Rethinking a hospital’s role in community health

Boston Children’s Hospital is giving community organizations more tools and resources to build a healthier future for children and families.

In 2018, the hospital launched the 10-year Boston Children’s Collaboration for Community Health. The collaboration is now providing funding to 51 projects supporting Boston families affected by health inequities and social determinants of health (factors like poverty, housing, education, and access to food that impact an individual’s health and well-being).

Helping to improve kids’ lives

“This is our opportunity for innovation in community health so that organizations and community programs can better improve the health and lives of kids and families,” says Dr. Shari Nethersole, executive director for community health at Boston Children’s.

Boston Children’s identified the most crucial health and social needs by seeking in-depth feedback from parents, community leaders, and local stakeholders. After a two-year process, the collaboration strategy was set with a focus on providing funding for interventions in the areas of early childhood development; behavioral and mental health; stable and affordable housing; support systems for children, youth, and families; and healthy and safe communities.

The funded partners that were selected are now working on projects such as promoting early childhood development, improving access to mental health care, and helping low-income tenants avoid displacement.

Expecting positive results

Boston Children’s expects to see many positives in community health as a result of this investment.

First, the collaboration is helping funded partners to build a network and create efficiencies. “One of our goals is that these organizations will make strong connections and support each other in their work with children and families,” says Dr. Nethersole.

There is also an emphasis on using advocacy as a lever for change. Many of the funded partners are already strong advocates for their communities so the Collaboration will leverage this energy and provide additional training and support. “It’s powerful if we can work together to identify and influence policies and systems that need to be changed in order to improve the health of communities,” she said.

Finally, the collaboration provides an immediate boost of funding to kick-start and support the groundwork needed to help ensure future efforts to improve the health of children. “We can get things started, build capacity and help organizations set up structures so they can take off on their own,” says Dr. Nethersole.

Charting a new course for community health

The Collaboration for Community Health has a strong focus on early childhood, which also fits Dr. Nethersole’s personal philosophy. She keeps this quote from Fredrick Douglass on her desk: “It is easier to build strong children than to repair broken men.”

“We know it’s more effective to do the work upfront to help children grow into healthy, strong, and productive adults,” says Dr. Nethersole.

The collaboration comes at a time when hospitals and health care providers have increasingly recognized the role of social determinants of health. “When I think about social determinants, I see the big picture in that the way to help individual people is to support broad changes in their communities,” says Dr. Nethersole. 

This perspective has been shaped in part by her role as a physician. In addition to her leadership of the Office of Community Health, she takes care of patients at Boston Children’s Primary Care at Longwood.

“Whether I’m having a conversation with a family about nutrition and weight or about managing asthma, I am very aware of how socioeconomic factors may affect them,” she said. “Parents may feel that their child does not have a safe place to play outside or they may not have access to healthy eating options in their neighborhood.”

Dr. Nethersole is pleased that social determinants are now on the radar of other health care providers, funders, and policy makers.

“There’s greater awareness and understanding,” she says. “But now we need to align on how to support and invest in efforts to change and improve systems over the long-term.”

Implementing strategies to address social determinants can be complex and the impact is not immediate. “I see it as similar to research in that the path to take is not always on a straight line,” says Dr. Nethersole. “With community health, flexibility and patience are required so we can learn from experiences, assess outcomes, and make adjustments along the way.”

These challenges don’t deter Dr. Nethersole from continuing to seek and advocate for new ways to address social determinants of health. “I’m excited to be working with our partners and steering Boston Children’s through this important time in our history to help build a healthier generation of children and families.”

Learn more about Boston Children’s community mission.