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Rural Health Information Hub

Services Integration and Multigenerational Approaches

Services integration programs deliver comprehensive health and human services. These programs can help address social determinants of health (SDOH) by increasing access to healthcare, connecting people with needed social services, and improving health outcomes. A multigenerational, or two-generation approach, is a type of services integration approach that focuses on addressing the needs of the entire family, often with the ultimate goal of reducing rates of poverty and improving the financial and employment outlooks of families. Programs using a two-generation approach typically focus on 5 key elements:

  • Postsecondary education and employment pathways
  • Early childhood education and development
  • Economic assets
  • Health and well-being
  • Social capital

For additional information about rural programs and models that use a services integration or multigenerational approach to address SDOH, see program models in the Rural Services Integration Toolkit.

Examples of Programs that use Services Integration and Multigenerational Approaches

  • The Community Caring Collaborative (CCC) collaborates with partner agencies and organizations in rural Maine to address SDOH by addressing health and social challenges and providing support to families in an effort to reduce health disparities. One CCC-incubated program using a two-generational approach is Family Futures Downeast (FFD). This program provides one year of post-secondary education to parents of young children and also provides services to help with workforce development. In addition, families are provided with high-quality educational programming for their children. FFD also links families with transportation services and technology resources to remove employment barriers.
  • Generational Opportunities to Achieve Long-Term Success (GOALS) is a program using a two-generation approach to improve access to stable, quality housing in Arapahoe County, Colorado. GOALS is a short-term housing program for families with children that aims to improve economic stability by providing housing and wrap-around social services. These services address needs of the adult members of the family as well as early development and educational needs of their children.
  • The National Association of Counties (NACo) recognizes that rural counties are uniquely positioned to help their residents address SDOH, especially in terms of developing multigenerational strategies to overcome poverty. NACo highlights several rural counties working to alleviate poverty, some of which are using a multigenerational approach, for example San Juan County, Utah. In this county they are addressing poverty in Native American communities and also focusing on improving educational attainment.

Implementation Considerations

For implementation considerations for using a services integration or multigenerational approach for addressing SDOH, see Implementation Considerations in the Rural Services Integration Toolkit.

Program Clearinghouse Examples

Resources to Learn More

Two-Generation Strategies
Includes webinars and information about two-generation approaches. Includes examples of states, tribes, and programs using this approach.
Organization(s): Administration for Children & Families