by David Mendez
Last month, at the Beach Cities Health District’s volunteer gardening day, CEO Susan Burden got back to what she does best: getting her hands dirty.
Clad in a bright blue shirt, sunglasses, calf-length pedal pushers and a pair of gardening gloves, Burden found a corner of a sunflower bed at Alta Vista Elementary School’s student garden — part of the LiveWell Kids program sponsored by BCHD — and got to work.
Bit by bit, the Missouri native took apart the crab grass that had invaded the soil, yanking out handfuls to prep for the upcoming growing season.
Unlike most CEOs, Burden wasn’t there for a quick camera opportunity opportunity: that much was evident when she gently sighed at the reporter pushing a camera in her face before her characteristic smile came back to her face.
“The farm girl is getting back to her roots,” Burden said, digging her hands back into the dirt.
At the end of October, Burden will be stepping down from her post as BCHD’s CEO, leaving a legacy of growth that stretches from the district’s partnerships with area schools to its role in the Blue Zones Project.
In her 12 years at the helm, the Beach Cities Health District has transformed from an organization on the fringes — one that, for the most part, was forgotten and forgettable — to the Beach Cities’ hub for health and wellness.
Moreover, it’s made a measurable impact on the health of the citizens it serves, from a 11 percent drop in Redondo Beach’s childhood obesity to the practical cessation of smoking among Beach Cities residents.
PUTTING THE PIECES TOGETHER
Burden was appointed Chief Executive Officer of the Beach Cities Health District in 2004, following the retirement of then-executive director Robert Reilly.
“The previous director’s motto was that, when people thought of health, he wanted them to think of the district,” said Lauren Nakano, BCHD’s Blue Zones Project Director, and one of the district’s longest-tenured employees.
When Reilly retired in 2003, the health district was in the middle of a rough patch. The organization was under fire for cutting costs by reducing program funding, particularly for local paramedic services.
Those cuts came as Little Company of Mary had recently elected to end its lease in the former South Bay Hospital. It had also recently opened Manhattan Beach’s AdventurePlex, which was suffering monthly $25,000 losses.
The district was in flux. To that point, the health care industry’s usual mode of public outreach consisted mostly of workshops, where attendees would “learn and get information, and hopefully have healthy behaviors,” Nakano said. “We saw the benefit of trying to engage the community, but the evolution was focusing on environmental policy change.”
The AdventurePlex represented a broad effort from the district, alongside a renovated Health and Fitness Center gym, to shift away from providing strict avenues to treatment to proactively raising the health profile of the community.
“We had to sharpen the internal understanding of what this organization is. At the time, it was like a bad PeeWee Herman movie,” Burden said. “We’re not a hospital, we’re not this, we’re not that…what are we?”
That year, Burden began the groundwork, building relationships in the community, meeting with people and organizations and finding out where they and the Beach Cities Health District might be able to help each other.
“I would find reasons to see them again and again, building that relationship,” Burden said.
Communication is among Burden’s strong suits — and it’s something that’s generally lacking with the health field.
“As an industry, we’re horrible at communication,” Burden said. “When something happens, it’s critical to communicate with the public, but for the longest time, the best we could come up with is a colorful picture of a germ.”
Reilly, Burden said, had done good work. “But the ‘community’ piece of the puzzle wasn’t in place,” she said.
It wasn’t long until that work would pay dividends for both BCHD and its partners.
“She got me and our mission from Day One,” said Redondo Beach Unified School District Superintendent Steven Keller, who was hired in 2006. “She’s like a second sister to me.”
The two districts have partnered with each other for many years, but one of the most meaningful occasions came from a call for help made by Keller to Burden. It was about five years ago, and the school district was in dire financial straits.
Budgets were tight, and Keller was concerned the district would have to cut elementary school counseling, which the Health District helps fund.
That’s when he knocked on Burden’s door, asking for a bridge piece of financial support, just beyond the norm.
“I went in with intent to beg, but she knew our intent was pure and sincere, and that we wanted to provide services without putting it up to BCHD each year,” Keller said.
Burden didn’t blink an eye, agreeing to champion the district’s needs to her board immediately. Within two weeks, the approval was granted.
“Counseling is still alive and well in Redondo Beach,” Keller said.
The architecture was in place and the bridges were built. Then, in 2008, the health district added Dr. Lisa Santora as the organization’s Chief Medical Officer.
With Santora’s mind for medicine and affinity for data, the health district was making inroads among children and the elderly in the Beach Cities.
“We had the relationships with interested and willing school districts and boards, and we could reach the frail elderly because they’re confined, their kids have moved, and they need help,” Burden said. “But it was with the working adult that we hit a wall.”
The wrecking ball that cleared this path was the Blue Zones Project, introduced as the Vitality City, in 2010.
At the time, Beach Cities residents were generally healthier than U.S norms, but not living as well as might be expected. Statistics bore this out. Life expectancies for Hermosa Beach residents, for example, were 60th out of 108 cities in L.A. County, and stress levels were through the roof.
But the Blue Zones Project brought measurable, marked change through the principals of healthy eating, natural movement, interpersonal happiness and personal satisfaction.
