Exploring how health equity is addressed in accountable communities of/for health (ACHs).

OBJECTIVE: To explore how Accountable Communities of/for Health (ACHs), a type of health-focused multisector collaborative, are developing strategies to address health equity with diverse partners. DATA SOURCES AND STUDY SETTING: Interview and focus group participants were recruited from a purposive sample of 22 ACH participant organizations in Washington (n = 9 ACHs) and California (n = 13 ACH). STUDY DESIGN: Interview and focus group data were thematized using constant comparison analysis. DATA COLLECTION: Interviews were conducted to learn how each ACH's system context, collaboration processes, and goals influence its progress toward health equity. Focus groups were conducted to gain a deeper understanding of how local context and power dynamics influence an ACH's ability to make progress toward health equity. There were 22 focus group participants and 65 interview participants. PRINCIPAL FINDINGS: Results indicate that ACHs advance health equity across the social-ecological spectrum of health with approaches targeting the individual, community, and societal levels. Specific approaches used by ACHs to collaboratively address health equity include providing equity education to participating organizations and community groups; including diverse community voices in collaborative decision-making; changing practices in their participant's daily operations; improving existing services and developing new services; and actively promoting a culture of keeping equity at the center of ACH efforts. CONCLUSIONS: This study identifies strategies for advancing health equity in multisector collaboratives. ACHs in Washington and California are devoting resources to ensure health equity is central to their work. The numerous approaches ACHs use to advance health equity are important to ensure everyone can reach their full health potential. While current literature argues that multisector health initiatives are integral for advancing health equity, there is a lack of research on how these initiatives advance equity in practice. Thus, this paper provides generalizable strategies that can be further investigated to optimize progress toward health equity.

Accountable Communities of Health, Health and Social Service Systems Alignment, and Population Health: Eastern Washington State, 2017-2019.

Objectives. To assess health system transformation and alignment in the Better Health Together (BHT) accountable community of health (ACH) region of Eastern Washington.Methods. This trend study leveraged cross-sectional data collected in 2017 and 2019 in Eastern Washington. A total of 165 responses from individuals representing 112 organizations were collected in 2017, and 211 responses from individuals representing 92 organizations were collected in 2019. More than one third (38%; n = 35 organizations) of cases overlapped between the 2 samples. Implementation of the ACH model is the exposure. Outcomes of interest included indicators of system transformation and alignment.Results. Organizations throughout BHT's region became more engaged, less siloed, and better connected from 2017 to 2019. At least some of the increased connectivity observed was directly attributable to the role BHT played in facilitating the creation or maintenance of interorganizational relationships across Eastern Washington.Conclusions. The ACH model is a promising approach to aligning health and social service systems for population health improvement. Evidence shows that ACH organizations can serve as trusted conveners able to facilitate interorganizational relationships across sectors.