New Haven’s Journey to Promote Health, Well-Being, and Equity
Five years into the Sentinel Communities Surveillance Project, New Haven’s capacity to promote health, well-being, and equity is led by the local health department, Yale University, and YNHH.
Others are also involved, including healthcare organizations, educational institutions, city departments, a robust nonprofit sector, workforce development organizations and coalitions, and local foundations. New Haven continues to take steps toward better health, well-being, and equity with significant grassroots activity and institutional initiatives on topics such as community safety and trauma, reimagining healthcare delivery, meeting basic needs in combination with upstream efforts, and engaging in equitable economic and workforce development. Many of these initiatives have been in place before 2017, though new investments and commitments have been made since then. New Haven’s history of confronting various social determinants of health and health inequities has shaped stakeholders’ broad definition of health, which incorporates education, poverty, violence and trauma, and housing, in addition to physical and mental health. Some community members are concerned that the dominant narratives in the community still emphasize downstream approaches and individual responsibility. New Haven’s approach to health equity has evolved over the past five years, from some discussion of equity by various stakeholders to rethinking funding, empowering grassroots leaders, and creating new structures with racial equity as a cornerstone.
Health Priorities and Narrative
Leading voices for health comes from the New Haven Department of Public Health, healthcare providers, and coalitions of stakeholders.
New Haven has a large nonprofit community with a diverse missions connected to well-being.
Many initiatives exist to address community violence, public safety, and trauma. A sizeable new collaborative focuses on youth-service coordination.
Primary care providers started to collaborate more formally with one another and expanded community-based health services.
Health Priorities and Narrative
Interrelated crises, including the COVID-19 pandemic and an escalation in violent crime, have elevated trauma and mental health in narratives about health and well-being.
Members of the diverse community appear to be embracing new conceptualizations of health that are more holistic, less tied to Western medicine, and more culturally informed.
Since 2017, health equity has become pervasive in local narrative: “People are now thinking about it in everything.”
Particularly impactful in the community’s health equity narrative has been the role of grassroots organizations and neighborhood groups.
Lessons Learned: Where is New Haven Five Years Later?
New Haven’s journey to promote health, well-being, and equity shows how a community can capitalize on both institutional and grassroots capacity, but it also sheds light on how acute community challenges may inhibit collaboration and action on long-term systems transformation.
Other communities can learn from New Haven’s approaches and challenges to inform their own journeys. And as COVID-19 recovery continues, with New Haven receiving historic funding through the American Rescue Plan Act, future research could consider the ways in which the community’s established track record for considering health and equity influences community health narratives and decisions moving forward.
New Haven has funding, capacity, and grassroots energy to address longstanding factors that influence health, equity, and well-being outcomes. Yet, instability in local leadership, a top-down approach to community health from many large institutions, and a lack of coordination present barriers to addressing significant unmet needs in the community.
Funding and capacity from large institutions
Culture of community engagement
Cultural diversity contributing to sense of community and vibrancy
Willingness to think collectively across sectors
Top-down approach to funding allocation
Small tax base limits funding to city government
Many acute priorities results in disjointed effort