventor, and engineer.

With a design partner, Colton invented a remote tuner for a ham radio antenna to improve performance of the transmission; this invention helped earn him a $3,000 engineering scholarship from the University of Idaho. In the words of his grandfather: “He’s a completely different kid. Now he’s ready to take on the world.”

So What Have We Learned?

  • Collaboration is key. At every step of the way, it was clear that no one sector of the community could do this work alone. Parents, advocacy groups, business leaders, hospitals, medical schools, and policymakers all work together to turn things around.
  • Clear vision brings people together. Spokane County used evidence-based research to drive their efforts. Just as importantly, however, Priority Spokane and other community groups worked hard to inspire people on an emotional level and give them a sense of what could be accomplished by working together.
  • By working together, we can change lives. As Colton Cox’s story demonstrates, there’s a person behind every statistic. Spokane County is proof that when communities come together to improve health, amazing things can happen.

The people of Spokane are learning to align available resources across sectors to address the social and economic factors that influence health for all. We have been able to look at ourselves and our community holistically, with community health in the broadest sense at the center of our concerns.

Learn more and watch a video about Spokane County’s efforts to improve health.