The BUILD Health Challenge® (BUILD) team spent the last month meeting one on one, virtually, with applicants from BUILD 4.0 (both those who advanced to the second and final round, and those who did not) in order to share feedback on their applications and hear about their experiences with the process. Our goal with the fourth cohort, developed in partnership with the funding collaborative and past awardees, is to further efforts to strengthen cross-sector and community-driven partnerships. In doing so we aim to ensure that no one is disadvantaged from achieving their full health potential because of social position or other socially determined circumstances. We received an incredible response with more than 150 applications. This left us even more excited for what the fourth cohort of communities will be able to accomplish and learn together over the next few years.

The BUILD 4.0 call for applications inspired communities from all across the country to put Bold, Upstream, Integrated, Local, Data-Driven plans into action. We saw everything from the training of community health advocates and repurposing of land, to creative data sharing platforms and food as medicine concepts. In aggregate, all of the applications focused on driving sustainable improvements in community health. Here are a few highlights from the applications and what we learned from them:

  • There was a wide geographic range: Applications came from 33 states in the US with most originating in California, Pennsylvania, and Texas.
  • The top focus areas we saw most often in applications included: Access to Care; Food; General Health/Wellbeing; Housing; Perinatal/Maternal Health; Mental Health; and Built Environment.
  • BUILD also looked to understand if applications focused on any specific populations: 72% focused on a specific racial/ethnic group. (In some cases, projects focused primarily on one or more racial or ethnic groups and were included in this count.) By contrast, 17% focused broadly on the general population or did not otherwise specify a population.
  • For the first time, BUILD changed its partner format to allow health plans/insurers to serve as the required health care partner (either in alignment with a local hospital/health system, or replacing that entity in a collaborative). Out of the 155 applications received, 18 included a health plan provider/insurer as one of their core partners.
  • Anecdotally speaking, it appeared from the questions we received and the applications submitted, that inclusion of the local public health department and in some cases the hospital/health system was particularly challenging for some applicants. We suspect this may be due in part to ongoing challenges in the health care system related to COVID-19.

The 38 applicants that were selected to move on featured not only a strong idea with a clear vision for how that concept would be brought to life using the BUILD principles, but they also succinctly identified and demonstrated buy-in from the core required partners. In addition, these proposals told a story of how their cross-sector collaborative had been working together to foster a shared vision of community power building and leadership that has the potential to lead to systemic change within their community. We are excited to provide limited technical assistance in Round 2 with a new accelerator program that supports applicants’ program development and design. Final applications for those invited to participate in Round 2 will be submitted in January 2023.

We applaud all the applicants for their innovation and ideation to support better health for all! We’ll announce which communities will receive a BUILD 4.0 award in Spring 2023.


Special thanks to our partner ChangeLab Solutions for managing Round 1 of the application review process and the Accelerator program.