Help People Be Independent

BOLD Goal 3: Help People be Independent

Why We Invest

80% of what makes an individual healthy is where one lives, works and plays. There is an increased need for mental and behavioral health services in our community. This need intensifies when paired with the many barriers faced by local individuals and families who are economically disadvantaged and underserved.

The Issue

Low-income individuals are nearly 2.5 times more likely to have depression.

The average nursing facility rate in North Dakota is $280.44 per day as of January 1, 2019, that equates to $102,360.60 for a year.

The Action

Our work expanded trauma-informed care and coordination for child victims of abuse.

We expanded navigation services for individuals throughout rural Clay County to stay independent and in their own homes.


United Way has taken great strides to understand national and local research and best practices in the areas of family stability and determinants of health. This research has allowed us to reexamine our Bold Community Goals and work to become more focused on specific areas and on services that have proven to create lasting social change and help families to reach their full potential in our community.

The County Health Rankings (Rankings) are published annually by Robert Wood Johnson Foundation (RWJF). Below is the Rankings model that illustrates the factors communities can change to improve overall health and the relating contributors of each factor. *

Looking at this model, we see 80% of what makes us healthy is: *

According to RWJF, “Disparities emerge when some groups benefit from consistently better access to opportunities and resources over a lifetime and across generations. For example, when children live in families with higher incomes, they typically experience stable housing in safer neighborhoods, have access to better-resourced and higher-quality schools, and are better prepared for living-wage jobs. When children live in families with lower incomes and do not have access to opportunities, they face challenges to gaining a foothold on the ladder to economic security and better health that helps them thrive.” **

Essentially, to create a healthy community and to achieve our Bold Community Goals, we need to lift people out of poverty. Previously, this has been a separate goal with a separate investment strategy. However, we recognize that reducing poverty truly encompasses all that we are trying to achieve.

Under the Affordable Care Act, nonprofit community hospitals are required to conduct community health assessments (CHA) every three years. A community health needs assessment helps the community build capacity to support policy, systems, environmental changes and community health improvement.

Locally, data is available from the most recent study conducted by Essentia Health, Sanford, ND Public Health Association, Fargo Cass Public Health, Family Health Care, Clay County Public Health, and many other community organizations and partners, including United Way of Cass-Clay. ***, ****, ***** Following this study, Essentia Health, Sanford, and Fargo Cass Public Health each published reports that detail themes and key findings as to the highest community priorities. This study included two surveys: one with key stakeholders and one with metro residents.  By nature of their missions and armed with new local data, our community’s health care partners are focused on health factors of Health Behaviors and Clinical Care for all in our community.

We feel United Way’s role in creating a healthy, vibrant community, where everyone has the opportunity to thrive, lays in focusing on the health factors of Social and Economic Factors and part of Physical Environment (specifically with our work to reduce homelessness and to ensure families have the support in maintaining safe, stable housing). These factors equate to 50% of what makes us healthy.

Having a poverty focus across all of United Way’s investment strategies naturally leads to the combination of investment strategies under Bold Goal #3, Help People be Independent, and Bold Goal #4, Lift People out of Poverty. In transition for the 2022-2024 investment cycle, we are looking to focus on the health factors not included in our other two Bold Community Goals of Reducing Hunger and Homelessness and Preparing Children to Succeed, mainly:

As the Rankings point out, “We all want to live in a place where everyone is treated fairly, where all people have a voice in the decisions that affect them, and where we all have an opportunity to succeed. When communities adopt strategies that ensure safe drinking water, provide early childhood education, improve neighborhood safety, or reduce obesity rates, we all benefit. This is an equity-focused vision of health — one where all members of a community have ample opportunity to access what they need to thrive.” *

This is why we see fully adopting a Two Generational Model (2Gen) as being the key in advancing this investment strategy. By supporting the entire family from the start, together we build a family’s capacity for sustained stability. We are moving forward with partnerships that enable better coordination of high-quality and well-timed services, with the focus of identifying gaps in services or problems that are blocking equitable access to essential resources and services families in our community need to thrive.  

According to The Aspen Institute, there are five key components of the 2Gen Approach: *******

  1. Postsecondary Education and Employment Pathways
  2. Early Childhood Education and Development
  3. Economic Assets
  4. Health and Well-Being
  5. Social Capital

Their research shows a $3,000 difference in a parent’s income when their child is young is associated with a 17% increase in the child’s future earnings. This relatively small increase in a household’s income can have a significant impact on the life of that child. *******

Additionally, social capital is a key success factor of the 2Gen Approach. According to The Aspen Institute, research has shown that social capital manifests as peer support; contact with family, friends, and neighbors; participation in community and faith-based organizations; school and workplace contacts; leadership and empowerment programs; use of case managers or career coaches; social networks, such as cohort models and learning communities; and mental health services. As they state, “Social capital builds on the strength and resilience of families, bolstering the aspirations parents have for their children and for themselves. It is a powerful component in programs that help move families beyond poverty.” *******

We are not currently accepting proposals for this community goal.  More details about the next grant cycle will be published in fall 2023.

For additional information on our strategy, please see the previous Notice of Funding Available.


* County Health Rankings & Roadmaps, What Drives Health?
** County Health Rankings & Roadmaps, Introduction to Equity
*** Fargo Cass Public Health, 2019 Community Needs Assessment
**** Sanford Health, 2019 Community Needs Assessment, Sanford CNA 2019-2021.pdf
***** Essentia Health, 2019 Community Needs Assessment, Essentia CNA 2020-2022.pdf
****** County Health Rankings & Roadmaps, What Works? Social and Economic Opportunities to Improve Health for All
******* Ascend, The Aspen Institute, What is 2Gen?