Durham, N.C. - With growing momentum behind the understanding that the majority of health, up to 80 percent by some estimates, is dictated by factors outside of the health care system, the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) Foundation announces $600,000 in grants to support six community-based collaborations to focus on social determinants to improve health and address the inequities that cause health disparities.
The grants expand
Community-Centered Health, the Foundation's approach to supporting clinical-community collaborations to better understand and act on non-medical drivers of health, with the ultimate goal of increasing health equity and improving health at the population level.
"Where we live; how safe or stressful our environments are; our access to quality education, healthy foods, transportation, community resources and more all affect our health," said Dr. Patrick Conway, president and CEO of Blue Cross NC and chairman of the Blue Cross NC Foundation. "This investment is designed to support communities to identify the factors that are impeding all people from achieving good health and to work in partnership to address those causes at a systemic and policy level to improve the health of communities."
The newly funded Community-Centered Health partnerships are:
Caswell Chapter of the Health Collaborative (Caswell County): addressing the impact of economic instability on chronic diseases including overweight/obesity and heart disease.
Hunger and Health Coalition (Watauga County): expanding and strengthening efforts to reduce obesity and diet-related chronic diseases in low-wealth populations with a focus on food insecurity.
Montgomery County Partnership for Children (Montgomery County): combating obesity by reducing food inequity and increasing economic stability.
North Carolina Community Health Center Association (Alamance, Caswell, Chatham, Durham, Guilford, Harnett, Lee, Montgomery, Moore, Orange, Person, Randolph, and Rockingham Counties): addressing inequities driven by occupational hazards, poor housing, language access, lack of transportation, and health care access in the farmworker and poultry processing worker populations.
Opportunities Industrialization Center (Edgecombe and Nash Counties): supporting residents to implement systems-focused solutions for marginalized communities to reduce stressors in their physical and social environments that have contributed to a high prevalence of chronic disease and depression.
West Marion Community Forum (McDowell County): driving systemic changes to reduce obesity in a rural Appalachian county by working with historically excluded residents in African-American, Latinx, and white communities focusing on food access, physical activity, transportation, and youth engagement.
While the specific focus of each partnership varies, all will be rooted in three core tenets:
- Developing multi-sector, clinical-community partnerships in which community members experiencing the conditions that cause inequities have leadership roles
- Making policy, systems, and environmental changes that will sustain impact and lead to increased health equity in the community
- Shifting processes and culture in health care to identify and act on non-medical barriers to good health at the population level
This cohort joins three ongoing Community-Centered Health partnerships established in 2014 as part of Blue Cross NC Foundation's initial work in this area. These grantees have been supported by more than $2 million in grants and technical assistance to date. They include Collaborative Cottage Grove, Guilford County; Healthier Highlands, Gaston County; and Mothering Asheville, Buncombe County.
These three partnerships are achieving the type of outcomes the approach is designed to spawn, among them: municipal investments in infrastructure to bolster access to parks and health care, large-scale housing improvements to combat asthma, and a community doula program to reduce inequities in infant mortality.
"For far too long, interventions have been prescribed by those living outside a community or those who haven't experienced health inequities directly," continued Conway. "This approach counters that instinct by engaging the wisdom and leadership of those who experience inequities directly to identify and prioritize changes necessary to transform health."
Specifically, these grants are supporting an initial partnership development and planning process. CommonHealth ACTION, a national leader in health equity, is the technical assistance partner. They will coach partnerships during the planning process and provide tailored support to maintain a focus on equity and systemic changes inside and outside the health care system that drive chronic disease and health inequities.
"Health is a production of society," said Natalie S. Burke, president and CEO of CommonHealth ACTION. "If we're going to create communities where everyone is able to achieve their best possible health, then we need to redesign systems that are currently producing health, well-being, and quality of life for some while producing illness, disease, and early death for others."
At the conclusion of the initial 15-month planning period, each partnership will be eligible for up to four years of implementation funding from the Blue Cross NC Foundation to put their plans into action.