Achieving true systems change requires stakeholders to commit to centering the voices of people with lived experience in identifying issues and developing solutions. Health care systems; public systems, like health and human services, education, and housing; and community-based organizations must commit to some common goals, values, and outcomes to improve population health and well-being.

These systems change principles are designed to foster conversation and support the framing of the social sector’s work through the lens of social determinants of health. With shared values focused on equity, diversity, and inclusion, as well as the knowledge of research and results-based practices, systems can work together to improve life for people of all ages in their communities. We support policy changes that modernize systems through design or redesign, drive cross-system functioning, provide robust and sustainable financing, and remove systemic and structural barriers that have upheld racist practices or policies that contribute to poor health outcomes.

These systems change principles improved population health and well-being were co-created by key leaders in the social service sector and the Alliance for Strong Families and Communities and Council of Accreditation (COA).

Partnering with the Entire Health Ecosystem

  • The collective health and well-being ecosystem, including but not limited to health care, education, behavioral health, child welfare, other key stakeholders involved with addressing community safety, social and economic mobility, and those with lived experiences, must be at the table and engaged. We are not in it alone. We must co-identify barriers to care and solutions. We want to mobilize and support the field in any identified workforce development needs.

Changing Power Dynamics

  • Systems must seek to balance power among all key stakeholders. Policymakers should promote and require that health care systems and the social sector, including community-based organizations work together to improve individual health outcomes, and provide reimbursement strategies that incentivize and further collaboration. Community-based organizations must be included as major stakeholders and experts on building community connection. 

People-Centered Focus

  • Systems must provide individualized care. These systems should commit to identifying barriers and co-creating solutions with the community and those with lived experience to address systemic trends that negatively impact individuals. Systems should ensure that individuals’ voices are heard, that they are active and fully engaged participants in their own care, and that they get the supports and services they need, not what providers think they need. 

Addressing Root Causes

  • Throughout history, our culture, economy, and policies have intentionally and unintentionally driven disparities in opportunity and outcomes. All solutions must address our assumptions, biases, and inequities, which are deeply rooted in who we are and inform the decisions we make. Community based organizations have a long history of surfacing and combatting root causes and are willing partners in addressing them.

Anti-Racist Approach

  • Racism is embedded in all sectors of our society. Racist practices and inequitable policies that contribute to poor health outcomes must be called out and confronted. We must name communities that are damaged by discrimination, which include but are not limited to Black, Latino/a/x, Indigenous, Asian-American and LGBTQ populations. 

Forming and Scaling Solutions

  • Together, systems must explore evidence-based interventions designed to eliminate health disparities, while also being mindful of opportunities to implement and scale new innovations and promising practices. 

Prevention and Early Detection

  • Health care systems, in partnership with community-based organizations, must commit to moving further upstream when developing solutions. 
  • Identifying and building upon protective factors can make a difference in enhancing individuals’ resilience and well-being. 
  • Strengthening individuals and families before they come upon difficulty leads to greater population well-being and healthcare savings overall.

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