The Evidence Base
What the Research Shows
James Heckman's Nobel Prize-winning research on early childhood investment showed that the earlier the investment in a child's development, the greater the return, economically, socially, and in terms of long-term contact with the justice system. Birth-to-5 interventions that address nutrition, stress, learning, and family stability produce adults who are more employed, healthier, and significantly less likely to be incarcerated.
13%
Annual return on investment
Birth-to-5 early childhood investment, Heckman reports returns among the highest documented for any public investment studied
The investment case does not weaken as people age, it shifts. Teen mental health, third spaces, mentorship, and housing stability during adulthood all reduce justice system contact. And the research on aging well is equally clear: social isolation in older adults is a profound health risk, with consequences for the entire community. The research literature documents associations between conditions at each life stage and later health and justice outcomes.
Adverse Childhood Experiences (ACEs) Research
Incarceration meets the ACE definition. The research documents associations between ACE exposure, behavioral health challenges, and justice system contact.
The landmark ACE Study found that traumatic childhood experiences, abuse, neglect, household dysfunction, parental incarceration, housing instability, accumulate and compound over time. Four or more ACEs are significantly associated with mental health challenges, substance use disorder, and contact with the justice system. Poverty is an ACE. Housing instability is an ACE. Experiencing racism is an ACE. The 2025 homelessness report shows 75% of unhoused Whatcom County households have a mental health disability, the research literature documents associations between childhood adversity, housing instability, and behavioral health challenges.
4+
ACEs significantly associated with incarceration
75%
of unhoused county households have mental health disability
29%
of Whatcom 10th graders report persistent sadness
1 in 24
Whatcom students experienced homelessness in 2024-25
The Lifespan Framework
Every Stage Is a Prevention Opportunity
The Frame
Published research documents associations between conditions at each life stage, prenatal care through aging well, and rates of justice system contact. Chuckanut Health Foundation's work is organized around this lifespan continuum, investing across all five stages described below.
Birth to 5
Healthy Starts
Heckman: 13% annual ROI. Quality childcare, parental support, nutrition, and stress reduction produce measurable cognitive and social-emotional development. Studies including the Perry Preschool longitudinal research document long-term cost reductions including in justice system contact.
Chuckanut Health Foundation's Work
- Established Whatcom County's Healthy Children's Fund, one of the county's most significant upstream health investments
- Technical assistance and grant-writing support to childcare providers; 8 awards from the childcare innovation RFP
- Collaborated with Family Council, parents with a pathway to impact policy
- Ongoing engagement with Healthy Children's Fund governance
- Litigation to challenge repeal of the Fund, affirmed by the Court of Appeals
Youth & Teens
Mental Health & Connection
Adolescents with trusted adults and safe third spaces have dramatically lower rates of substance use, depression, and justice system contact. 29.1% of Whatcom 10th graders report persistent sadness. 16.1% have considered suicide. Connection is protective.
Chuckanut Health Foundation's Work
- Community needs assessments on youth mental health
- Convened groups around third spaces and mentorship
- Created space for relationship-building and healing for K–12 teachers and medical professionals
- Generated youth mental health report, then hosted ongoing roundtables to activate it
- Funding partner projects to build third spaces and mentorship opportunities
- Elevating student and parent voice in policy and program design
Community & Place
Civic Power & Belonging
Community connectedness and civic participation are documented protective factors against crime. Places where residents have decision-making power over their own community health produce better outcomes than places where decisions are made for them.
Chuckanut Health Foundation's Work
- Supporting community leadership from the ground up in East Whatcom
- Piloted community-owned process for policy development
- Celebrated, grieved, protested, and co-created with communities of color
- Elevated community voice through a study designed and led by community members
- Founding sponsor and backbone for the Whatcom Racial Equity Commission, built through an exhaustive, inclusive community-led process; now independently led
- Began process for an NAACP chapter and potentially a youth chapter
Adults & Recovery
Opioid Response & Re-entry
Addiction is a health condition. Medication-assisted treatment (Medication-Assisted Treatment (MAT)), peer support, and harm reduction approaches are documented in published research as associated with reduced mortality and reduced rates of justice system contact. Re-entry with connection is the difference between cycling and stability.
