Improving the health and well-being of children and families across the US is a critical imperative, and it is no easy feat. Social determinants of health, including socioeconomic and environmental factors as well as structural and systemic inequities that are rooted in racism and discrimination, drive over 80 percent of health outcomes. Research suggests that partnerships for health equity can improve both health system capacity and health outcomes. To this end, more and more community-based organizations are working together to help residents thrive.

In a new paper based on research I did as a Gramlich Fellow in Economic and Community Development, I focused on what can be learned from the experiences of community-based organizations (CBOs) that have leveraged partnerships to create healthy and equitable communities. I divided my research into three phases. During Phase 1, I conducted background research by reviewing relevant literature. I also interviewed researchers and the leaders of two national organizations working on place-based partnerships.

In Phase 2, I focused on the work of six CBOs around the country that have played a central role in partnerships, five of whom are part of the NeighborWorks America network. I reviewed the organizations’ materials, spoke with their leaders, and conducted site visits. Ultimately, I interviewed twenty-five staff and leaders—most, but not all, in the six local organizations. In Phase 3, I shared preliminary findings from my research with practitioners and experts who helped hone my findings.

The research and interviews made it clear that successful partnerships almost always require a “backbone” or coordinating entity. I identified five practices used by successful partnerships and their backbone organizations:

• Managing tensions: Tensions are inherent in partnership work and can include competition for resources and influence. A backbone organization is not a neutral convener but can deploy tools strategically to reduce these tensions. The most successful organizations address tensions through open discussions, adopting new tools, and adapting when needed.
• Shifting from a programmatic to a holistic approach: Backbone organizations and partners with local context have a broader commitment to the community as well as a longer time horizon to build trust and make progress in the community and in the partnership. This type of adaptability is critical to shifting to a holistic, transformative approach to improve the health and well-being of children, families, and communities. For example, in San Francisco, the programs at the Mission Economic Development Association (MEDA) have expanded from direct person-to-person to systems transformation, including programs like the Mission Promise Neighborhood, the Community Real Estate affordable housing development program, and Fondo-Adelante, a new community development financial institution.
• Leveraging physical assets and on-the-ground social services: CBOs with physical assets in a community (e.g., housing, commercial corridors) and social services often have a longer time horizon in their work and have strong community development and outreach capabilities. Local CBOs are uniquely positioned to leverage physical assets for broader social impact. For example, Beyond Housing in St. Louis County, Missouri heard from residents that they wanted closer, more affordable entertainment options. Beyond Housing now has 24:1 Cinema, whose $5 ticket and popcorn option provides a source of affordable entertainment for the community.
• Building on a history of local collaboration: The pandemic accelerated cross-organization collaboration and working with the government for funding and coordination. The backbone model builds on past formal and informal engagement. Leaders who have been with their organizations for over ten years, such as those at MEDA and Beyond Housing, have cultivated relationships and often serve as stabilizing forces that encourage community coordination and trust.
• Embracing ongoing change: Successful partnerships are marked by an ability to adapt, experiment, and innovate to produce better outcomes and reduce tensions. This longer-term perspective allows for more investment in innovative tools and resources to serve both the community and the partnership. For example, ONE Neighborhood Builders in Providence recently collaborated with their partners and residents on a ten-year vision.

Strong local partnerships can provide the physical infrastructure and organizational capacity to address health, racial, and economic inequities and create thriving communities. These models can also help the convergence of physical and human capital solutions at the place-based level to improve health and well-being for the adults and children who live in historically underserved communities.

Photo credit: Eric Fredericks, Fruitvale Village Transit Oriented Development (June 2006), CC BY-SA 2.0