What Philanthropy Can Do to Help Cross-Sector Collaborations for Health and Well-Being

Regional cross-sector collaborations are growing rapidly across the U.S. leading to the creation of integrated, equitable, and sustainable systems for health and well-being. In these venues, organizations from many sectors come together and recognize that health and well-being will never thrive if we work in fragmented ways; nor will it emerge by defining health as a product of health care alone. When we address the many interconnected areas influencing health, communities can reach their full potential. It’s important to recognize, however, that there is a long way to go before cross-sector partnerships reach a mature state in regions across the country—and there are many ways that philanthropy can help move things along.

What do we know about these collaborations? At ReThink Health, an initiative of The Rippel Foundation, we conducted a 2016 Pulse Check survey of 237 health-focused cross-sector groups. We found that many have existed for decades, and since 2010 their numbers have steadily increased! We also learned that participants most commonly come from public health, health care delivery, education, social services, and community-based organizations. These collaboratives work primarily at a county or multi-county level and focus on issues like improving clinical care, health behaviors, socioeconomic factors, and the physical environment.

The breadth and diversity of these efforts are impressive, as are their bold visions and deep engagement from a broad range of stakeholders. The trouble is that most face significant obstacles and are not as far along in their development as observers like us suspected. Among the largest barriers from the research we published in the January 2018 issue of Health Affairs are:

• Many groups are disconnected from other collaborative efforts to improve health in their community.
• Their infrastructure to coordinate collaboration is often fragile and underfunded.
• Partnerships primarily rely on short-term grant funding, making it hard to plan beyond a two-to-three-year time horizon.

What can philanthropy do to help collaborations overcome obstacles? Philanthropy often plays a central role in advancing this regional work—both as funders and collaborative participants. To help cross-sector groups break through barriers, here are some strategies philanthropy can consider:

• Encourage networked leadership across a community. Multiple cross-sector collaborations and organizations are working to advance similar health goals. Yet their efforts are often disconnected, with overlapping or incompatible strategies. The opportunity for impact could be significantly increased if programming and resources were strategically integrated across stakeholders and philanthropists can structure their proposal and grant requirements to encourage coordination. For example, they can offer increased funding or require that funded efforts are governed by a broad range of sector leaders who have real authority to make necessary changes in their own organizations.
• Support long-term strategic planning. Most partnerships have grand aspirations that may take many years to achieve. Real change requires planning for the long-term—extending over decades or even across generations—so that there is a strategy in place that will persist through inevitable leadership transitions and changes in wider contexts. Supporting work that can help regional efforts sustain a long view, including scenario planning and longer-term or multi-phased grant projects could shift regional approaches and improve outcomes.
• Remember that infrastructure is essential to a region’s long-term success. Resources dedicated to supporting a partnership’s core infrastructure are often a decisive factor in their development over time. Funders can greatly impact the long-term strength of collaborations—and their communities—by intentionally and substantially supporting infrastructure, not just direct program work.
• Consider how grant funding can be a bridge to other financing sources. Grants can be especially useful as early-round seed money, to finance riskier activities such as pilot projects, and to leverage other sources of funding—but they are not a sustainable form of long-term financing unto themselves. Philanthropy can and should consider how to build bridges to more dependable financing over time.

Overcoming the barriers to creating an integrated, equitable, and sustainable system for health and well-being will require having the courage to take risks, try new approaches, step out of one’s comfort zone, and embrace collaboration. While many philanthropists are already embracing some of these important practices, we are increasingly hearing calls for the sector to be even bolder and go beyond where historical evidence-based approaches will take us. We have yet to tackle many of the health challenges we face on a national scale, but we increasingly know that approaches of the past may not be what will help us move forward. Rather, we should be bold in embracing new tactics, while learning from our past. Cross-sector collaborations are positioned to be key players in shaping a new future for health. We invite you to share in the comments below: how will you take advantage of the opportunities to support their impact and success?