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Voices from the Field: Lessons learned from BHPN’s Community Innovations Initiative

Written by Renae A. Badruzzaman on January 28, 2022

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For decades, healthcare and community development have been working in the same places, sometimes with the same people, and often not together. Community development organizations with the greatest amount of capacity and support have been most able to access the resources and network needed to accelerate health partnerships. Meanwhile, many smaller and lower-resourced community development corporations are excluded from the national dialogue, resulting in less access to the resources needed to successfully engage healthcare investment partners in the social determinants of health (SDOH). 

Community Innovations, was a 18-month BHPN initiative funded by The Kresge Foundation that launched in 2019 with the aim of connecting local organizations to other peer organizations; facilitating healthcare-community development partnerships through access to tools, resources and capacity and  the Network’s understanding of how best to support community development organizations’ cross-sector efforts.

Community Innovations was designed to reach smaller cities in low-resourced areas and organizations working in low-income communities and communities of color. Through an RFP process, five organizations were invited to participate in a peer cohort to uplift communities’ needs and develop a cross-sector strategy or capacity to engage healthcare in their neighborhood investment efforts. 

Despite the challenges of the COVID-19 pandemic, the Community Innovations cohort demonstrated perseverance and resilience. They successfully advanced partnerships with the healthcare sector, making significant progress towards shared priorities, building relationships, as well as securing additional funding support for their work (ranging from $10,000 from a Medicaid managed care plan to $3.2 million from the State legislature). 

“Do not judge me by my successes, judge me by how many times I fell down and got back up again.” -Nelson Mandela

When asked, “What successes (small to big) would you attribute to Community Innovations?” themes emerged that mirrored BHPN’s main goals and intent of the grant opportunity. Community Innovation partners expressed that completing a landscape analysis with support of BHPN and a consultant was extremely valuable in understanding the healthcare market, how to approach healthcare partners, and framing for partnerships. Additionally, crafting a solid pitch and presentation to healthcare partners and “becoming fluent in SDOH” were also noted as key successes. 

 

What we’ve learned

Demand for cross-sector partnerships, but limited local capacity

  • We conducted a Community Development Organization Survey to better understand community development and healthcare strategies, connections to healthcare, and capacity needs. We received 119 responses that highlighted three priority needs: connections to peer and national leading organizations, capacity to engage healthcare, and technical assistance for moving forward. Nearly half of the responses demonstrated a need for dedicated staff time and resources to develop partnerships, training to build capacity for cross-sector collaboration, and support to identify common language around health indicators and metrics.
  • Research data tells us that for smaller or newer community development organizations there are clear gaps in finance, the capacity to bridge partnerships across sectors, and to build health and racial equity into a strategic approach as compared to larger more established organizations. Black and Indigenous People of Color (BIPOC)-led CDCs in particular often display strong local networks, yet due to systemic and historical oppression, these valuable organizations often have limited financial and staff capacity for and/or access to the resources needed to tackle the root causes of poor health in communities they serve.

Sustainable place-based investment led by community members is required

  • Low-resourced and historically and persistently marginalized communities in small to mid-sized cities have intersecting and compounding challenges that were created by structurally racist and discriminatory laws, policies, and practices. 
  • There has been a persistent lack of investment support for newer, smaller, BIPOC-led community development organizations. The lack of access to capital as well as the underwriting standards and criteria have prevented developers with less experience or lighter balance sheets from qualifying for capital – another illustration of the impact of systemic barriers on community development corporations. 
  • Continued disinvestment results in widespread and growing impacts on individuals and families living in low-resourced communities, not least an increased need for services, increased isolation, economic challenges, financial insecurity, and lack of access to affordable and quality health care, stable housing, good jobs and more. Factors also known to have downstream impacts on the health of a community.

Bridging the divide across sectors 

  • The retreat of health systems from long-term investments during the COVID-19 pandemic in response to more acute crises has stifled conversations with community development partners, blocking tangible steps forward. 
  • Organizations that represent and serve marginalized communities recognize the value and importance of community members leading the decision-making process to shift power and agency in neighborhood revitalization efforts. This can be seen with the rise of community-land trusts, limited equity housing cooperatives, cooperatively-owned businesses and organizations, and community-based participatory methods and governance. 
  • Forming coalitions can encourage healthcare partners to learn from and lead new efforts, to build trusting relationships and allow partners to show up in new and different ways. For example, developing alliances around housing as a SDOH, advocating for anti-displacement and tenant protection policies, and working in coalition to address multiple barriers through community investments that bring access to quality affordable housing. For more of these examples, check out BHPN’s Healthy Neighborhood Investments: A Policy Scan and Strategy Map. 

 

To learn more about the Community Innovation partners stay tuned for interviews where we uncover common challenges to engaging with healthcare, strategies and tools that help, and gather advice for others embarking on this work.

About the Author

Renae A. Badruzzaman