Health happens in communities.
Many people living in low-income communities in the United States are mired in a constant and unremitting fog of stress. This chronic stress is driven by housing insecurity, food insecurity, fear of crime, unemployment, exposure to pollution, and poor education. These things lead to poor community health and are often collectively conceptualized as social determinants of health.
The good news is that this situation is largely manmade and thus can be unmade. Our initiative, Building Healthy Communities (BHC), is a holistic attempt to help reweave the fraying fabric of low-income communities by harnessing the latent power and potential of their residents. Launched in 2010, it is a 10-year, $1 billion, place-based initiative that aims to transform 14 communities by building power (social, political, and economic), implementing proven health-protective policy, and changing the narrative about what produces health (beyond health insurance and individual behavior). BHC’s strategy is grounded in the belief that health is fundamentally political. The idea is to revitalize local democracy to transform these environments into places where everyone has the opportunity to thrive.
The BHC model envisions these communities as proving grounds for community-driven policy and practice innovations that, in turn, advance statewide policy and systems change. It creates unprecedented space for community organizing, leadership development, and sustained multi-sector collaboration by enabling residents, community groups, and institutional leaders to work together across all sorts of boundaries, including different races and ethnicities, personal experiences, legacies of discriminatory treatment, and differential levels of power.
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