Report Publish Date: February 2022
This report summarizes Baltimore, Md.’s health, wellbeing, and equity journey from 2016 to 2021, as part of RWJF’s Sentinel Communities Surveillance project.
“Baltimore benefits from significant support provided by its large anchor institutions and is further bolstered by a network of community-based organizations that aim to improve the health and wellbeing of city residents,” the authors write. Government collaboration was significant, too, they say, and cross sector collaboration on health and wellbeing was steady during the five years of the study.
The city has a number of longstanding, large-scale initiatives to tackle health and social issues, with varying impacts. The city has also taken steps to address the trauma and other mental health effects of violence, poverty, and racial injustice.
Begun in 2016, RWJF’s Sentinel Communities Surveillance project tracks how a Culture of Health is developing in 29 communities across the country. The authors wanted to describe key challenges, opportunities, and insights in Baltimore.
The authors gathered information from phone interviews with Sentinel Community leaders; online, published, and local materials and media about the communities; and data sources including the Census Bureau’s American Community Survey, the CDC’s Behavioral Risk Factor Surveillance System, County Health Rankings, and state and local data collection systems.
For this report, the authors conducted 30 hourlong, semi-structured interviews between summer 2017 and fall 2021. Interviewees came from a number of different types of organizations and sectors.
"Baltimore’s journey to promote health, well-being, and equity is one that illustrates that a shared understanding of the drivers of health and equity is not sufficient to make progress at the community level in the absence of strong leadership, established goals, and systems changes.”
—RAND Corporation
“There is currently momentum around improved health and health equity, yet Baltimore has a long way to go to help residents out of deep poverty as well as to overcome logistical barriers, such as high turnover among leadership and the lack of a shared vision and framework for action for the city,” the authors write. “Other communities can learn from Baltimore’s approaches to finding common ground, as well as the challenges it encountered, to inform their own journeys.”
Baltimore is a mid-sized East Coast city that benefits from many influential health and education anchor institutions. The city government, philanthropic foundations, and a range of community-based organizations have long supported efforts to promote health and wellbeing and address entrenched inequalities between Baltimore’s large Black population and its White population. Maternal and infant mortality; HIV infections; environmental hazards; and substance abuse, mental health, and the effects of trauma are persistent health issues in Baltimore, particularly for the city’s communities of color. When grappling with the 2015 death of Freddie Gray in police custody, the city strongly embraced both racial and health equity lenses and continues to take steps toward creating a more just community—though progress is slow. More recently, the events of 2020 have prompted a new generation of Baltimoreans to voice their concerns about injustices in the city; this is reflected by younger people taking leadership roles in the mayor’s office and on the city council.
Longstanding place-based interventions and youth workforce development efforts continue to show progress in improving birth outcomes and access to employment opportunities, while new collaborative efforts are attempting to combat the effects of trauma on residents and develop a community-informed strategic vision for creating safer streets. Significant funding through the American Rescue Plan Act may help advance these efforts, though the city is still working to overcome significant challenges, including high turnover among city leadership, residents’ distrust of large anchor institutions, and concerns with the authenticity of community engagement efforts.
Robert Wood Johnson Foundation, February 2022
Figure 1: Population characteristics for Baltimore, Maryland
This study and report was conducted and created by:
Residents are engaged in a number of cross-sector collaborations to improve the health and wellbeing of all who call Baltimore home.
A library of research and perspectives about Sentinel Communities, 30 diverse communities around the country.