The BUILD Health Challenge welcomed its third cohort of communities at a kickoff event in Chicago November 13-14, 2019.

The BUILD Health Challenge® (BUILD) welcomed 18 new awardees to its third cohort in November. These communities throughout the U.S. will embark on a two-year endeavor to transform health at the local level, working on healthy housing, safe communities, community revitalization, food access, and other issues. The de Beaumont Foundation, in coordination with 10 other funding partners, is proud to support this innovative program designed to improve the quality and standards of health across the country. We sat down with BUILD’s executive director, Emily Yu, about what cohort members have learned and what’s to come in 2020.

1. Tell us about the third cohort. What makes this cohort different from the past two?

The shared goal among all of them is a desire to move resources, action, and attention upstream — to address the root causes of disease and improve community health. They do this by advancing bold, upstream, integrated, local, and data-driven approaches (the BUILD principles) in their local neighborhoods. This third cohort includes issue areas that we haven’t explored with communities, such as elderly care, and represent new cities like Reno, Nevada, Milwaukee, Wisconsin, and Greenville, South Carolina. In addition, payer involvement has a more formal role, with an insurer as a lead partner in one of the communities supplanting the traditional hospital/health system role in BUILD communities.

2. What do you expect to learn over the next two years?

Working with these communities, we aim to better understand what factors and processes need to be in place to achieve long-term, sustainable change. By deepening our understanding as a sector — for example, how new funding streams are created, how community leadership is fostered, and how policy changes are implemented — we can help communities advance their efforts to improve health outcomes.

3. What should leaders in health and other sectors know about BUILD that they may not realize?

Interestingly, BUILD is not about a didactic process for change. It’s actually a loose framework that is structured so communities can determine for themselves how to implement it. The creators of the program intentionally designed it that way, with the BUILD principles serving as broad ideals to consider and to operate in tandem with one another. Since this original set of principles was created, we have observed and formalized an Outcomes Framework and Progress Continua that help articulate and measure the change we’re seeing in BUILD communities.

And while the framework itself is important to recognize in this process for change, it is important to note that so too is the history of collaboration among partners, grounding in health equity for the project, and the strong community influence present throughout all aspects of the program.

 4. Can you recommend a few resources from BUILD to help others interested in creating sustainable improvements in health take action?

Over the last four years we have learned quite a bit! For leaders interested in learning more about the BUILD process and insights on success, I’d suggest checking out our new “Community Approaches to Systems Change” compendium, which includes practices, reflections, and findings on not only systems-level changes, but also health equity, partnerships, and community engagement. It provides evaluation findings from the second cohort and offers practical ideas for stakeholders in this space.

We’ve identified four mutually reinforcing precursors for systems change: enhancing knowledge, expanding capacity, strengthening relationships, and deepening community ownership. Together, the presence of these factors can indicate that a community is on the path to achieve long-term improvements in health. These precursors create the necessary conditions to change entrenched local systems for the better.

I’ll also add a personal favorite resource of mine — the set of 19 new community stories we recently released. These short stories featuring the work of each awardee from the second cohort provide an overview of the communities that participated in the second cohort, a variety of issue areas, and how the collaboratives addressed them.

Learn more at

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