Joining Forces for Health Justice in East Nashville

  ·  Health Policy Hub   ·   Kyle Marie Stock

Pictured: A picture of the James A. Cayce Homes housing development with two people holding hands overlayed over it. Photo credit: Nashville Metropolitan Development and Housing Agency

Last month, we traveled to Nashville, Tennessee to spend time with our community and state partners, the Martha O’Bryan Center and the Tennessee Justice Center. Through our Partnering for Community Health project, we are collaborating to identify ways to support the health and well-being of children, families and seniors living in the James A. Cayce Homes, a low-income housing development. The aim of Partnering for Community Health is to ensure that community voices are heard and represented during the policy making process. On the heels of our recent visit, we wanted to share how Cayce residents are taking the lead to improve their community and amplifying their voices during a time of transformation and uncertainty in their neighborhood.

Our visit took us to East Nashville, where the Martha O’Bryan Center sits at the center of the James A. Cayce Homes housing development. Completed in the early 1940s, Cayce Homes originally restricted occupancy to white families only. By the 1970s, discriminatory lending practices had helped white people purchase their own houses and move out of low-income housing like Cayce, while in contrast, many banks refused to offer mortgages to qualified Black families. Over time, these discriminatory practices meant that Cayce became home to approximately 700 predominately African-American families. As of today, the City of Nashville is in the process of demolishing every unit at Cayce and rebuilding mixed-income housing in their place. The City has assured residents they will be able to remain in the community if they choose, but many residents have expressed concerns that they might be pushed out as development continues to change the face and affordability of the neighborhood. 

During our time in East Nashville, staff from Community Catalyst and the Tennessee Justice Center (TJC) had the opportunity to tour the Martha O’Bryan Center and connect with some Cayce community residents. We had the opportunity to meet and talk with Ms. Vernell McHenry, who is a longtime resident and a member of the O’Bryan Center’s Family Resource Council (FRC). Ms. Vernell and her fellow council members are working to ensure that current Cayce residents are taken care of as Cayce transitions to mixed-income housing. The FRC also provides guidance and insight about the needs of Cayce residents that will help inform policy changes at the state and local levels. Ms. Vernell and others have shared some of their experiences living in Cayce and what the community needs going forward on the podcast, The Promise.

Through conversations with our project partners and community residents, we identified these important takeaways from our time in Nashville:

  • Connecting in person is critical: The time spent in person with the residents of Cayce and the staff of our partner organizations made a significant difference in strengthening our relationships and our understanding of the needs of the community. We were able to get to know one another better, build stronger trust and learn more about Cayce in just one afternoon together, making a connection not easily replicable through email or telephone.
  • We must honor and elevate lived expertise: The Cayce residents that we met with had a wealth of knowledge and experience to share with us. One woman, Ms. Gloria, made suggestions on how to best share information and get support for other residents by explaining that in-person communication in families’ homes would be most effective. She had learned this through her own experience visiting elders in the community and finding out who was sick or might need additional assistance with getting enough food that month.
  • Social determinants of health are key: While Cayce residents did not use the term social determinants of health, they certainly knew how these impact their lives. For example, we found out that Medicaid renewal packets had been sent to community residents by mail. However, some individuals and families were not receiving them in a timely manner because of the City’s demolition of the apartment units. During construction, residents must travel outside the community to a nearby post office to get their mail rather than have it delivered directly to the unit where they are temporarily staying. Without this important paperwork, some residents might lose their health insurance coverage, which can be highly detrimental even if their coverage lapses for only a short period. Unfortunately, we heard that getting to the post office can be challenging for residents because of a lack of transportation. In addition, for some residents, walking to the post office was simply not an option due to the high summer heat or limiting health conditions.

The opportunity to hear directly from residents helped make clear that individuals in the community are the experts on their lives and on how to improve the health system. The goal of Partnering for Community Health is to ensure that this expertise is heard and incorporated into the policy making process. As residents share their experiences, our partners are taking steps to further hone in on and address the community’s articulated needs. Our partners worked with residents to distribute a survey to identify barriers to health care access in the community and we are in the process of analyzing the data. TJC has been tabling at the O’Bryan Center’s food bank to share information about the organization’s services and identify individuals who are willing to share their story. Plans are also in the works to arrange transportation for residents to the post office to pick up their mail during construction.

Community Catalyst is excited to continue collaborating with all our Tennessee partners to move this work forward in the coming months and years. Stay tuned for future updates!

Megan Whitehead, state advocacy manager at Community Catalyst, also contributed to this blog.