As 2025 came to a close, BUILD’s fourth cohort found itself doing community-centered systems change work in an increasingly difficult environment. Across the country, community health initiatives are facing hostility towards public health and social services, funding turmoil, federal actions in local communities, and growing risk associated with accessing public spaces.
Yet BUILD awardees did not step back from their work. Instead, they adjusted, listened, and found new ways to remain vital resources for the communities they serve. Drawing from awardee reports submitted at the end of 2025, several themes emerged that reveal how collaboratives are navigating this moment.
Shifting Community Engagement
Several BUILD partners have seen declines in local participation and service access, particularly in areas with heavy federal presence, anti-immigrant rhetoric, or heightened political tension. In these conditions, health clinics, housing programs, and community centers may become associated with fear and surveillance, regardless of immigration status.
In response, teams shifted how and where they show up. Outreach strategies changed. Language became more intentional. Partners focused on Know Your Rights trainings, trusted-messenger models, and small-group or one-on-one engagement. Some collaboratives created new pathways for connection outside of traditional service settings.
These adaptations point to an important driver of health: access goes beyond the availability of services. In this moment, rebuilding trust and meeting people where they are at are essential factors of public health work.
Federal Instability as a Public Health Issue
Beyond politics, federal budget volatility has reshaped the daily work of many awardees. Shutdowns, SNAP disruptions, Medicaid changes, and unpredictable funding decisions created ripple effects that affect food access, resource allocation, clinical volume, and staffing. Decisions made at a distance from local communities are shaping health access faster than local systems can adapt.
Several BUILD teams reported diverting staff time toward emergency navigation services, pausing planned programming, or seeking and reallocating funding to stabilize resources and engagement. Awardees are working hard to respond in real time, repeatedly making tough decisions to balance long-term systems goals with immediate community needs.
Resident Leadership Becomes Community Infrastructure
Even amid uncertainty, many BUILD communities are strengthening resident-led leadership in ways that go beyond advisory roles. Across the cohort, resident councils, youth leadership groups, and peer organizers are evolving into durable structures, in some cases moving toward co-governance and shared decision-making.
This shift is especially visible among awardees working in economic development, food systems, youth engagement, and civic space. Residents are not only informing programs; they are shaping priorities, guiding partnerships, and stewarding community resources. These leadership structures have the potential to exist beyond BUILD, creating local capacity and power that will continue to have impact.
Strategic Pivots in a Changing Landscape
Several initiatives recalibrated their original plans in response to workforce shortages, funding constraints, and policy changes. Some moved away from building physical facilities toward systems coordination. Others leaned into virtual access infrastructure in rural areas or shifted toward policy advocacy.
While this may mean some BUILD teams are now working on different goals than initially outlined in their BUILD applications three years ago, these pivots are examples of responsiveness and adaptation to local conditions, priorities, and emergent opportunities. In practice, this has meant letting go of carefully-laid plans and staying open to what communities and conditions require in real time. The fact that most collaboratives continue advancing their goals – despite natural challenges and external constraints – speaks to the strength of their partnerships, the flexibility of the BUILD model, and the resilience that emerges from community-centered approaches.
Looking Ahead
As BUILD collaboratives move into the final stretch of the award cycle, these themes tell a larger story about what it takes to pursue community health today.
In a moment defined by fear and instability, partners are responding with solidarity and innovation. BUILD collaboratives are choosing to invest in trust, in resident leadership, and in flexible strategies that respond to lived realities. They are showing that systems change does not happen in ideal conditions – it happens when communities and partners decide to stay engaged even when the path forward is challenging or uncertain.
BUILD remains committed to learning alongside collaboratives, supporting reflection, adaptation, and sharing lessons across the network. What this cohort makes clear is that community-centered work is not just a model – it is a commitment. And in this moment, it may be one of the most powerful tools we have for building healthier, more equitable futures.
