Leaders of nonprofit social service organizations see the benefits of intersectoral collaboration with government partners as they work to reduce health resilience. injustice in their communities. These avoidable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health are caused by social, economic, and environmental factors. Across the country, this inequality was rated costing $93 billion in unnecessary medical expenses and $42 billion in lost productivity each year.
When state government agencies work closely with communities experiencing health inequities, together they can better identify key issues and develop a common vision for equitable solutions. More broadly, health equity is the guiding principle that disparities in health outcomes caused by factors such as race, income or geographic location should be eliminated and prevented, giving all people the opportunity to be as healthy as possible.
Public health officials use multisectoral approaches, a key component of what is known as “Public Health 3.0”, to address the issue of health and health equity. Public Health 3.0, launched by the U.S. Department of Health and Human Services in 2016, is a new public health improvement model focused on targeted collaboration between health and non-health sectors. In particular, governments should engage communities of color who have been disproportionately affected by poor health outcomes that can be explained, at least in part, by systemic racism.
However, limited resources, language issues, and historical distrust of government, among other factors, may hinder such partnerships. The Health Impact Project, created in partnership with the Robert Wood Johnson Foundation and the Pew Charitable Trusts, seeks to fill these gaps through its Call to All Sectors: Public Agencies United for Health initiative. The initiative supports government agencies in nine states and the District of Columbia that work with nongovernmental partners to close inequalities, with a focus on maternal and infant health. In line with the goals of Public Health 3.0, Calling All Sectors partners work together across multiple sectors and with communities to address complex health issues.
Through this initiative, participants learned about effective engagement strategies to remove barriers to collaboration. Here, coordinators of three non-governmental organizations in Washington, Colorado and Mississippi share their experience of working in intersectoral groups.
Leon Garnett – COO Bird Barr Place, which provides direct services and promotes systemic change to help African-American and black families in Washington state move from poverty to self-reliance. Patty Velasquez is the Implementation Director Association of Family Resource Centers in Colorado, which supports family development programs at 31 family resource centers in 58 counties. And Adrian Cross is the chief executive Liberty Meridian Project in Mississippi. The project offers programs for young people to prepare them to become academically capable, socially conscious and mentally disciplined leaders in their communities. All three recently responded to questions about lessons learned since the initiative began in October 2019:
What are the benefits of this intersectoral effort?
Garnett: “Sometimes it seems to us that the government is far away from us and does not understand the problem. In our team, I realized that the government is really committed to work and ensure justice. But sometimes their systems limit them and there are things they can and cannot say. That’s where we can collaborate on policy change, because as a community partner, I can do some things that they might not be able to do. We are creating a joint strategy to further increase equity, and I think we have started this process.”
Velazquez: “In partnership with all of these organizations and the Colorado Equity Alliance, we’ve come together and are really trying to create care systems that are responsive to the needs of clients and communities.”
Cross: “I learned about all the resources available to mothers and children through our program so that we can provide them with additional access and information about what is there. [For example,] We have a 15 year old mom in our program and thanks to what I learned from our core team, I was able to help her get a car seat for her baby.”
Can you describe some of the challenges of an intersectoral approach?
Garnett: “When we go to the community and say we are working with the government and WIC [the Special Supplemental Nutrition Program for Women, Infants, and Children], which they have not always had the best experience with, there is distrust, so even as a community partner we have some distrust. People were reluctant to even participate because of their past experiences.”
Velazquez: “It’s hard to ask people to sit down at the table and help inform the process of effective work when there’s no funding for that work, or the funding is really specific to an area or program, so there’s not a lot of flexibility.”
Cross: “COVID was the biggest problem. We started off with the opportunity to travel and learn from our wonderful partners who have been kind enough to still meet virtually. But just being in these rooms with other minds from different states [through the Calling All Sectors initiative]there was something different about it, a different energy that we experienced during face-to-face meetings.”
What advice would you give to others doing similar work?
Garnett: “Instead of jumping straight into a project, really understand each individual organization and think about what will allow the project to move smoothly into the future. The government or other institutions often reach out to communities when they have the opportunity, and the community may or may not be ready for it. If they can first find ways to build constructive relationships with the community when the opportunity presents itself, they will already be working in partnership. Trust has already been established there, and it will be easier.”
Velazquez: “The approach we have taken is to really connect with other people doing this work – not just in our field or area, but on this human level. We work towards the same goal, ultimately to help families thrive and provide what they need. If we can build that trust and share power, we can come together at the same table.”
Cross: “Stay rooted in the cause to get results. If you have set three goals for yourself, stick to those three goals. Expand as you wish, but don’t lose sight of and focus on what you’re doing.”
Maura Dwyer works on the Health Impact Project, a joint project between the Robert Wood Johnson Foundation and the Pew Charitable Trusts.