Chuckanut Health Foundation's Work
- Buprenorphine in the Field by select EMS personnel, cutting-edge access to MOUD at the point of crisis
- MOUD treatment expanded at PeaceHealth Emergency Room; ScaleNW network developed
- Impact Fund: 133 families, $32,000 in one year, critical flexible emergency support
- Criminal justice system change: Prosecutorial Diversion, warrant quashing, ITA reimagining
- ~1,460 people engaged across summits, webinars, Native Transformations, Re-Entry Simulations
- Government declarations of emergency: Lummi Nation, County Council, Bellingham, Ferndale
- Lunches between prosecutors and formerly incarcerated individuals, building relationships that changed policy
Older Adults
Aging Well
Social isolation in older adults is associated with cognitive decline, depression, and increased emergency service use. Communities where older adults age with dignity and connection have lower overall rates of crisis-driven system contact.
Chuckanut Health Foundation's Work
- Conducted extensive community needs assessments across the county
- Developed the Aging Well Whatcom Blueprint, 6 focus areas, policy recommendations
- Pathways for intergenerational connection; leveraged arts to shift culture around aging
- Created opportunities for older adults to tell their own stories
- Advocacy for sustainable senior centers across Whatcom County
- Support for Dementia Support NW, connecting families facing dementia to care and community
- Lara Welker's leadership: helped City of Bellingham pilot Nesterly, roommate matching for seniors seeking connection, belonging, and income, and people seeking affordable housing
- Supported feasibility and growth for Lummi Island Health & Wellness Program
Across the Lifespan
Care for a Lifetime
Health is not a destination, it is a practice across a whole life. This year, Chuckanut Health Foundation's cross-cutting focus includes: healthcare access as Medicaid cuts loom, with ripple effects across every system we touch; human-centered system design to ensure care works for the people who need it most; and care for the caregivers, workforce support for the people who hold this community together.
Chuckanut Health Foundation's Work
- Advocacy for healthcare access as federal Medicaid cuts threaten the most vulnerable, with ripple effects across every system Chuckanut Health Foundation touches
- Convening and supporting the Family Care Network Primary Care Fund & Partnership and the Northwest Medical Society Partnership to strengthen primary care capacity
- Human-centered system design, ensuring care works for the people who need it most, not only those easiest to serve
- Workforce support and development across the care system, from clinicians to community health workers to peer support
- Care for the caregivers, because the people who hold our community together need to be held too
- Backbone support for Healthy Whatcom Partnership (with the Whatcom County Health Department) and the Oral Health Coalition
- Fiscal sponsorship of the Health Ministries Network and Oasis, community health workers serving migrant communities
Cross-Cutting Themes, Running Through All Five Stages
Science of aging well, promoting what we know keeps people healthy longer.
Civic connection & belonging, supporting community belonging and full participation in civic life.
Structural equity, addressing the underlying causes and conditions that shape healthy opportunities and outcomes.
Grassroots leadership, ensuring every issue Chuckanut Health Foundation works on is informed and led by authentic community voices and those most impacted.
Early childhood as prevention, the first years as the foundation for a lifetime of health.
Care across the lifespan, healthcare access, care for the caregivers, and human-centered system design at every stage.
Chuckanut Health Foundation's Work
How Chuckanut Health Foundation Works, and What We're Doing Across the Lifespan
All Hands Whatcom · Lummi Nation · A Teaching We Are Honored to Follow
The Reefnet Model of Wellness, a framework for how we hold each other.
Honoring Lummi Leadership & Sovereignty
Lummi Nation is a sovereign nation and a leader in this region, in governance, in cultural knowledge, in community care, and in how a community can respond to crisis with wisdom, relationship, and accountability. Lummi Nation leaders have been present and influential in every aspect of All Hands Whatcom's work. The Reefnet Model of Wellness is rooted in Coast Salish oral tradition and the Lummi practice of reefnet fishing, one of the most complete expressions of community health we have encountered. Chuckanut Health Foundation does not own this framework and does not claim it as ours. What follows is Chuckanut Health Foundation's interpretation of a teaching we have been honored to receive, and how it shapes how we show up across the lifespan of our work. We are grateful to have been taught, to have listened, and to follow where Lummi Nation leads.
