The third cohort of The BUILD Health Challenge® (BUILD) has been one of the most complex to date. After kicking off in November 2019 with a great convening of the teams in Chicago, BUILD communities dove right into their work. Based on learnings from prior cohorts, we were excited to add some new elements to the program, including an extended grant cyclea renewed focus on systems change in our technical assistance, and cross-site visits and an alumni mentor program that would allow for increased peer learning. Instead, less than six months later, our communities – like much of the world – were turned upside down by the arrival of the COVID-19 pandemic.   

As we approach the one-year mark of the third cohort, nearly half of which has been spent battling a deadly pandemic, an economic crisis, and racial injustice, what have we learned?  


BUILD coalitions are being tested like never beforeMany of the BUILD sites are some of those hit hardest by the pandemic. In addition to bearing a disproportionate burden of the disease, the existing environment, economy, and resource challenges in BUILD neighborhoods mean that social distancing restrictions are exacerbating historical traumas.  

Beyond the immediate impacts of the pandemic on residents, BUILD partners face more demands than ever before. Many health departments have deployed all team members to COVID response. Hospitals are not only dealing with a strain on their capacity, but a decrease in funding due to limited elective procedures. Community-based organizations are seeing the need for the services they provide multiply, as food pantries, healthy home interventions, mental health support, and other social services become critical lifelines.  

BUILD communities are resilient. Despite all of the challenges, there is momentum. The national spotlight on structural determinants of health and health equity have fueled a resurgence in interest in the BUILD partnerships. They have brought in new partners, found ways to adapt their programs to social distancing restrictions, and leveraged new opportunities to respond to existing and emerging needs of their residents.  

BUILD awardees are connected to their community membersEarly evaluation efforts highlighted one standout finding  this third cohort of BUILD communities is leading the way when it comes to incorporating community voice. Early on, we heard from BUILD teams that having community members be part of the decision-making process was a core component of achieving their goals, and we have seen that echoed over and over again in the year since. From hiring processes to participatory budgeting to advocacy, community members are central to every aspect of the BUILD work.  

BUILD partners are being recognized as leaders in the field. Mayors, city council members, and corporations have reached out to BUILD partnerships, as trusted entities in their communities,  to help implement COVID response. They are being highlighted in national publications as changemakers on pressing health issues. They are receiving federal grants recognizing their innovative approaches to critical issues. BUILD partners are advancing the field, and others are noticing.  

BUILD communities are committed to making change. Perhaps most of all, what we are most impressed by is the continued commitment by BUILD communities to fight injustice. Whether that means advancing leadership by Black- and Hispanic-led organizations, advocating for more equitable policies, or building the capacity of community members to step into decision-making roles, we see how hard the BUILD awardees continue to work, even in some of the most difficult circumstances. That work has never mattered more.