“Blue Zones Project is about environmental policy change, a whole new angle on prevention that the district wasn’t doing much of,” said Nakano, who has been with the district for 20 years. “It’s also allowed us to be a vehicle for engaging the community in a much deeper way…a much more robust way for the community to move the dial around on well-being.”
According to the 2015 Gallup-Healthways Well-Being Index, which polls cities throughout the U.S. and was implemented locally as part of the Blue Zones Project, rates of exercise, produce consumption and stress have improved, while the number of residents above normal weight and smoking use has dropped.
Daily stress levels have dropped 10 points since 2010, when they were on par with levels from post-Hurricane Katrina New Orleans. Smoking has fallen to just 8.9 percent of residents, nearly 10 points lower than the national average. Two-thirds of Beach Cities residents report exercising for thirty minutes, three times a week, 12 points better than national figures.
Most tellingly, obesity rates are dropping. Childhood obesity rates among Redondo Beach’s elementary-aged students are at seven percent, from 20 percent in 2007, and obesity rates among adults within the Beach Cities are at 12.1 percent; nationally, that figure is at 28.7 percent.
People in the Beach Cities are living longer, better, with the influence of the Beach Cities Health District.
That couldn’t have happened without a cultural shift within the district itself.
A GENTLE TOUCH
In November 2015, “Modern Healthcare Magazine” named BCHD among the top 100 workplaces to work in health care for the fourth time in the last five years.
That recognition joined not only its predecessors on BCHD’s mantle, but workplace recognitions from Outside Magazine, the American Psychological Association and the Los Angeles Business Journal.
“What’s special about Susan is that she does an excellent job communicating our message externally, and walking the talk internally,” BCHD board member Vanessa Poster said.
The key to a productive workplace — and productive employees — is creating a healthy workplace environment, Burden said.
“What I brought in, having worked in the healthcare field was…well, I use this group as a testing ground on things that I believed. If you work in the health care system, you should be healthy,” Burden said. “You can tell, this isn’t the norm in most of health care today. It’s spotty here and there, but health care workers of overweight.”
The District’s internal culture has become that of gentle reminders, where coworkers will check on each other and their health.
“Everyone needs it; we’ve got a culture of nudging all the time, without trying to be nags,” Burden said.
Just as important as physical health, though, is emotional and mental health, and facilitating a workplace of employees that are striving toward the same goals.
“You know what Susan does almost as well as we do? She hires well,” Keller said, with a wink. “Hiring is critical in our jobs, and she’s savvy.”
When bringing people on board, the district has developed a system that looks beyond the resume of their candidate to see if they’re a fit in the organization.
“They ask good questions that have to do with people’s experience and skill set, but also incorporate into hiring soft skills, personalities and the ability to work on a team,” Nakano said. “I think that enhanced the ability to find people who, for us and them, are the right fit.”
Which leads to current Hermosa Beach City Manager, and incoming BCHD CEO Tom Bakaly, who was tapped to replace Burden in August.
“He came here and he instantly connected with what we’re about,” Burden said. “He was the one, when the oil crisis was going on, to call and say ‘we need a mindfulness workshop, to bring people together.’”
He brings something different to BCHD’s table, Burden said. Bakaly still needs to get up to speed with evidence and science-based medical findings, she said, but he has the skills to run the agency smoothly as a business.
Yet Bakaly isn’t dissimilar from Burden, said Eric Garner, a BCHD communications specialist.
“He’s worked on major events: two Super Bowls in Pasadena, the 2002 Winter Olympics in Park City, and a World Cup in the Rose Bowl,” Garner said. “Those events taught him the importance of a culture where all hands are on deck; no job is below any employee, and he expects all employees to work together.”
That, Garner said, is Burden to a tee. “I’ve seen her at events serving coffee, picking up afterwards, helping with seating assignments, setting up tables, and Tom’s philosophy is right in line with that.”
Bakaly’s enthusiasm is palpable; despite his ongoing work with the City of Hermosa Beach, he still finds time to volunteer and check in at BCHD events, and his orientation with Burden involves a seven-page long list of tasks he’s burning through.
“The culture of the organization, its reliance on volunteerism, on staff, and its collaborative, participative culture are aligned with my style,” Bakaly said. “Even at [a recent volunteer event], I saw how engaged the staff and the community was and — it sounds kind of corny, but — it’s extremely healthy, from an organizational standpoint.”
But like many in the Beach Cities, he will miss Burden’s constant presence.
Said Bakaly: “It’s lonely at the top, you know? Having another person who is in a similar position to bounce ideas, staff issues, policy issues, off and being a resource to…I’ll miss that camaraderie.”
So too will Redondo Beach Mayor Steve Aspel. “It seems like she’s been there forever…I know her more as a friend than an executive, because she never came across like she was running an organization,” he said. “Truly, if you go to an event, she’s there. She works, she volunteers, she picks up trash and puts in signs. Tom Bakaly’s going to have a hell of a job following her up.”
But no person in the Beach Cities may support Burden as much as Keller, who similarly rebuilt Redondo’s school district from an ailing organization into an academic powerhouse.
“I’m not saying this to insult anyone, but she is the number one leader, true leader, in Redondo Beach,” Keller said. “When I look around and see what she’s made, she’s at the top of the chart, and I’ll say that ten years from now.”
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