Can community-based ecosystems make health more equitable?

By Nicole Kelm, senior manager, and Matt Piltch, manager, Deloitte Consulting LLP

Improving health outcomes is a top priority for 90% of health plan leaders and 74% of hospital/health system leaders, according to the results of a recent survey conducted by the Deloitte Center for Health Solutions (CHS). However, more than two-thirds of those respondents said they are not doing enough to leverage partnerships with community-based organizations to make health and health care equitable and accessible to everyone.

While 80% of respondents say they are screening their patients and members to determine whether they might need access to food banks or food vouchers, only 35% have established community partnerships to address the food needs they identified. Establishing partnerships with community organizations could make it easier for health care stakeholders to improve the health and well-being of the populations they serve. For example, the health and health outcomes of patients might improve if they had access to healthy and affordable food at local grocery or convenience stores, or through a neighborhood food bank.

Hospitals and health systems, health plans, suppliers, vendors, government agencies, local businesses, community-based organizations, and patients are all connected, and they all have a role to play in making health more accessible and equitable. The new CHS report, Advancing health equity through community-based ecosystems, describes how bringing together multiple types of organizations—from a broad range of sectors—could have a significant impact on population health.

In a community-based ecosystem, multiple stakeholders share a common vision to create, scale, and align impact in ways that are beyond the scope of any single organization. Each stakeholder in this ecosystem contributes a wide range of lived experiences and expertise that can help address complex issues. This community-based ecosystem approach could help remove some of the barriers that can make it difficult for everyone to achieve their potential in health and well-being.

Deloitte Health Equity Institute reaches one-year milestone

The health disparities highlighted by the COVID-19 pandemic, combined with the murder of George Floyd in Minneapolis two years ago, accelerated Deloitte’s equity agenda. During the summer of 2020, Deloitte joined other groups in acknowledging that racism is a public health crisis. We also began building the Deloitte Health Equity Institute (DHEI), which recently celebrated its one-year anniversary.

The goal of the Institute is to reduce health disparities through a combination of philanthropic investment and pro bono strategic services, while leveraging many of the leading practices identified in our community-based ecosystems report and across our practice. As of the end of May, DHEI had launched more than 20 collaborations with a wide range of cross-sector organizations. We intend to launch seven more collaborations in June.

DHEI’s theory of change is driven by the recognition that every organization has a role to play in advancing health equity. As part of our mandate to build bridges and break down siloes, the Institute has played a key role in engaging public, private, and community leaders to help enable and advance change. Significant health disparities exist in cities and communities throughout the country. In Washington, D.C., for example, Black people make up 45% of the population, but accounted for about 75% of the city’s COVID-19 deaths.¹ To help reduce such health disparities, and improve health equity, DHEI launched several collaborations in Washington that use a community-based ecosystem approach. Multiple organizations, using a range of approaches, are working together to improve health equity. Here are a few examples:

• Thrive United 365: The initial goal of this program was to improve access to COVID-19 vaccinations by meeting members of the community where they are, centering their experiences, establishing trust, and building ongoing relationships with them. In collaboration with 35 community-based, faith-based, and health care organizations, United Way of the National Capital Area (United Way NCA) launched a grassroots campaign in the heart of the community. United Way NCA collaborated with local churches, clinics, and apartment complexes to vaccinate nearly 6,000 individuals. This broad community engagement initiative, which included emails, phone banking, texts, townhall meetings and canvassing, also helped extend United Way NCA’s reach to nearly 130,000 people. Thrive United 365 is now working to make preventive care more accessible to members of the community. For example, United Way NCA is overseeing HIV/STI screenings, blood-pressure and blood-sugar testing, kidney and liver screenings, and referrals to additional health services.
• Mary’s Center: Mary’s Center is a community health center that serves nearly 60,000 people of all ages, incomes, and backgrounds in the Washington, D.C. metro area. United Way NCA’s work is often done in coordination with Mary's Center, which also received an investment from DHEI. Mary's Center acts as a lead service provider for Thrive United sites to provide COVID-19 vaccines. It also runs separate clinics that provide quality health care, education, and social services throughout the region.²
• Greater Washington Partnership: The Greater Washington Partnership is a civic alliance of CEOs in the Capital Region. It draws from leading public, private, and nonprofit organizations that are committed to making the region from Baltimore to Richmond one of the most inclusive economies in the nation. Deloitte is working with the Greater Washington Partnership to develop a first-of-its-kind Regional Blueprint for Inclusive Growth—a 10-year roadmap to close regional equity gaps that highlights private sector opportunities to collaborate across sectors. With support from Deloitte, the Greater Washington Partnership will work to activate local decision-makers and to help scale in-flight efforts. To date, more than 25 Greater Washington Partnership organizations have committed to advancing supplier diversity, racial equity, and access to capital through a $4.7 billion investment in regional efforts.³

DHEI will continue to take a community-based ecosystem-driven approach to help make high-quality care more accessible and equitable. Every community-based ecosystem is unique to its geographic area and its participants. Health care stakeholders and their partners should identify opportunities to work together, learn from each other, and truly engage with people who live in the community. Partnerships that evolve into ecosystems can have a significant impact on the drivers of health, health equity, and the overall health of communities.

This publication contains general information only and Deloitte is not, by means of this publication, rendering accounting, business, financial, investment, legal, tax, or other professional advice or services. This publication is not a substitute for such professional advice or services, nor should it be used as a basis for any decision or action that may affect your business. Before making any decision or taking any action that may affect your business, you should consult a qualified professional advisor.

Deloitte shall not be responsible for any loss sustained by any person who relies on this publication.

Endnotes:

¹ Racial disparities in Washington, D.C. COVID-19 vaccine administration, Legal Defense Fund, 2022

² St. Mary’s Center, Overview (www.stmarysharlem.com)

³ Greater Washington Partnership announces $4.7 billion toward advancing inclusive growth in the Capital Region, Press Release, March 29, 2022

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