« June 2019 Issue

Supporting Social Determinants of Health Work on the Ground

By: Jack Cardinal, Communications Manager, Center for Consumer Engagement in Health Innovation, Community Catalyst

“Social determinants of health” is currently the hot topic in health policy. Global organizations, massive health systems and major foundations are all talking about the importance of addressing the factors outside of the doctor’s office that keep people healthy.

Over its 20-plus years, Community Catalyst has built its reputation on successfully partnering with state and local health advocates to organize a consumer voice in efforts to affect change at the state and community levels. And while past projects have brought its work into the social determinants of health field, the growing focus in investing and organizing around the issues that create and keep communities healthy has presented new opportunities and challenges to the organization’s advocacy work. These have played out in several current projects, along with the Center for Consumer Engagement in Health Innovation at Community Catalyst’s (the Center) consulting work, where projects focus on organizing and empowering consumers around social determinants and helping forge new connections between health care, community-based and consumer organizations.

In addition to the Partnering for Community Health project, which builds connections between state health advocacy organizations and community-level non-profits, Community Catalyst and the Center have two additional new projects focused on organizing consumers to address the non-medical factors that affect health.

The Center recently launched Consumer Voices for Innovation 2.0, which invests $1.4 million over two years in seven state-based advocacy organizations. These organizations will engage and organize consumers with complex health and social needs to advocate for policy and program changes that expand the ability of the health system to address housing security, food security and transportation. The project will prioritize subgrants to people of color-led organizations.

And a new two-year project, Building Community Capacity to Shift Health Care Investment, will support grassroots community leadership development and advocacy for public or institutional policy changes that incentivize investment from health care institutions in historically disadvantaged communities. The work will build on an earlier Kresge Foundation-funded initiative that used grassroots training to drive partnerships between health care providers and community-based organizations to address community health priorities.

“This time, we’re using a spoke-and-wheel model to support community residents,” said Center Senior Advisor Jessica Curtis, who is overseeing the new Kresge-funded project. “By ‘training the trainer,’ we’re laying the foundation for community-level leadership and infrastructure that will affect state and local policy and drive institutional change.”

While Community Catalyst and the Center have been applying the organization’s system of advocacy to the work underway, particularly understanding how important grassroots organizing and coalition building are to a successful campaign, working on social determinants of health issues under more community-focused campaigns presents new challenges.

Associate Director of Policy Eva Marie Stahl said her work with advocates on the Partnering for Community Health project involves “learning a ton about how to work with local groups, support their capacity building and assess their readiness. We are seeing the barriers and challenges to state-local partnering from the process, and recognize the deep and vital need to support local people and state-level advocates in building trust.”

In this work, building trust also extends beyond state and local partnerships with traditional consumer advocacy groups. Addressing the social determinants of health requires building meaningful partnerships with advocacy organizations with long histories of work in fields like housing, education, food security and transportation access who may not have pre-existing relationships with advocates in the health community.

But the new challenges present new opportunities, both for Community Catalyst and its vast network of state and local advocates, to build meaningful lasting partnerships that create opportunities for future campaigns and improve their financial sustainability.

As Stahl says, “This work is where it’s at – it’s the future of transforming the health care system – one community at a time. If we want people to trust government to do good things to improve health, then we need to dismantle the systems that keep them sick – from the housing they live in to what food is available nearby to feed their loved ones. We need to listen first, forge trust and include people in efforts to reimagine what delivery of care is for people in the community and who best to deliver it.”