News  |  August 21, 2019

Discussions on how to address high healthcare spending, poor health outcomes, and wide-ranging health disparities have centered on an increasingly important point: none of these issues can be solved by one sector alone. Recognizing the growing body of evidence that the environments in which we work and live are largely responsible for the health of a community, an “all hands on deck” approach is needed to tackle health and health equity. One such approach is cross-sector collaboration, where public health, healthcare, and social services organizations work together with communities. An example of a cross-sector collaboration could include a health department, hospital, and community-based organization working together to address chronic health conditions (e.g. asthma) through preventive housing interventions. In recent years, multiple initiatives have emerged to support cross-sector collaborations, including the Cross-sector Innovation Initiative (CSII).

The Center for Sharing Public Health Services (CSPHS) and PHNCI, with funding from the Robert Wood Johnson Foundation (RWJF), are co-leading the CSII, a three-year effort to support public health, healthcare, and social services organizations striving to build stronger, sustainable connections to improve population health, wellbeing, and equity for all.

At the start of the initiative, the CSII conducted an environmental scan — including a literature review, key informant interviews, and data analysis — to better understand cross-sector collaborations addressing health across the U.S., including facilitators and barriers; continuums of collaboration; roles within collaborations; outcomes associated with cross-sector collaboration; and areas for future research.

Each cross-sector collaboration differs in focus, partner involvement, and level of collaboration — there’s not a one-size-fits-all model. That said, common factors that encourage or discourage cross-sector collaboration were identified:

  1. Environment matters. National and local priorities and policies can encourage — or discourage — cross-sector collaboration. For example, healthcare market competition in a region can hinder the development of cross-sector collaborations, while local crises can catalyze it.
  2. Organizational priorities and capacity dictate involvement. Organization-specific factors, like capacity, capabilities, and historical and cultural norms, impact whether organizations can and want to participate in cross-sector collaboration. These factors are particularly important when organizations are considering whether to join a collaboration.
  3. Collaboration dynamics can sustain an effort. As with any partnership, interpersonal and inter-organizational dynamics are the secret ingredients to keep an effort moving. Having high levels of partner trust, a shared vision and goals, community involvement, and a solid governance structure create a foundation for collaboration efforts to grow. Planning for and securing funding, if needed, also can ensure sustainability.

Cross-sector collaboration can benefit partner organizations via new skills and efficiencies, increased capacity, and stronger partner relationships. Population-level health improvements, like lower mortality rates, improvements in disease management, and immunization rates, attributed to cross-sector collaboration also were documented in some cases.

Cross-sector collaborations appear to be a promising way to address health issues, but more research is needed. Measuring improvements in population health can be difficult, and documenting population health improvements may take time as collaborations mature.

For more information, check out the full environmental scan.