Every month, Teddy Ayele gathers with a community group at the Medhane-Alem Evangelical Church in Seattle’s Rainier Beach neighborhood. The group discusses steps they’re taking to support their health, like committing to regular exercise and regular monitoring to keep their blood pressure in check.

As a community health navigator with the YMCA of Greater Seattle, Ayele facilitates these meetings, and other workshops and programs for East African immigrants, all with the goal of fostering greater health equity. “Somebody has to take initiative to do work like this to support the community,” he said.

Ayele’s personal story of how he became a community health navigator certainly fits that sentiment. Before working for the YMCA, he had no professional experience in medicine. He had earned a degree in aviation technology management from Oklahoma State University and worked in aerospace science for years, arriving in Seattle in 2005 to work for Boeing.

But after his brother died unexpectedly in 2015, his life took a turn.

“That kind of shook to my core, and it was from 2015 to the beginning of 2016, for one year, life for me was really unbearable,” Ayele said.

In 2016, he made a personal decision to reevaluate what he wanted to do with his life.

He ended up leaving aviation in 2019. And when the COVID-19 pandemic hit, he served as COVID task force leader at his church.

In 2021, he connected with Rahel Schwartz, the program executive of health equity at the YMCA of Greater Seattle, who was doing outreach work within Ayele’s community. Upon their introduction, Ayele became the first community health navigator at the YMCA.

Now, he’s part of the important and unique work the YMCA of Greater Seattle does to connect community members with health resources for disease prevention and treatment, as well as holistic wellbeing, tailored to the cultural and language experiences of different immigrant communities.

For folks who associate the YMCA with affordable gym memberships and not much else, it might be news to find out about this all-encompassing health care work. But the organization has much to offer aside from affordable spaces for exercise, said Dr. Sonya Walker, senior program executive of healthy living, health equity and health integration at the YMCA of Greater Seattle. Walker oversees the YMCA’s branch operations, including offerings like group exercises classes and personal training, and health integration programs operated in partnership with health care providers. Walker’s work also focuses on the YMCA’s mission to support health equity, ensuring everyone has the same access to the best health possible.

 

Nahom Daniel, Zewdie Terry, Rahel Schwartz and Teddy Ayele.

The YMCA of Greater Seattle health equity program was started by, from left to right, Nahom Daniel, Zewdie Terry, Rahel Schwartz and Teddy Ayele.

Meeting communities where they are

The YMCA of Greater Seattle’s focus on health equity began at the Meredith Matthews Branch in the Central District. Named after the first African American YMCA executive, the branch has long provided resources and services to the Central District’s predominantly Black community, and was once a meeting place for civil rights leaders. The space provides health and wellness resources to the community, including treatment and prevention for chronic illnesses — like diabetes, hypertension, and cancer — that disproportionately impact Black and Brown people.

But in recent years, gentrification has pushed communities of color out of the area the branch serves. As neighbors were displaced, it occurred to program director Schwartz that they might also lose access to health services the branch had provided. She wanted to find a way to broaden access to these services, to ensure continuity of care as folks changed addresses. “Being a public health professional, our focus is how can we serve the most impacted populations in a way that eliminates the barriers?” Schwartz said.

To offset the impact of gentrification, Schwartz said YMCA staff had to identify new, centralized locations where they could reach displaced residents, like community centers or faith-based organizations like the one where Ayele facilitates his monthly meetings. Now, community health navigators like him tailor the YMCA’s healthy living programming to a diverse range of communities, Schwartz said. To do this work, she said, health equity team members have to understand the problems community members are facing and how they can find holistic solutions.

It also means addressing historic health disparities, which Walker said have been exacerbated by the COVID-19 pandemic. “If we have the opportunity to actually go out to meet people where they are, one, you’re going to have a higher rate of success,” Walker said. “But two, you’re really going to be able to build trust, and really form the community that you’re looking for.”

What is healthy equity?

When it comes to health, true equity — which, per Schwartz’s definition — would mean everyone is able to access their healthiest lives — is rare. That’s because systemic barriers often prevent marginalized communities from accessing needed health care services. The YMCA’s health equity team is trying to minimize these disparities.

“Health equity is crucial to the well-being and vibrancy of communities,” Schwartz said. “The Health Equity Team at the YMCA of Greater Seattle is working to address social and health inequities in shaping health disparities. Our goal is to serve everyone despite their socio-economic background, attain a dignified life and enjoy the highest attainable standards of health through programs and services tailored to each community we serve. This work calls for coordinated actions among organizations, and civil society to jointly address the social determinants of health.”

These efforts go beyond physical health, bringing a more holistic approach. “We want to make sure that we understand that we’re more than physical beings,” Walker said. “Our physical health matters, our emotional health matters, our spiritual health matters, our financial health matters; and so we want to make sure that we’re having an impact in all of those areas of people’s lives.”

The YMCA starts with physical health, and through those programs, Walker said, staff build relationships to find out what other needs program participants have, such as assistance with transportation, obtaining vouchers for food programs, or accessing health screenings. Ayele is one of five navigators in the program, all representing different communities.

“Everyone should have a chance, an opportunity to access health without any barriers,” Ayele said.

 

Participants in YMCA health equity programs

Participants in YMCA health equity programs can foster connections as they learn how to take charge of their health.

Long-term health — led by communities

To determine what resources his community needs, Ayele meets with focus groups once a month to identify pressing concerns and potential supports. From there, he convenes workshops, sometimes bringing in experts to educate community members in their own language. “People in the community respond better to their own language,” Ayele said. “They feel like they have this belonging to us.”

When experts share the same cultural and linguistic backgrounds as the communities they serve, it builds trust between community members and service providers, Ayele said. By identifying the community’s needs, Ayele is able to target his work based on what will be most helpful. If someone is struggling with chronic disease, but also lacks basic housing or food security, for example, the chronic disease won’t be their first priority, said Ayele. To really assist communities, community members’ intersecting problems must be adequately — and holistically — addressed.

This emphasis on community is unique to the YMCA’s health equity work. So is the organization’s commitment to serving people of all ages, in every life stage. “There are not many organizations where you can show up with your infant and stay there through the course of your entire lifetime,” Walker said. “At YGS we really are focused on what we call ‘whole person health.’ So we have the ability to serve families, from the youngest infants and to our active older adults.”

Hope for a healthy future

Walker sees a clear connection between health equity and positive impacts communities can make when bolstered with the resources her programming offers. “If my quality of life is improved, I’m going to show up better in the world, and then I’m going to hopefully spread a little joy and spread a little sunshine and a little bit of love, and people can take that in,” Walker said. Watching communities thrive, she added, “gives me hope that we are on the path to creating a healthier society that people want to be a part of.”

It’s a mission slated for growth. The program is just two years old, and since its inception, the YMCA has focused on priority populations — East African communities, African American communities and Latinx communities. Schwartz said the goal is to hire more community health navigators to represent more immigrant populations. Their expansion efforts into south King County have been made possible in part by a grant from the Premera Blue Cross Social Impact program. The YMCA of Greater Seattle and Premera Blue Cross are hoping that the programs and assistance can expand to deepen health equity in Washington.

As for Ayele, he finds great satisfaction in his community-rooted outreach work. “I do feel a sense of fulfillment,” he said. “People feel like I do quite a lot of work for them, for the community, but I feel like I’m doing it for myself … I gain more than I give.”