In Coast Salish oral traditions, salmon were once people, and people just like the salmon today, are most drawn to swim with the currents. The forces in people's lives, their families and communities, can be like currents pulling and carrying them in different directions.
Properly set reef nets can guide the salmon on either ebb or flow of the tide. The anchors of the net are like the individual and spiritual characteristics of a person. Some anchors do not carry enough weight to keep the net strong, but with time the right amount of weight can be added to hold the line and shore up the passage.
Protective factors, like floats on a net, help keep a person, family and community open to wellness, and provide for safe passage through life's ebbs and flows. The net, like a mother's womb, represents life and transformation, outcomes of a safe passage.
Watchmen in the cedar canoes keep lookout for salmon entering the net. At the right moment the net is pulled into the inshore canoe and fish are deposited in the shore canoe. The people on the canoes each know their place and purpose as part of the crew. And working together, they support the net from both sides.
Properly set reef nets can guide the salmon on either ebb or flow of the tide. The anchors of the net are like the individual and spiritual characteristics of a person. Some anchors do not carry enough weight to keep the net strong, but with time the right amount of weight can be added to hold the line and shore up the passage.
Protective factors, like floats on a net, help keep a person, family and community open to wellness, and provide for safe passage through life's ebbs and flows. The net, like a mother's womb, represents life and transformation, outcomes of a safe passage.
Watchmen in the cedar canoes keep lookout for salmon entering the net. At the right moment the net is pulled into the inshore canoe and fish are deposited in the shore canoe. The people on the canoes each know their place and purpose as part of the crew. And working together, they support the net from both sides.
⤳ The Current
The forces in a person's life, family, community, historical trauma, structural conditions, the economy, the policies we live inside. These are real and they are moving. Chuckanut Health Foundation's work begins with reading the current honestly: naming what is actually carrying people toward or away from wellness, rather than assigning blame to the person being carried.
⚓ The Anchors
Individual and spiritual characteristics, the things that hold a person in place: culture, identity, relationship, belonging, faith, a sense of purpose. Treatment and services that do not engage the anchors do not hold. Chuckanut Health Foundation's partnerships with culturally grounded organizations, lived-experience leaders, and community-based providers are about strengthening anchors, not replacing them.
🜂 The Floats
Protective factors, what keeps the net open to wellness. Housing, connection, access to care, cultural affirmation, economic stability, safe community. These are what Chuckanut Health Foundation's upstream investments build. Floats are not luxuries; without them, the net closes and people are lost to currents that were never theirs to fight alone.
🛶 The Crew
No one holds the net alone. EMS, hospitals, prosecutors, public defenders, schools, tribal health centers, faith communities, families, Chuckanut Health Foundation, each knows their place and purpose. Working together from both sides of the canoe is what All Hands Whatcom means. It is what real coordination looks like when a community chooses to hold each other.
Chuckanut Health Foundation is also guided by other frameworks for community health practice, the Spectrum of Community Engagement to Ownership, the PRECEDE-PROCEED model, and the Groundwater approach to health equity, each of which affirms what the Reefnet Model embodies: health is relational, structural, and communal.
Passage: Coast Salish oral tradition as shared through the Lummi Nation's work on the Opioid Response Framework and in partnership with All Hands Whatcom. Interpretation: Chuckanut Health Foundation's understanding of how this teaching shapes our work, offered with gratitude and without claim of ownership.
Uplifting Grassroots Leadership
Fiscally Sponsored Partners & 2026 Grant Investments
Every child gets a healthy start. Every person receives the care they need throughout their lifetime.
Chuckanut Health Foundation is the nonprofit backbone home for a growing family of fiscally sponsored partners, organizations doing direct care, community health work, and grassroots leadership across Whatcom County. We are honored and proud to support so many partners whose work advances our shared vision across the full lifespan.
