Jason Lacsamana, Director of Programs and Partnerships, St. Joseph Community Partnership Fund
Sandra Viera, Associate Program Director, Prevention Institute
This June, funders and practitioners from across the country will come together during the Grant Makers in Health (GIH) Annual Conference in Miami to reflect on 40 years of innovative efforts to create healthier communities. For organizations like the St. Joseph Community Partnership Fund (the Fund) and Prevention Institute (PI), GIH conferences have served as a critical space to bring together advocates across sectors and spark new ideas to address complex health issues. The Fund, as the strategic grantmaking arm of the Providence-St. Joseph Health System, is dedicated to advancing health and justice though community capacity building. PI is a national nonprofit dedicated to building prevention and health equity into key policies and actions to foster health, safety, and well-being. Inspired by a PI-led session on upstream prevention and health equity at GIH’s March 2016 annual conference, the Fund noted the promising landscape for a grantmaking initiative that could focus on root causes of poor health and dismantling systems of inequity, and a partnership was born.
At the time of the conference, the Fund had observed that despite important progress in engaging hospitals as partners in community work, their potential to serve as agents of community power building was not fully tapped by the field of health care or public health. Through a series of strategy conversations with PI, the Fund saw the opportunity to engage its legacy hospitals in supporting transformative community work beyond individual care and service coordination through what would become the Intersections Initiative. From the beginning, the intention was to create something different: a community of grantees chosen not through a competitive process, requiring complex work plans to match funder-driven priorities, but through thoughtful engagement and mutual understanding of the purpose of the work and the realities and aspirations of the communities.
To do so, the Fund and PI engaged in a two-part planning period with community partners to have difficult but necessary conversations about equity, root causes, and other systemic challenges to health in their communities. After identifying key community residents and partners with whom to advance a change and capacity-building agenda, the communities spent the second planning period identifying key issues and strategies around which to build their work.
Between 2017 and 2021, these seven California-based community partnerships worked to improve health and equity in their respective communities during the implementation phase. Driven by community leadership, they built capacity within organizations and among decisionmakers to address issues as diverse as affordable housing, education, economic and workforce development, immigration, community trauma, and civic engagement. Many partnerships addressed multiple social determinants of health at once, creating the potential for even greater impact. While the partnerships all started with different histories of collaboration, community engagement, and advocacy, each built capacity to operationalize practices, redesign systems, and promote policies to dismantle systems of inequity and oppression while advancing health and wellness.
The Intersections communities faced many external challenges throughout the years, from political situations to natural disasters, but the onset and fallout from COVID-19 in 2020, as well as increased calls to advance meaningful racial justice efforts, completely changed the landscape. The partnerships were able to mobilize partners to act on these issues swiftly. For example, the coalition in Anaheim built on their previous efforts in education equity to advance a community-centered policy platform that addresses how COVID-19 disproportionately impacts students of color and longstanding systemic racism in public education. In Napa, collaborative partners advocated for equity and justice-centered priorities to be a major part of how American Rescue Plan Act Funds were allocated by their county. In almost every Intersections community, partnerships worked with local government agencies to support resolutions that declared racism as a public health crisis. While implementation was originally supposed to end in 2020, the Fund decided to add an additional year of financial support to allow the partnerships to continue advancing this critical work at the local level through 2021.
As we reflect on the lessons we’ve learned from Intersections, we offer the following recommendations:
- Acknowledge power dynamics between funders and grantees from the start and seek to address those dynamics through co-creation and open conversation throughout the initiative
- Meet communities where they are and acknowledge the different “starting points,” investing time in developing the infrastructure of the collaboratives to focus and anchor their approach to upstream prevention and equity
- Remain flexible and adapt to changes in internal and external environments, providing as much support as possible to help collaboratives weather challenges, including additional financial support when possible
- Implement a learning-focused evaluation approach to identify how capacity building lays the groundwork for future success—learn more about our approach to equity-based evaluation here
We hope these offerings spark additional thinking and dialogue in support of our field’s ambitious goals and informs the launch of the next wave of health equity and racial justice initiatives.