By David A. Kindig, MD, PhD
As I’ve pointed out previously, no one entity today has accountability for population health outcomes. But one doesn’t have to look far to find people and organizations collaborating for population health improvement. The vast majority of federal, state, local, and foundation funders consider partnership a prerequisite for action.
Yet we know relatively little about what makes partnerships successful. We have much to learn about how and to what degree they facilitate actual health improvement. One reason for this lack of knowledge is that partnerships are difficult to evaluate. They tend to be complex, idiosyncratic, and constantly evolving with often no easy way to tease out the many factors influencing process and outcomes.
The most recent issue of Preventing Chronic Disease showcases a set of fresh perspectives on partnerships for population health improvement (commissioned through the Robert Wood Johnson Foundation MATCH grant). This is the final installment in a series of three special issues (the first and second focused on metrics and incentives respectively).
The essays are introduced by commentaries by Stephanie Bailey and Stephen Shortell and include a range of observations and insights on the following:
- Relationships among structure, function, and impact of multi-sectoral partnerships (Mays and Fawcett/Schultz)
- “Take home” messages from the Healthy Communities Movement (Pittman)
- Exploring models of and evidence for multisectoral partnerships (Woulfe)
- How principles of "social entrepreneurism" can help maximize use of available resources (Wei-Skillern)
- The business case for bringing employers to the partnership table (Webber)
- The role evidence plays in policy development and implementation (Fox)
- How a Vermont healthcare pilot is providing resources for a community health system (Hester)
These topics were introduced and discussed about a year ago at an Expert Meeting in Madison, Wisconsin, where many questions were raised. Overall, the essays and the conversations around them underscore:
- The relevance of metrics and incentives to partnerships.
- That research and practice on partnerships should address both structure and function as well as the broader networks and systems within which partnerships are embedded (including the contexts in which they are created and sustained).
- That individual and/or organizational motives determine in large part who comes to the table and who stays.
- The need and opportunity for partnerships to make efficient use of available resources to drive population health improvement, especially when dollars are scarce.
- The possibility of cultivating truly shared agendas among sectors (health, housing, transportation, regional planning, education, etc.).
- The importance of leadership.
Since population health improvement requires balanced investment and coordination across multiple sectors, we all need to work together more effectively in the future. We hope these essays contribute to this goal, and we invite you to share your own thoughts, questions, and ideas on partnerships here on the blog.
David A. Kindig, MD, PhD is Emeritus Professor of Population Health Sciences and Emeritus Vice-Chancellor for Health Sciences at the University of Wisconsin School of Medicine and Public Health.
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