Starting a Fire, to Improve Health

“If a community wants to bring organizations together to carry out a project to improve health, what’s the most effective way to get action started?”

A member of the audience asked that question, after I delivered a talk at the National Press Club in Washington, D.C. on the day after Election Day. I had described some of the results from national research conducted by Wilder Research and the Federal Reserve Bank of Minneapolis that examined collaboration between the health and community development sectors in the United States. My talk and a related panel discussion were hosted by Health Affairs, who brought together several authors from their November 2014 issue, Collaborating for Community Health, to shed light on new strategies, partnerships, and measurement tools that show great promise for addressing the health needs of our communities.

Why is this important? Because your health and my health depend on much more than medical care. The condition of our bodies, the illnesses we get, and even how long we live depend largely on the social determinants of health. These social determinants include our housing, our income, the availability of nutritious food, air quality, the level of crime in our neighborhood, facilities to promote physical activity, and other aspects of our environment. In short, health care leaders have come to recognize that many of the factors that lead to illness, or promote good health, lie outside of the health care system.

Risa Lavizzo-Mourey, who heads the Robert Wood Johnson Foundation, recognized that both the health and community development sectors devote significant attention to achieving better health for all by addressing these social determinants. However, they have traditionally worked in their own spheres, with little to no collaboration. She promoted a national movement (including The Commission to Build a Healthier America) to align their efforts.

A few years ago, Wilder Research teamed up with the Federal Reserve Bank of Minneapolis and the Robert Wood Johnson Foundation, to support this movement. We carried out national research to explore current collaboration between the health and community development sectors, to identify factors that underlie successful cross-sector initiatives, to identify obstacles that prevent successful efforts, and to determine how to best support additional collaboration.

So, back to the question, “What’s the most effective way to get action started?” I pointed to “leadership.” When members of a community recognize the importance of addressing social determinants of health and when they understand the increased effectiveness of working together rather than separately – that provides the fuel for cross-sector collaboration. The fire ignites from the spark of a person or some organization who reaches out to unfamiliar partners who share similar goals and invites them to sit at the same table and work jointly.

Do successful collaborations occur now, and how do you increase the quality and quantity of that work? Some of the most interesting findings from our research, included in an article in the most recent issue of Health Affairs, were:

·         In most parts of the U.S., health and community development organizations have begun to work with one another to collaborate to improve health.

·         To date, this work is limited; much opportunity exists for expanding these efforts.

·         Organizations within the health and community development sectors continue to lack a full understanding of one another’s activities; they also lack understanding of the roles one another can play in community health initiatives. For example, public health agencies rarely think of community development finance institutions as potential sources of health information for people who need care, but they could make such information available to people who use their services.

·         Initiatives to improve health seek better measures, to understand their accomplishments and to develop strategies for improvement. Standard, commonly-accepted measures of success do not currently exist. As Risa Lavizzo-Mourey has also said, “You can’t improve what you do not measure.”

Another audience member asked a question you might expect on the day after Election Day: “What implications do election results around the country have for cross-sector collaboration to improve health?” I suggested that cross-sector collaboration is non-political and can appeal to individuals across the political spectrum. Public officials who want to promote effectiveness and greater access to health care can see collaboration as a means for influencing social determinants of health and improving services for those in need. Public officials who want to reduce cost and promote efficiency can see collaboration as a means for leveraging limited dollars for greater impact.

We look forward to continued participation in this movement to improve the health of all residents of our communities.