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What Are the Five Drivers of Change?

One of the hallmarks of Building Healthy Communities is our focus on how community transformation is achieved—what we call Drivers of Change — rather than a focus on narrowly determined outcomes and a range of pre-determined strategies for getting there. Underlying all Building Healthy Communities activities is a fundamental belief in the power of a functioning democracy in which all people are valued and included.


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People Power

GOALS: Resident organizing and training activities support resident engagement and leadership in local decision-making forums and policy and systems change campaigns. Local systems and institutions promote full and active participation by residents in policy development and implementation. Residents value and have the tools to engage in multi-racial alliances for change.

Across the BHC communities, local residents understand their leadership and change making potential, lifting their voices in public forums, and exercising real power. In turn, local institutions and government agencies are being challenged to reorient the civic infrastructure to truly optimize democracy and incorporate genuine resident input in decision making beyond the minimal and often superficial methods typically used.

It is important to emphasize quality of leadership development and organizing over quantity of residents turning out to a meeting. BHC supports developing the skills residents need to organize, occupy positions of influence, and lead locally, regionally, and statewide. Ensuring these activities persist beyond 2020 also requires building local structures for increased community participation in decision making, such as Participatory Budgeting. Finally, BHC supports arts and culture as an essential component of building strong community ties.

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Youth Leadership Development

GOALS: Youth leadership training and a continuum of other youth development activities support a network of motivated, activated youth leaders in reaching their full potential, serving as leaders in the movement to create healthy and just communities. Youth are organizing within and across all Building Health Community (BHC) sites and beyond. BHC supports leadership development as well as youth academic, economic, and socio-emotional development, employing a trauma- and healing- informed approach. Additionally, BHC supports pushes for norms change within public and private institutions to promote active participation by youth in decision making at the local, regional and statewide levels.

Youth leaders come in a variety of forms other than the traditional stereotypes of the honor student or student council member. Young people who have firsthand experience with unfair school discipline practices, interpersonal violence, and incarceration speak with authenticity and help organize their peers to transform their communities, if given the opportunity. Understanding the trauma experienced by youth in the BHC communities, and incorporating this understanding into youth-oriented programming is a critical component of engaging youth who do not fit the dominant youth leader mold.

Youth development activities prepare youth to take advantage of opportunities, providing spaces for healing, identity development, and engaging in policy advocacy.  Through these activities youth form a sense of hope and self-efficacy, as well as concrete skills, such as data analysis, critical thinking, giving effective public presentations, serving on committees, and organizing and chairing meetings.

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Enhanced Collaboration and Policy Innovation

GOALS: Improve the way key systems collaborate by enhancing the quality and quantity of interactions between systems players, community-based organizations, and residents to promote constructive and innovative system redesign and performance optimization. Enhance the quality of cross-sector collaboration, resident/stakeholder engagement, and data-sharing/analysis. Tools and mechanisms are made available to facilitate root cause analysis, stakeholder engagement, collaboration (such as the Hub, the convening and coordinating table for all BHC stakeholders), data sharing, and improved local policy analysis and development.

BHC deepens the impact of people power—adult and youth—through effective collaboration. Our early experience has confirmed that there is a critical need to “bust silos” and pull unlikely partners together to work on issues that might be outside their mission but address the common goal of community well-being.

What does TCE mean by collaboration?  It is the proposition that achievement of desired outcomes depends to a large degree on the ability of individuals and organizations to collectively set goals, share information, agree on appropriate divisions of labor, work together and hold each other accountable.

Another key theme is the ability of communities to align financial and other resources to achieve those shared goals. TCE support for Hub structures in each of the communities is intended to provide a locally-appropriate structure to promote collective action. TCE also understands that once funding for the BHC initiative ends, the degree to which any progress will be sustainable will depend in large part on the efficacy and durability of those local collaborative relationships.

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Leveraging Partnerships and Resources

GOAL: Strategic partnerships among the many sectors connected to BHC priorities leverage new dollars or other discrete resources so that transformative community strategies thrive and are sustained.

TCE funding, substantial as it is, will not be sufficient to advance all the community priorities and sustain community transformation in all fourteen BHC sites over time. BHC success relies on private and public sector partnerships. BHC is mobilizing TCE’s assets to support its social change goals through impact investing, such as the Freshworks Fund that supports investments in healthy food retail in underserved communities. BHC is also seeking out new and diverse partners across sectors—from foundations to corporations to policymakers—that can bring new ideas, leverage our investment with new dollars, and/or contribute other resources to multiply the value of TCE’s direct investment many times over. To sustain and maximize these partnerships once initiative funding ends, they must be formed/enhanced in each community such that they are grounded in efforts to build the power of local residents.

An overarching partnership goal is to deepen strategic engagement with anchor institutions in each BHC site. These institutions (e.g. major educational institutions and hospitals) are rooted in place because of invested capital and long-term relationships with customers or employees and have a vested interest in improving the welfare of their surrounding communities.

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Changing the Narrative

GOAL: Engage the local media and local messengers influential with elected officials and other leaders in weaving a compelling and new narrative about community health and prevention, and the historical and structural context for low income communities.

BHC is seeking to weave a new narrative about community health and prevention; one that recognizes the environmental, political, and economic determinants of health and moves the dominant frame from one focused on personal responsibility and exclusion to one focused on the collective and inclusion. BHC supports efforts to shape the views of policymakers and the public to increase support for prevention and equity.

A key component of BHC is developing community residents’ capacity to effectively drive the local dialogue on health away from conventional debates about access to health care to include addressing the social determinants: the existence of poverty, racism and hopelessness and the absences of all of the resources and opportunities people and communities need to be healthy, such as good schools, jobs, housing and so on. Supported narrative change activities include fostering partnerships with local and regional media and enlisting local messengers who have influence over elected leaders and other key opinion leaders to advance goals and spread the success stories coming out of the BHC sites. Additionally, BHC proactively seeks out opportunities for BHC leaders to present their work in venues where they are not traditionally heard.