Building Stronger Communities: How Coalitions Can Tackle Health Disparities

Coalitions play a crucial role in catalyzing change and reducing health disparities.^1,2 Health equity refers to the fair and just opportunity for everyone to achieve their highest level of health, which requires removing obstacles such as poverty, discrimination, and lack of access to quality care.³ Health disparities refer to the differences in health outcomes that are closely linked to social, economic, and environmental disadvantages.⁴ These disparities are often seen in marginalized populations, including racial and ethnic minorities, low-income communities, and they result in poorer health outcomes, reduced access to care, and higher mortality rates compared to more privileged groups.^5,6 The need for coalitions is essential in empowering community stakeholders across various levels- community, policy, and societal- to provide ongoing support and protection for targeted audiences and public health professionals, especially during changing landscapes.⁷

This fact sheet is designed to be used for a wide range of community-based stakeholders, including healthcare outreach coordinators, staff at community health centers, youth program coordinators, school-based health advocates, grassroots organizers, and people with lived experiences who are working in various communities to address and reduce health disparities. By engaging local leaders, healthcare providers, and residents, the goal is to foster collaboration, develop actionable strategies that address the root causes of health inequities, and drive meaningful change to promote health equity.

Health Equity and Social Determinants of Health

Achieving health equity means ensuring that everyone has a fair and just opportunity to reach their highest level of health. It requires addressing the root causes of health disparities by removing barriers that prevent individuals from accessing the care and resources they need. This involves policy changes, resource allocation, and community support aimed at overcoming systemic inequities and promoting equal access to healthcare.⁸

A key factor in health disparities is the social determinants of health (SDOH)—the conditions in which people are born, grow, live, work, and age. These conditions include factors such as income, education, housing, access to healthcare, and environmental conditions, all of which influence health outcomes.⁹ For example, individuals living in low-income areas often face limited access to nutritious food, quality education, and healthcare services, contributing to poorer health outcomes.

Addressing health disparities requires collective action.¹⁰ Community coalitions play a vital role in this effort by uniting diverse stakeholders such as healthcare providers, local leaders, and residents around common goals. By focusing on social determinants of health and advancing health equity, these coalitions can develop sustainable, community-driven solutions to improve health outcomes and reduce disparities.¹¹

What is a Community Coalition?

A coalition is a group of individuals and organizations that come together with the common goal of addressing a specific issue.¹² Coalitions are most effective when they are inclusive, equitable, and reflective of the community's diverse population. By bringing together stakeholders from different sectors, coalitions can leverage resources, advocate for policy changes, and implement local initiatives that address complex health challenges.

Steps to Building a Successful Coalition

The formation of a coalition involves several key steps. These steps, adapted from community health frameworks, are critical for ensuring that the coalition is both effective and sustainable.¹³

1. Identify a Community Need: Start by assessing local health disparities or unmet needs. Tools such as community health assessments or focus groups can help pinpoint issues like food insecurity, healthcare access, or chronic disease prevention.
2. Recruit Core Members: Assemble a group of stakeholders, including healthcare providers, community leaders and volunteers, educators, local organizations, and representatives from historically marginalized communities. A diverse group of stakeholders ensures that the coalition can address the community's unique needs from multiple perspectives.
3. Develop a Mission and Vision Statement: Work collaboratively to define the coalition's purpose and long-term goals. For example:
   • Mission: To reduce health disparities in [Community Name] through equitable access to resources and education.
   • Vision: A thriving, healthy community where all members experience equity.
4. Host an Initial Meeting: Bring members together to establish common goals, define roles, and build trust. This meeting is crucial for aligning expectations and identifying shared values. After the initial meeting, consider one-on-one meetings, focus groups, and collaborative activities to further strengthen these connections, laying the groundwork for sustainable, inclusive progress.
5. Secure Resources: Seek funding through grants, partnerships, and in-kind contributions. Ensuring sufficient resources will allow the coalition to sustain its efforts over time.
6. Establish a Governance Structure: Develop a framework for decision-making, communication, and conflict resolution. Clear roles and responsibilities are essential for effective coalition operation. Consider including a steering committee to provide leadership and community advisory board to ensure diverse community representation.
7. Plan Activities and Events: Develop an actionable plan with specific events, campaigns, or educational initiatives. Ensure that activities are relevant and accessible to the community.
8. Evaluate and Adapt: Regularly assess the coalition's impact through surveys, performance metrics, and feedback. Continuously adjust strategies to remain aligned with the community's evolving needs.

Identifying and Engaging Stakeholders

To build a strong foundation for meaningful coalition work, it is essential to begin with a deep understanding of the community landscape, particularly the stakeholders, or individuals and organizations, who have a vested interest in the coalition's goals. Tools like asset mapping can help pinpoint those already working to address health disparities. Just as important is involving people with lived experience, whose insights can meaningfully shape the coalition's direction. As relationships are built, it's crucial to assess both strengths and gaps to help pinpoint where additional expertise or resources may be needed.

