Community Context 

Butte is the fifth largest city in Montana, with a mining history dating back to the 19th century. Since the 1980s, the population of Butte has declined, in part due to the closing of most mines in the area. Since the 1980s, Butte has been home to one of the largest Superfund sites in the United States, but the Environmental Protection Agency did not make Butte a priority until 2017. Close to $1 billion has been spent to stabilize the site. 

Today, industries within Butte include advanced materials and high-tech manufacturing, apparel manufacturing, and information and communications technologies. 

Butte elected a new chief executive in 2020, who pledged to improve communications between local government and residents by increasing involvement, accountability, and transparency.  

Butte grapples with affordable housing issues, high rates of suicide, and increased rates of drug use and overdose death. Cancer and heart disease are the leading causes of death, exacerbated by a continued lack of providers in the region.

Butte’s Journey to Promote Health, Well-Being, and Equity

Butte’s community capacity to promote health, equity, and well-being remains a cross-sectoral collaborative effort to address community needs.

Many anchor institutions continue to provide critical services, and there has been some increase in community capacity, specifically around mental and behavioral health services. A new homeless shelter was built and a new food co-operative was formed during the COVID-19 pandemic to help meet residents’ needs. Health is still largely perceived to be an individual responsibility, and health equity remains a nascent part of the local narrative.


Baseline research started in 2016 to track community programs and initiatives. The most recent report, from 2022, provides more in-depth insights and analysis into the community's efforts to build a Culture of Health.

Lessons Learned: Where is Butte Five Years Later?

Butte’s journey to promote health and well-being is one that illustrates the importance of collaboration and local investment for creating a shared value around health. Progress has happened slowly, but measurably, as an appreciation for social determinants of health has expanded and local organizations remain committed to finding new ways to address both longstanding and emerging community needs. 

Other communities can learn from Butte’s approaches to promoting health and well-being, and addressing challenges encountered. And, as COVID-19 recovery continues, with historic funding flowing to local communities, future research could consider the ways in which momentum around health, equity, and well-being influences community health narratives and decisions moving forward.

Butte has leveraged its natural resources, strong sense of community, collaborations, and investments from local businesses and organizations to make progress toward health and well-being. However, the city is challenged by state policies that restrict the authority of the local health department, insufficient capacity to meet the needs of individuals facing homelessness, and a lack of recognition and understanding of health equity.

Facilitators:

  • A culture of solidarity

  • An appreciation for community healthcare systems, and prioritizing access to healthcare 

  • Organizational investments in the community to address social determinants of health

  • Collaborations poised to address the growing mental and behavioral health concerns

Barriers:

  • State policies preclude the local health department from pursuing COVID-19 mitigation measures

  • Lack of clarity around health equity

  • Residents view health as an individual responsibility

  • Lack of capacity to address needs of individuals facing homelessness

  • The superfund site continues to pose a health risk