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How to improve health for all in Miami? Focus on the cultures that give the city its zest.

This feature was produced by Robert Wood Johnson Foundation, and does not reflect the opinions or point of view of Vox Media or Vox Creative. Vox Media editorial staff was not involved in the creation or production of this content.

Miami is like no other place in North America, or possibly the world. Famously welcoming, Miami-Dade County — also known as the "Gateway to the Americas" — has served as a haven for generations of refugees from Cuba, Colombia, Nicaragua, and other Latin American countries. The county's population of 2.7 million encompasses 79 different cultures; 51 percent of Miami's residents are foreign-born, more than any other city in the United States. This multicultural mecca also hosts 13 million visitors a year, all contributing to a vibrant stew of Latino music, international restaurants, regular street festivals, forests of high-rises downtown, and brightly hued houses and streets in its many ethnic neighborhoods.

But under the high-energy surface, Miami is grappling with pressing social and health risks. About one in five of the county's residents live below the federal poverty line, including nearly one in three children. A third of the population is uninsured, two-thirds of adults are overweight or obese, and too many neighborhoods lack nearby access to affordable healthy food or safe parks.

In Liberty City, home to one of the oldest black communities in Florida, Miami Children’s Initiative aims to transform the neighborhood block by block.

[How do you battle childhood obesity? A day (or two) in the park]

A fractured response wouldn't meet these challenges. Instead, in 2003 the Consortium for a Healthier Miami-Dade County was formed to address the county's overall health. Determined from its creation to be as inclusive as possible, the consortium started with 160 partner organizations, and focused on prevention and on the social factors that impact health. Successes over the past decade include putting healthy menus in place in the county's public schools, which serve 340,000 children; installing fitness equipment that is free to all in 16 parks, with seven more teed up; reducing the homeless population; and offering routine HIV testing in all health facilities.

The consortium's membership grew along with its mission. There are more than 900 members and 300 partners today, including government agencies, nonprofits, restaurants, churches, broadcasters, universities, insurers, schools, and city planners.

"The strength of the consortium is that it is made up of members of the community from every sector," says co-chair Alina Soto. "We have everyone from the state health department to Holly Zwerling, founder of the Fatherhood Task Force of South Florida, who is a spokesperson for engaging fathers in the community. We have over 75 restaurants that now offer healthier menu items. It's community, it's grassroots, and it's individuals. And it's a foundation for us to create a culture of health in this community." Explore the links throughout this story to learn more about Miami-Dade County's work.

[An approach to healthcare that ensures access for the elderly]

Because of this long-term focus on collaboration, inclusion, and outreach, Miami-Dade County has been honored with the RWJF Culture of Health Prize.

The consortium's broad-based action is driven by its determination to address health in ways that resonate with each unique culture and community. Take Little Havana, for example. One of the city's most underserved neighborhoods, it has been lifted by ConnectFamilias, a nonprofit formed in 2007 by a variety of local partners dedicated to strengthening the community's children — and by extension their families. On any given day in ConnectFamilias' offices, in the heart of the neighborhood's business district, staffers and volunteers are helping adults learn how to write a resume and handle a job interview, conducting "mommy and me" classes for mothers and their toddlers, and reading with young children and their parents, in English and in Spanish. ConnectFamilias offers job training and helps teens find internships. The organization also worked with the community to build a safe park — an amenity Little Havana sorely lacked.

[In a place famous for its beaches, neighborhoods still need parks and playgrounds]

"When you think about the work that needs to take place to have a healthy community, it's not just going to the doctor," says ConnectFamilias president and CEO Betty Alonso, who grew up and still lives in the community she serves. "It's really going to find a job, having a good education, addressing so many things around those social determinants of health. No one agency, no one funder, no one partnership can do that by itself."

The range of consortium-supported programs is as vast as the county, but most are tailored to the communities they serve. Initiatives developed for Little Havana are not shoehorned into Liberty City, a neighborhood that is home to one of the largest black communities in Florida and the site of the nation's first public housing project. There, the nonprofit Miami Children's Initiative provides many of the same types of supports and the same level of community empowerment as ConnectFamilias does in Little Havana, but in ways that best meet the needs of Liberty City.

[A homeless center mends spirits and health]

At the same time, broader countywide initiatives, such as those geared toward preventing violence, serve the county's common good. Miami's crime rate is twice the national average. The Violence Intervention Project and the Miami-Dade Anti-Gang Strategy were created to engage and empower youth to halt violence in their communities, with support from law enforcement. In August, dozens of residents and police officers came together in a show of unity to march through Liberty City, which has been plagued by gang violence. The parade was followed by a back-to-school block party and barbecue that gave residents and police a unique opportunity to connect.

"It takes all of us coming together to create a different Liberty City and a different reality for the children of this neighborhood," said Cecilia Gutierrez, the event organizer and president of the Miami Children's Initiative.

[A children's initiative takes on education, health, and employment in one neighborhood]

The consortium and its partners also enjoy robust support from county and city government, and, indirectly, from the millions of visitors to the city. Miami-Dade's safety net hospital network, Jackson Health System, is financed in part by a half-penny sales tax, while a portion of the food and beverage tax is used for homeless services.

Irene Onody paints at the Camillus House, in Miami, which offers comprehensive services for the homeless.

In July, the county commission approved a $300 million overhaul of Liberty City's public housing, with grocery stores and parks — now almost nonexistent — as part of the master plan. "You'll see our communities that are traditionally underserved will begin to thrive," predicts Miami-Dade Deputy Mayor Russell Benford, while hailing the capital investments. "Every part of this community needs to prosper if any of us are going to prosper."

Share this story with a friend or colleague who cares about health in America.

This feature was produced by Robert Wood Johnson Foundation, and does not reflect the opinions or point of view of Vox Media or Vox Creative. Vox Media editorial staff was not involved in the creation or production of this content.


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