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Rural Health Information Hub
Rural Health Information Hub

Cross-Sector Partnerships for Rural SDOH Programs

Rural communities working to address social determinants of health (SDOH) emphasize the importance of developing robust, cross-sector partnerships. Strong partnerships are essential for effectively engaging the right audiences, pooling limited resources, and building capacity to address complex SDOH challenges. Having a strong network of partners collaborating towards a common goal can help build social capital, increasing the likelihood of successful coordination, improved community outcomes, and long-term program sustainability.

Forming lasting partnerships requires programs to identify partners with similar interests and goals, involve them from the start of program planning, and build strong coalitions and alliances. Many rural communities already have existing partnerships and coalitions, such as those formed for conducting community health assessments (CHAs) and community health improvement plans (CHIPs), which can be leveraged to advance SDOH work. Rural communities should explore how to utilize these existing collaborations and identify where additional partnerships are needed to support program implementation.

Examples of cross-sector partners who may collaborate to address SDOH in rural communities include:

  • Child welfare organizations and other social services
  • Community-based, nonprofit organizations, such as Rotary Clubs, Kiwanis Clubs, and Lions Clubs
  • Community development institutions
  • Farmers, farmworkers, and others in the agricultural sector
  • Federal, state, and local health and human service agencies and programs
  • Faith-based organizations
  • Healthcare systems and healthcare providers
  • Housing authorities or other community-based housing providers
  • Job training programs
  • Land grant universities and Cooperative Extension offices
  • Law enforcement agencies and justice systems
  • Local agencies and businesses
  • Schools and school systems, including pre-K, K-12 schools, and colleges and universities
  • Transportation providers, such as local transportation authorities and organizations
  • Tribal agencies
  • Philanthropic organizations and other funders
  • Public health departments

Community Champions

When developing cross-sector partnerships, it is also important for rural programs to identify and engage community champions and local change agents. This can help ensure the program reaches a greater number of residents and engages them throughout the duration of a program. Champions who are trusted community members may be able to develop effective messaging strategies for addressing SDOH and improving community buy-in.

Health in All Policies Approaches

Health in All Policies (HiAP) is a formal process for integrating health considerations into policies across multiple sectors with the goal of addressing the many SDOH that influence health outcomes. HiAP approaches involve cross-sector partnerships to address SDOH. Key elements of HiAP include:

  • Defining goals that benefit many sectors and partners.
  • Engaging a range of partners, including community members affected by the policies under discussion.
  • Creating permanent changes to the way that agencies make decisions to ensure that commitments addressing health are sustained over time.
  • Recognizing the ways systems contribute to negative health outcomes and incorporating these considerations into policymaking.

Sectors that may be involved in implementing an HiAP approach include:

  • Agriculture – policies may involve food production and access to healthy food. Rural communities may also focus on the environmental implications of agricultural production and the health of farmers and farmworkers.
  • Planning – policies may involve land use decisions that affect SDOH, including zoning and density of residential housing, access to and preservation of open spaces, and bicycle- and pedestrian-friendly developments.
  • Energy – policies related to heating and energy usage may affect indoor and outdoor air quality.
  • Housing – policies can affect the location and availability of affordable housing, as well as the quality and safety of rural housing stock.
  • Natural Resources – policies may address the environmental effects of key industries in rural communities, including fishing and hunting. Policies could also involve management of water quality.
  • Transportation – policies may address the safety of pedestrians, drivers, and cyclists. Access to transportation can also connect communities to economic opportunities, healthcare services, healthy food, recreation, and other necessities.

When HiAP involves multiple sectors and collaborators, public health agencies can play key roles in promoting and creating awareness of health considerations in policy development. Rural health professionals may need to build their policy and communication skills and train others in HiAP principles and tools. HiAP approaches can involve considerable time and investment. HiAP champions may need to plan for the resources required to inventory existing health-related policies across sectors, build collaborative partnerships across multiple agencies, create the infrastructure to monitor progress, and evaluate the results of the initiative.

Rural communities may find that Health Impact Assessments (HIAs) are useful tools to guide HiAP initiatives. HIAs help measure the health effects of proposed policies or projects.

Resources to Learn More

Engaging Communities Through Issues Forums: A How-To Guide for Onsite and Online Community Engagement
Document
Offers suggestions and strategies for cooperative extension staff working to develop issue forums to increase and support community engagement.
Author(s): Braun, B., Pippidis, M., Ketterman, J.M., Inwood, S., & Wright, N.
Organization(s): The Ohio State University Extension, University of Delaware, University of Maryland
Date: 3/2022

Principles of Community Engagement: Second Edition
Document
Provides an overview of community engagement principles and serves as a guide for public health professionals, healthcare providers and organizations, researchers, and community-based leaders working to improve population health through community collaboration. Includes examples of community engagement in rural communities.
Organization(s): Clinical and Translational Science Awards Consortium, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, National Institutes of Health
Date: 6/2011