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Systems Change Starts with Relationships 

Healthy Places by Design loves collecting stories of leaders going above and beyond to address social isolation in communities. They know that social isolation is a growing and overlooked threat to health and wellbeing, and it is rooted in systemic inequities. Like other social determinants of health, social isolation requires public health practitioners and other local leaders to work across their disciplines and beyond their traditional comfort zones to help reconnect communities for the good of the people who live in them.

Social Connectedness as Part of a National Public Health Strategy

Mara Galic is a project coordinator for the Building Resilient Inclusive Communities (BRIC) initiative for the National Association of Chronic Disease Directors (NACDD). And she is a true systems-level thinker. NACDD leads the Centers for Disease Control and Prevention grant program, which invests in 20 state public health agencies to integrate social connectedness with strategies to promote nutrition security and safe physical activity access. Galic described how BRIC launched to help public health agencies pivot during the pandemic as they faced social distancing mandates, impromptu redeployments for COVID-19 testing and vaccine response, and unprecedented staffing shortages. Community engagement, health equity, social justice, and systems change are key aspects of the initiative.

Galic says, “Social connectedness was completely new. We had a lot of support from Healthy Places by Design, Mental Health America, and the Foundation for Social Connection to help us really think it through. You can imagine this learning journey over the last two years.” Initially, grantees assessed who was doing what work to combat social isolation, which led them to create new relationships and partnerships, and incorporate social connection into existing coalitions. BRIC grantees are now updating State Health Improvement Plans to address social isolation.

“Social connectedness has become near and dear to my heart. I’m trying to integrate it into all aspects of my work. [With BRIC] we really emphasized policy, systems, and environmental change versus individual programs. One thing I learned from the communities was that it’s not an ‘or’ it’s an ‘and.’ We need both [approaches].”

State Support for Connected Communities in Illinois 

Sarah Flores, a senior program manager for the Illinois Public Health Institute (IPHI), is a real connector in service to increasing social connection. She coordinates Illinois’ BRIC program’s physical activity and social connectedness strategies. IPHI supports two regions identified as “high opportunity-high need for mental health and social isolation.” Regional partners engage local partners—Area Agencies on Aging (AAAs), local community colleges, and faith-based coalitions—to create referral systems to connect isolated older adults to community resources, pilot and expand intergenerational programs, and train older adults on technology usage. At the state level, IPHI worked with coalition partners to incorporate social connectedness into policy, systems, and environmental change work. Illinois is also working to strengthen its State Health Improvement Plan by incorporating social connectedness data items into the update process.

The Illinois BRIC program supports trusted organizations within neighborhoods to engage their communities in meaningful ways. Flores acknowledges that expecting residents to help identify priorities and be involved in the work is “a big ask.” IPHI recognizes that community expertise is valuable and that residents should be compensated for it.

Flores reflects on how BRIC’s emphasis on social connection has impacted her work. “This has spurred a broadening of thought. We were always hyper-focused on nutrition and physical activity in health. We’ve begun to think much more broadly about, ‘What is optimal health, mental health, social connectivity?’ It spurs us to think how to bridge our work to the many facets of health.”

New Partners for Equity and Connection in St. Louis

Dr. Diana Parra, a Research Assistant Professor in the Prevention Research Center at the Brown School at Washington University in St. Louis, forges diverse partnerships to decrease social isolation. The BRIC program in St. Louis promotes social connection with the local AAA organization, senior centers, local libraries, and an urban agriculture nonprofit supporting senior black farmers. Parra created new relationships while forming the BRIC Collective, a coalition to explore and prioritize the needs of the St. Louis community that is most heavily impacted by the pandemic.

The learning process clarified for Parra how racial segregation led to the nutrition inequities seen today. “The concept of food apartheid was new to me. They don’t use the words ‘food desert.’ A desert is a natural occurrence,” she explains. “In St. Louis, what we have is the legacy of segregation. It was by design. Redlining created the conditions where neighborhoods, particularly neighborhoods in North St. Louis, do not have grocery stores. They do not have access to healthy produce and community gardens.”

Through the BRIC Collective, Parra is working alongside community leaders, residents, and local people who are trying to make change. She has learned how important intersectionality is—not just between gender and race—but also between nutrition security, social isolation, and physical activity issues. “We must understand the history and legacy of harm done to communities, but also appreciate their resilience and wisdom.” Parra urges us to “Put intersectionality and equity at the center of everything. It’s not just a lens, something that you put on and you take off. It should always be at the center.”

Following Up

Healthy Places by Design is interested in what organizations and communities from across the country are doing to create socially connected communities. If you have an example to share with us, want to learn more about what others are doing, or have interest in partnering with us, please email your question to Gabriella Peterson at gabriellap@healthyplacesbydesign.org.

We applaud the more than 300 people joining us in the Local Leaders Network for Socially Connected Communities, who have come to learn together and share insights as we work to create healthier and more inclusive communities. These stories are collected from meetings of that group.

Resources for this session are now available including the recording and presentation slides. Other 2022 presentations, recordings, and helpful reports for socially connected communities are available here.