Over that past few months, I have had the opportunity to learn and engage with a diverse group of professionals at national, state, and local conferences focused on a common theme – the “why” and “how” to engage in multi-sector collaboration to improve population health. If you have been paying attention, this theme is emerging in some facet in conferences being held across the nation this year – e.g. NACCHO Annual 2017: Bridging Clinical Medicine and Population Health or the 2017 Practical Playbook National Meeting: Improving Population Health, Collaborative Strategies that Work.
The “why” can be centered on understanding that being healthy does not just mean going to a healthcare provider. If population health is truly to be improved, then it is important to recognize that a persons’ zip code, including social and economic factors, access to care, and the physical environment, has more affect on their health than their genetics. Research has shown that factors such as disproportionate access to goods and services, unhealthy environmental exposure, and poor quality housing often contribute to chronic disease. And that is something that a healthcare provider can not fix alone. For example persons living in rural and underserved communities may have the desire to be healthy, but if they do not have access to a licensed health care provider and affordable fresh fruits and vegetables, their decision to be healthy is determined by factors that may be out of their control. To truly improve population health, partners across multiple sectors such as community, research, elected officials, worksite, school, and healthcare are essential, because one sector can not do it alone. Engaging in a collaborative approach to understanding the health of a community the first step to improving health.
You are likely a member of a sector in your community that can affect change through multi-sector collaboration…but are you doing it? Are you a healthcare provider working with your local transportation officials to improve access to care? Are you a school who partners with your city officials to offer access to your gym for residents to be physically active who normally would not have the opportunity? A person who drinks soda daily, likely knows it’s not good for them, but it’s only one right?...”that’s what I’ve always done.” What if that daily soda was replaced with water…how much better would a person feel just by making that one change. It is easy to stay in silos in within sectors because that is what people know and that is what has always been done. But…is that really working to affect change? The answer is likely no. In order to build a healthy community and improve population health, it is important to understand that multi-sector collaborations of community stakeholders, organizations, decision-makers, sector representatives, and strategic investments are necessary.
Multi-sector collaborations can be established and sustained on the basis of trust. By establishing and building trust, partnerships can flourish to have greater, collective impact on health outcomes. Using evidence-based strategies to guide the collaborative work is how impact can be acheived. The community health needs assessment and improvement planning process conducted in partnership with healthcare, community, public health, and other sectors helps to understand the health of a community and identify collaborative, actionable strategies to affect health outcomes. Policy, systems and environment change can support a healthy community across the spectrum. For example, implementing a sun safety child care policy in partnership with a state-based cancer program supports a healthy environment for children and reduces their risk of developing skin cancer as an adult. Involvement of employers and business leaders in community health initiatives can be cultivated with small investments. In addition, data sharing across sectors and organizations is also becoming and essential strategy to truly understand populations and identify appropriate strategies to support them. These are just some of strategies on how to engage in multi-sector collaborations. Understanding and improving the health of a population cannot be the sole responsibility of healthcare systems or one sector, rather it can be best achieved by engaging multi-sector stakeholders and partners, community health advocates, private and public funders and policy makers to promote long-term health.
In the words on Matt Longjohn, MD, former National Health Officer for the YMCA and keynote speaker at the 2017 South Dakota Chronic Disease Partner’s Meeting, “I am preaching to the choir….but are you actually doing it?”