An innovative funding collaborative and award program, The BUILD Health Challenge is contributing to the creation of a new norm in the U.S. BUILD is putting multi-sector, community-driven partnerships at the center of health to reduce health disparities caused by system-based or social inequity.


The National Challenge

In the United States, more than 95 percent of healthcare spending is attributable to direct medical services; however, medical care accounts for only a fraction of our nation’s health and well-being. A far greater share, as much as 70 percent, can be attributed to the interplay and influence of our social, physical, and economic environments, and their effects on health behaviors. These upstream factors—often referred to as the social determinants of health—include influences as diverse as early childhood development, employment opportunities, food availability, air and water quality, transportation, educational attainment, public safety, housing, and a myriad of others. No one organization in a community – or even one sector – can successfully address these factors alone. Too often, efforts to improve community health are conducted in silos, seeking to address big picture problems with narrowly focused interventions.

In response, the Colorado Health Foundation, de Beaumont Foundation, Kresge Foundation, Robert Wood Johnson Foundation, and the Advisory Board Company partnered to launch BUILD in 2015. As an innovative funding collaborative and award program, BUILD has created a new pathway for communities to drive sustainable improvements in health. By catalyzing and learning across multi-sector, community-driven partnerships, this initiative is moving resources, attention, and action upstream. Together, we can drive sustainable improvements in community health, contain downstream health care costs, and promote health equity.


The Awards

BUILD is a national program designed to support partnerships between community-based organizations, health departments, and hospitals/health systems that are working to address important health issues in their community. Each community collaborative addresses root causes of chronic disease (also commonly referred to as the social determinants of health) in their local area by leveraging multisector partnerships, and working with their local community. To date, BUILD has supported 55 projects in 24 states and Washington, DC.

Collaboratives are selected during an open call for applications process when a new cohort is being created. Applicants selected for BUILD must have a strong track record of working together; have developed their joint priorities and implementation plans with strong levels of community engagement and leadership; and are primed to advance equitable systems-level changes in their community. Many of the efforts include cross-sector partners such as health plans, businesses, foundations, and others that are aligned with the proposed efforts are encouraged.

Communities may be awarded up to $250,000 over two-years to implement their efforts to drive sustainable improvements in community health. The partnering hospitals and health system(s) in each award also commit a 1:1 match with financial and in-kind support to advance the partnership’s goals. In addition, they will receive access to a robust array of coaching and support services; specialized trainings and capacity building opportunities; opportunity to participate in a national network of peers engaged in similar work; and the opportunity to spotlight their local work on a national level.


BUILD Stands For:

When applied in concert, the BUILD principles—Bold, Upstream, Integrated, Local, and Data-Driven—represent a powerful model that has the potential to transform community health. The principles are the engine that drives how BUILD operates. The model reflects an innovative and flexible approach to population health that allows any community using it the opportunity to identify how to leverage the five principles most effectively. No one principle is more important than the other: they are neither mutually exclusive nor independent. They serve to guide BUILD sites as they start to design strategies and approaches within their respective communities.


Partnerships that aspire towards a fundamental shift beyond short-term programmatic work toward longer-term influences over policy, regulation and systems-level change


Partnerships that focus on the social, environmental and economic factors that have the greatest influence on the health of a community, rather than on access or care delivery


Partnerships that align the practices and perspectives of communities, health systems and public health under a shared vision, establishing new roles while continuing to draw upon the strengths of each partner


Partnerships that engage neighborhood residents and community leaders as key voices and thought leaders throughout all stages of planning and implementation


Partnerships that use data from both clinical and community sources as a tool to identify key needs, measure meaningful change, and facilitate transparency amongst stakeholders to generate actionable insights