Key stakeholders may include:

• Community Members: Residents directly impacted by the health disparities being addressed.
• Local Leaders: Faith leaders, neighborhood advocates, and other influential figures who can help mobilize support.
• Healthcare Providers: Physicians, public health officials, and other health professionals who provide expertise on healthcare access and needs.
• Community-Based Organizations: Nonprofits working on social determinants of health, including food access, housing, and economic stability.
• Educators: Teachers and administrators who can engage young people and support health education.
• Government Representatives: Local policymakers who can facilitate systemic change and provide resources.
• Businesses: Local businesses that play a role in economic development or contribute to improving community health.

Best Practices for Maintaining a Successful Coalition

Once a coalition is established, it is essential to focus on ongoing collaboration and sustainability:

• Communicate Effectively: Regular communication through meetings, newsletters, and digital platforms fosters trust and keeps all coalition members and the larger community informed.
• Set Measurable Goals: Establish clear, trackable objectives that can demonstrate progress and maintain momentum. Use the SMARTIE Goals approach to ensure goals are Specific, Measurable, Action-oriented, Relevant, Time-bound, Inclusive, and Equitable.¹⁴
• Value Diverse Perspectives: Actively engage individuals from different cultural, professional, and lived backgrounds to ensure a well-rounded approach to problem-solving.

Takeaway Tips for Success

1. Foster Community Ownership: Ensure that the community drives coalition activities to build trust and long-term sustainability.
2. Invest in Capacity Building: Provide training for coalition members on topics like cultural sensitivity, health equity, and effective coalition management.
3. Leverage Existing Networks: Collaborate with local organizations and leaders who already have deep community ties.
4. Emphasize Equity: Make equity a core principle by addressing systemic barriers and ensuring all voices are heard.

Coalitions are powerful tools for driving community change, especially when addressing the complex and deeply rooted causes of health disparities. As this fact sheet illustrates, building an effective coalition requires inclusive planning, diverse stakeholder engagement, and a shared commitment to equity. By centering the voices of those most impacted and aligning efforts across sectors, coalitions can create sustainable solutions that promote health and well-being for all.

Whether you are a community leader, healthcare provider, educator, or advocate, your role in a coalition is vital. Through collaboration, clear goals, and a focus on the social determinants of health, we can work together to remove barriers, amplify community strengths, and ensure every individual has the opportunity to live a healthy and fulfilling life.

References

1. Crowder SJ, Tanner AL, Dawson MA, et al. Better together: Coalitions committed to advancing health equity. Nurs Outlook. Nov-Dec 2022;70(6 Suppl 1):S48-s58. Doi: 10.1016/j.outlook.2022.02.013
2. National Academies of Sciences E, Medicine. Committee on Community-Based Solutions to Promote Health Equity in the United States ib, Weinstein JN, Geller A, Negussie Y, Baciu A. Communities in action: pathways to health equity. The National Academies Press; 2017.
3. Prentice KR, Beitelshees M, Hill A, Jones CH. Defining health equity: A modern US perspective. iScience. 2024/12/20/ 2024;27(12):111326. Doi: 10.1016/j.isci.2024.111326
4. Braveman P. What Are Health Disparities and Health Equity? We Need to Be Clear. Public health reports (1974). 2014;129(1_suppl2):5-8. Doi: 10.1177/00333549141291S203
5. Braveman P. Health disparities and health equity: concepts and measurement. Annu Rev Public Health. 2006;27:167-94. Doi: 10.1146/annurev.publhealth.27.021405.102103
6. Castro A, Marmot M, Garay J, de Negri A, Buss P. Achieving sustainable health equity. Bull World Health Organ. Jan 1, 2022;100(1):81-83. Doi: 10.2471/blt.21.286523
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8. Gómez CA, Kleinman DV, Pronk N, et al. Addressing Health Equity and Social Determinants of Health Through Healthy People 2030. Journal of Public Health Management and Practice. 2021;27(Supplement 6)
9. Hacker K, Auerbach J, Ikeda R, Philip C, Houry D. Social Determinants of Health-An Approach Taken at CDC. J Public Health Manag Pract. Nov-Dec 01 2022;28(6):589-594. Doi: 10.1097/phh.0000000000001626
10. Paskett E, Thompson B, Ammerman AS, Ortega AN, Marsteller J, Richardson D. Multilevel Interventions to Address Health Disparities Show Promise in Improving Population Health. Health Aff (Millwood). Aug 1, 2016;35(8):1429-34. Doi: 10.1377/hlthaff.2015.1360
11. Nagorcka-Smith P, Bolton KA, Dam J, et al. The impact of coalition characteristics on outcomes in community-based initiatives targeting the social determinants of health: a systematic review. BMC Public Health. Jul 15, 2022;22(1):1358. Doi: 10.1186/s12889-022-13678-9
12. Lawlor JA, Metta KR, Neal Z. What is a coalition? A systematic review of coalitions in community psychology. Journal of Community & Applied Social Psychology. 2022;32(1):3-18. Doi: 10.1002/casp.2554
13. Cohen L, Baer N, Satterwhite P. Developing effective coalitions: an eight step guide. In: Wurzbach ME, ed. Community Health Education & Promotion: A Guide to Program Design and Evaluation. 2 ed. Aspen Publishers Inc; 2002:144-161.
14. Anonymous. Set a SMARTIE goal to target inclusion and equity. The Learning Professional. Dec 2021 2024-04-19 2021;42(6):66-68.

June 2025