Fiscally Sponsored Programs & Partners
Recovery Café Bellingham · Chardi Kala Project
BIPOC Women's ReStorying Retreat · Hearts to Soles
Health Ministries Network · Whatcom Food Network
Oral Health Coalition
Oasis, Community Health Workers for Migrant Communities
Healthy Whatcom Partnership (with Whatcom County Health Dept.)
Northwest Medical Society Partnership
Family Care Network Primary Care Fund & Partnership
Halogen, Support for Black and Brown Youth
Catch Me, Rural Mental Health Support for Youth
PRIME Sports Clinics, Free Sports Clinics for Youth
BIPOC Women's ReStorying Retreat · Hearts to Soles
Health Ministries Network · Whatcom Food Network
Oral Health Coalition
Oasis, Community Health Workers for Migrant Communities
Healthy Whatcom Partnership (with Whatcom County Health Dept.)
Northwest Medical Society Partnership
Family Care Network Primary Care Fund & Partnership
Halogen, Support for Black and Brown Youth
Catch Me, Rural Mental Health Support for Youth
PRIME Sports Clinics, Free Sports Clinics for Youth
Not exhaustive, Chuckanut Health Foundation continues to onboard new partners as community needs evolve.
2026 Open Grant Round, 45 Organizations · $588,020
71 organizations applied across 7 priority areas requesting $1.67M. Chuckanut Health Foundation funded 45, our most expansive round to date. These organizations are Chuckanut Health Foundation's boots on the ground: the practitioners, navigators, educators, clinicians, and community builders who translate our vision into lived reality.
| Priority Area | Selected Recipients |
| Youth Mental Health | Ferndale Youth Collective · NAMI Whatcom · Nooksack Valley SD · Whatcom Dispute Resolution · The Resilient Project · FuturesNW · Make.Shift · Gifts of Music NW · Roots & Resilience · Compass Health · Animals as Natural Therapy |
| Healthcare Access | Clean Cut Futures · Unity Care NW · Planned Parenthood · WC Medical Reserve Corps · WC Fire District 16 · Health Ministries Network · Opportunity Council/WRIC |
| Civic Belonging & Equity | Racial Unity Now · Vamos Outdoors · HEZ Foothills Engage · HEZ Vehicle Scholarship · Whatcom Literacy Council · Downtown Bellingham Partnership · Community Boating Center · Max Higbee Center · BPS Racial Literacy |
| Healthy Children & Families | Communities in Schools · Skookum Kids · Common Threads Farm · Kids in Motion Therapy · United Way of Whatcom County |
| Seniors & Aging | Dementia Support NW · Whatcom Council on Aging · Palliative Care Institute · Lummi Island Health & Wellness · Christian Health Care Center · Allied Arts |
| Basic Needs | Whatcom Clubhouse · A Watered Garden · Twin Sisters Mobile Market · Ferndale Community Services · Catholic Community Services |
| Opioid Epidemic | Recovery Café · Cascade Medical Advantage |
The Investment Case
Prevention Pays, What the Data Shows About Returns
Heckman Equation · Perry Preschool · RAND
Return on Investment by Intervention Stage
Earlier investment produces higher returns, per dollar invested, per year
Sources: Heckman Equation (birth-to-5); RAND Corporation early childhood research; Perry Preschool longitudinal study; WSU Progress Report (diversion).
ACE Research · WSU Progress Report 2023
Recidivism Trend, Whatcom County, WSU Analysis
1-year recidivism in Whatcom County per WSU 2023: 35% (2015 cohort) → 18% (2019 cohort)
Source: WSU Washington Rural Jails Network Progress Report 2023. 1-year recidivism by booking year cohort.
The Connection to the Jail Debate
Whatcom County's current planning cycle involves decisions about both justice facility capacity (addressed in the Pasquo forecast and STV/EP&A analyses) and upstream behavioral health investment (addressed in the Interlocal Agreement (ILA) and Implementation Plan). The research summarized on this page, on early childhood investment, ACEs, and recidivism trends, is part of the evidence base that policymakers and community members can draw on in evaluating those decisions. Chuckanut Health Foundation's role includes both direct programming across the lifespan and participation in the governance structures (including as Incarceration Prevention and Reduction Task Force (IPRTF) co-chair) that shape how the sales tax revenue is allocated.