Leadership Interview: Jeff Kuhr, PhD, Executive Director, Mesa County Public Health

Jeff Kuhr is the director of public health for Mesa County, Colo., which serves 150,000 residents on Colorado’s Western Slope. He serves on the Colorado Board of Human Services, the Colorado Early Childhood Leadership Commission and the Regional Early Head Start Governance Council. Kuhr is leading an effort to build social capital in a Mesa County neighborhood in Clifton with an aim to improve community health, education and the economy.
Ascent: Social capital is about social connectedness—the sum of an individual’s or a community's personal network and institutional affiliations. Why is Mesa County's social capital project focused on this particular neighborhood?  
Kuhr: We brought together about 80 local agency partners in January 2017 to prioritize the needs in Mesa County around social determinants of health. Over the course of that meeting, social and family connectedness stood out as an area that was its own priority, and one that, in and of itself, supports better education, health and the economy.  
When you talk about community connectedness or building social capital across a whole county—or even across a whole zip code—it’s overwhelming. A survey on social capital identified the Clifton community as our highest need area in terms of social capital, and even that seemed like a huge undertaking. So we narrowed the focus to a neighborhood around a single school in Clifton, Rocky Mountain Elementary. 
Then the work became more manageable for us: If we all do what we do better there than we do it anywhere else, then we’ll build social capital. And then we can move to the next neighborhood. 
Ascent: Building social capital is about relationships and trust. What are the steps necessary to build social capital? 
Kuhr: The Community Transformation Group has a steering committee that meets regularly, and we’ve mapped out three major steps. The first is building a sense of community in the neighborhood. That’s really about social cohesion, or getting people in the neighborhood connected, so they can empower themselves and rely on each other more to form bonds. That does require trust—trust in leaders in the neighborhood, trust in policymakers and trust in us, Mesa County Public Health. 
The second step is neighbors partnering with local organizations toward solutions. An example of this is the new Mesa County community policing policy over the last six months, which has already resulted in a drastic reduction in crime. We’re also in the process of interviewing a second code enforcement person who will be dedicated to this area.  
We’re also becoming more actively involved in the community, so we can help those eligible for benefits enroll in WIC, SNAP, Medicaid and other programs. That takes more than just sitting down with them in their neighborhoods, because it’s a self-efficacy question. They need to understand why the benefits can help them and trust us to help them enroll. 
The third step is to increase participation in neighborhood activities. We are working to increase activities—both recreational and academic—for parents and children around Rocky Mountain Elementary School. The Riverside Education Program just received a grant to start after school activities there for students, siblings and older kids. We’re planning to apply for additional grant funding to build up those resources. 
Ascent: What are the benefits of reaching all members of this community, especially with regard to health? 
Kuhr: When you think about the whole social capital theory and structure, it starts with building greater trust in the community. Once people trust each other, they will access more programs and resources in the community. For example, take a family of four that earns $24,000 a year or less. If we can build trust and empower them to take advantage of WIC, SNAP and Medicaid benefits, free and reduced lunch, housing vouchers and other needed services, they could effectively increase their hourly wage equivalent from $12 an hour to $15 an hour. And that allows them to become more self-sufficient and reduce daily financial stress. Mental and physical health improves, and that’s how you get to better outcomes.  
The next step in the model is more frequent community participation—people start going to functions in the neighborhood, and they become civically engaged. I really think that people in some of our neighborhoods don’t feel like they have a community or a political voice. I want people to feel like they have a voice.