Q&A: How to build community partnerships to fight the root causes of poor health

By Eric Sun and Kalyn Saulsberry, Health Disparities Initiative

Forming and maintaining partnerships with community organizations to tackle the root causes of poor health can seem like a daunting challenge. But Rachel Keller Eisman, the executive director of the BUILD Health Challenge, tells us that a few key factors can make all the difference.

Question: For those not familiar, what is the BUILD Health Challenge?

Rachel Keller Eisman: We're a funding collaborative focused on improving community health by supporting partnerships between hospitals, community-based organizations, local health departments, and other groups.

BUILD is focused on the root causes of health disparities, such as patients' environment, education, and urban infrastructure. Though more than 95 percent of health care dollars continue to be spent on direct medical services, as much as 70 percent of health outcomes can be attributed to the influence of non-clinical factors. Those are the factors we hope to address.

After receiving more than 300 applications for its first round of funding, last year we awarded nearly $8.5 million in grants and low interest loans to 18 communities across the United States. Eleven of them now have the opportunity to apply for an additional round of funding and support, and a new round of applications will be awarded next year.

Right now, the original five funders—The Advisory Board Company, the de Beaumont Foundation, the Colorado Health Foundation, the Kresge Foundation, and the Robert Wood Johnson Foundation—are seeking new partners at the national, regional, state, and local level to join in the initiative. To learn more, email me at rachel@buildhealthchallenge.org.  

Question: Why did the BUILD Health Challenge decide to award funding to partnerships rather than just individual organizations?

Eisman: No individual organization has all of the resources, perspectives, and data needed to make meaningful improvements in the health of its population. That's why BUILD required all applicants to bring at least three core partners from different sectors to the table:

  • A hospital or health system, which could lend data as well as financial or in-kind resources;
  • The local public health department, which brings evidence-based practice as well as a policy lens; and
  • A community-based, not-for-profit organization, which offers the most attuned understanding of the challenges that residents face.

Q: When looking at the BUILD awardees, what features stand out as the hallmarks of a strong partnership?

Eisman: At their foundation, the most effective partnerships between hospitals and community groups have a shared vision for community health improvement, clear systems for governance and program implementation, and well-defined roles for each contributing partner organization.

Strong partnerships also understand that good ideas aren't enough—you need community buy-in. Partnerships that keep community voices front and center throughout all stages of planning and implementation will produce solutions with a greater likelihood of being embraced by the people they are intended to serve.

For instance, just outside of Houston, the Harris County BUILD Health Collaborative has more than 10 partners working together to remake the food system to eliminate the root  causes of food insecurity.

Leaders of the health collaborative have forged relationships with city government to change zoning laws so that urban agriculture can flourish, partnered with corner stores to bring fresh produce into food deserts, and supported the establishment of subsidized CSAs (community supported agriculture) in schools so that busy parents have easy access to local, nutritious food.

Q: Based on what you've seen at BUILD, what's your advice for health systems looking to develop or strengthen their partnerships with community organizations?

Eisman: First, if health systems don't have any prior relationships with community organizations, they'll need to take steps to build trust and actively signal their commitment to long-term investments in community health improvement.

One way to do that is to demonstrate that community health is a core part of your mission. UnityPoint Health CEO Eric Crowell in an interview did just that when discussing the system's successful partnership with the Mercy Health System and Broadlawns Medical Center in the "Healthy Homes Des Moines" project. The collaboration made sense for all involved because, Crowell noted, "our end game is healthier and safe homes, neighborhoods, and communities."

Second, a listening ear and an open mind are essential. Health systems should be prepared to discover that their new partners' perspectives on community issues or priorities may not align with their own, and see such differences as an opportunity to share learning, gain knowledge, and discover opportunities. 

Third, health systems also need to be transparent about what resources they can lend to community health work and which stakeholders need to be involved to help community organizations navigate what they may perceive as a dauntingly complex task.

Finally, the most progressive health systems will connect community partnerships to their strategic plan. That will give them the advantage of being able to prioritize, measure, and sustain them even with staff turnover or leadership changes.

Learn more about the BUILD Health Challenge at www.buildhealthchallenge.org. Find us on Twitter at @BUILD_Health.

For more of the Advisory Board Company's research on Health Disparities, check out the Health Disparities Initiative, or email us at HealthDisparities@advisory.com.

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Providers and partners are coming together through the Population Health Services Organization (PHSO)—a centralized entity from which they can purchase shared services such as analytics, quality monitoring, and contracting resources. Learn more about how Chief Medical Officer, Dennis Weaver, MD, is adding high-level efficiency to complex care networks.

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