Health Equity in Colorado: Field Building & Community Change
The Colorado Trust believes advocacy for policy change is a cornerstone to achieving health equity. The Health Equity Advocacy (HEA) Strategy launched in 2013, was a seven-year investment of $19.95M with the goal to build a strong and diverse field of health equity advocates in Colorado.
Key learning from the HEA evaluation around approaching equity-focused advocacy and field building include:
Advocacy partners
must have a shared understanding of “health equity.” One which acknowledges the importance of addressing racial equity and racial justice in efforts to achieve health equity.
Meaningfully engaging communities
most impacted by health inequities in policy advocacy efforts is difficult to do, but it is essential. Engaging authentically in health equity advocacy requires a willingness to re-examine mainstream/traditional notions of advocacy “success” and “progress.”
Field building
requires long-term investment support. This is particularly critical in an effort as ambitious as HEA, which not only endeavored to build an entirely new field, but also aimed to engage in policy and systems change, create meaningful paths of engagement for affected populations, address racism at multiple levels, and shift traditional funder-grantee dynamics toward a model of power sharing.
Investments
in infrastructure and capacity building are essential to the success of complex, equity-focused, field-building efforts. These investments enable grantees to focus more squarely on the actual work of field building and field strengthening (rather than on administrative aspects of the work).
“In response to persistent health inequities across the state, there is a palpable shift in understanding that solutions lie in the social determinants of health that are driving those inequities."
The HEA Strategy has unfolded in phases:
The first phase (2014) served as a planning phase designed to unpack assumptions behind this approach going forward, foster relationship building across diverse stakeholders, identify what capacities and skills needed to be developed to strengthen health equity advocacy work, and consider how best to improve coordination and collaboration to advance shared health equity goals.
The second phase (2015-2016) was intended to provide an opportunity for 18 funded organizations (“the Cohort”) to begin implementing health equity advocacy field building—both as individual organizations and as a collective group—establishing a shared vision, strengthening capacity, and building local, regional, and statewide networks positioned to advance health equity advocacy goals.
The third phase (2017-2019) focused squarely on active field building, as the Cohort worked to build a robust field of health equity advocates. This phase was characterized by unprecedented levels of field-level capacity building, coordination, and collective action to advance health equity policy aimed at ushering in change for Colorado’s diverse communities.
The Trust also funded a resiliency year (2020) for the HEA strategy which was designed to create a space for closure for the 18 funded partners of the HEA Cohort and to support their transition out of this initiative.
SPR has served as the evaluation and learning partner for the HEA Strategy since its launch. In this role, SPR has had the dual priority of (1) evaluating strategy-level progress, and (2) providing learning that both supports strategic implementation of the HEA Cohort’s work and offers insights from their experience for the broader field of social change philanthropy.
Related resource
State of the Field: Findings from a 2020 Scan of Colorado’s Emerging Health Equity Advocacy Field
04/08/2022
Related resource
Engaging Affected Populations in Health Equity: An Emerging Framework in Colorado
05/06/2022
Evaluation Reports
Resiliency Year – Supporting Resiliency in the Health Equity Advocacy Field
This report details how the HEA Cohort relied upon relationships and structures developed between 2015 and 2019 to build capacity for change and advocate for equitable policies in 2020.
Evaluation Framework
Health Equity Advocacy Strategy: What is the Evaluation Framework?
The HEA evaluation is guided by an evaluation framework designed to do justice to the innovative nature of the field-building work, while still maintaining flexibility to capture the unexpected and respond to any emerging needs that might arise within the cohort. The framework builds upon key concepts in field building and community-driven change research, and integrates shared understanding generated from the HEA cohort.
Evaluation Framework & Case Studies
Seeds of the Field: Case Studies of HEA Cohort Organizations
These case studies highlight the health equity advocacy work of the 18 HEA cohort organizations and illustrate growth in both individual and collective capacity to “seed” an emerging health equity advocacy field in Colorado.
Recent Event
Centering Race in Health Equity Advocacy: 2020 Addendum
This addendum to the original learning paper details participation in, and outcomes of, these continued efforts. It also includes a rearticulation of the HEA Cohort’s vision and a description of the multilevel framework that guided this work.
Learning Papers
Shifting the Advocacy Paradigm in Colorado: The Health Equity Advocacy Journey
This learning paper tells the story of how the HEA Cohort experimented with ways to align their health equity advocacy efforts and take collective action. It provides some of the tools that the Cohort developed to invite the involvement of individuals and organizations with various levels of advocacy capacity. It also shares core lessons that have been learned from the efforts to build advocacy capacity to advance health equity.
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