“Inverting the burden” is an operational approach to achieving health equity by placing the burden of addressing racism and other inequities on institutions rather than individuals. It includes techniques for addressing the “downstream” immediate needs of complex care patients, the “midstream” supply of affordable housing, quality jobs, and insurance coverage, and the “upstream” root causes of systemic racism. In this webinar, we heard how Atlanta Regional Collaborative for Health Improvement (ARCHI) is inverting the burden at all three levels through the Community Resource Hubs serving the immediate needs of patients at Grady Health System and Mercy Care Atlanta. ARCHI is a multi-system health-housing collaborative of 100 partners, which is aligning health system investment in affordable housing and engaging in ongoing dialogue and learning through a now 4-year exploration of racism and health inequities.
The various systems within communities — including medical care, public health, housing, education, transportation, justice, and human services — directly influence the health and well-being of community members. Yet often, these systems’ policies and practices have excluded, marginalized, and disadvantaged some communities of people — especially people of color — creating long-standing inequities in health and well-being. Cross-system initiatives play an important role in countering these impacts, but they must invest in, work with, and be accountable to the communities they serve in order to truly promote equitable health outcomes. One way to ensure alignment and accountability is through shared measurement: using a common set of measurable goals that reflect shared priorities across systems and with community members.
Supporting health-related social needs is increasingly recognized as important in addressing health disparities among vulnerable patients, but a patient’s willingness to engage in social needs screening and support requires trust in their care team. Rural communities’ emphasis on self-reliance and general distrust of institutions are barriers providers often face when seeking to develop trust with rural patients. At St. Mary’s & Clearwater Valley Hospital and Clinics, a rural healthcare organization serving the North Central Idaho community, community health workers (CHWs) are uniquely positioned in care teams to develop strong relationships with patients through community health events, home-based screening, and coordinating clinical and social care.
In the absence of comprehensive economic and antihunger policies, emergency food systems and healthcare organizations have organized to meet increasing demand during the COVID-19 pandemic. In this webinar, we heard from two collaboratives about their strategies to address acute food insecurity in urban environments. We heard how their strategies were tailored to their specific populations and what lessons they’ve learned that can be applied to other organizations and cross-sector initiatives.