Improving Social Determinants of Health–Getting Further Faster Initiative

Since 2020, CDC has partnered with the Association of State and Territorial Health Officials (ASTHO) and the National Association of City and County Health Officials (NACCHO) to award funds to community health coalitions across the country as part of the Improving Social Determinants of Health–Getting Further Faster (GFF) initiative. This funding was made possible through the Strengthening Public Health Systems and Services Through National Partnerships (CDC-RFA-OT18-1802) cooperative agreement.

Selected community coalitions have demonstrated impact in advancing health equity by addressing social determinants of health (SDOH), the conditions in which people live, learn, work, and play. Recipients participate in a retrospective evaluation to build the evidence base on successful coalition-led strategies. These strategies advance health equity by addressing SDOH in five domains directly linked to chronic diseases:

  • Built environment
  • Community-clinical linkages
  • Food and nutrition security
  • Social connectedness
  • Tobacco-free policies

What We’ve Learned So Far

Forty-two community multi-sector partnerships participated in the first year of the initiative. Highlights of the key findings are summarized below:

  • All 42 GFF partnerships built community capacity for addressing SDOH through new or strengthened partnerships, data and data systems, or strategic plans; leveraged resources; or engaged residents. Forty-one partnerships involved state or local health departments.
  • Ninety percent of GFF partnerships contributed to community changes that promote healthy living, such as building new walking trails, bike lanes, and playgrounds; creating new community and school gardens; and adopting tobacco-free policies.
  • More than half of GFF partnerships reported positive health outcomes data for their SDOH initiatives, including improved health behaviors, clinical outcomes, and overall health and wellness, and decreased health care use and costs.
  • A modeling analysis of 29 partnerships’ SDOH initiatives suggested promising long-term impacts over a 5-, 10-, and 20-year time frame.

See the evaluation report for year 1.

Coalition Highlights

Built Environment Success

West Louisville Outdoor Recreation Initiative’s infrastructure improvements and outdoor educational and recreational programming: Infrastructure investments included park amenities that expand youth outdoor educational and recreational programming and use of outdoor spaces by the community. Physical activity increased among participants in park programs. Of 128 participants, 60 completed pre-post surveys, which showed a significant increase in the number of days participants got at least 60 minutes of physical activity in 2018.

Community-Clinical Linkages Success

The Diabetes Research, Education, and Action for Minorities (DREAM) Coalition’s culturally tailored community health worker (CHW) intervention: CHWs were embedded into primary care practices and, using a randomized control design, enrolled patients at risk of developing type 2 diabetes or unable to meet blood sugar targets into treatment or control groups. Participants in the treatment group received five group educational sessions and two one-on-one visits delivered by a trained CHW, whereas those in the control group received only the first group educational session. The treatment group achieved significant improvements compared to the control group in physical activity, healthy eating and portion control, weekly blood glucose testing, daily foot checks, and medication adherence (N=127–144).

Food and Nutrition Security Success

Community Builders / Avondale Children Thrive Collaborative’s health champions: This coalition coaches mothers to adopt healthy behaviors, including eating healthier foods, attending prenatal appointments, maintaining smoke-free homes, adopting safe sleep practices for babies, and breastfeeding. Health champions also promote housing stability, facilitate preschool enrollment, and promote early literacy. This initiative is implemented in collaboration with the local health department and a children’s hospital. The program reported that mothers with a health champion shop for fresh produce at a mobile market 5 times more than other mothers.

Tobacco-Free Policy Success

Health Promotion Council of Southeastern PA’s tobacco dependence treatment (TDT): This coalition was able to reduce tobacco use by offering TDT programs at worksites, multi-unit housing sites, and behavioral health and community settings to reach populations at higher risk of tobacco use. About 1,100 adults annually, on average, receive TDT services from Southeastern Pennsylvania Tobacco Control Providers, and 39% of respondents to a 1-month follow-up survey reported not smoking in the past 30 days. Overall, there was a decrease in smoking rates in all but one of the counties where TDT was implemented.

Current Recipients

Fourteen community multi-sector coalitions, most of which include local or state health department partners, have been selected to continue to participate in the retrospective evaluation for a second year. The coalitions will focus on the cost and sustainability SDOH initiatives, the role of health departments in supporting partnerships’ SDOH work, collaboration with clinical delivery systems, and the role of community coalitions in building community resilience. ASTHO/NACCHO will provide technical assistance to the coalitions to support their program evaluation, communications, partnership development, health equity, and sustainability efforts related to SDOH and chronic diseases.

Site Name Location SDOH Domain Addressed
BPSOS Center for Community Advancement Westminster, CA Community-Clinical Linkages, Tobacco-Free Policy
The Diabetes Research, Education, and Action for Minorities (DREAM) Coalition / Council of Peoples Organization Brooklyn, NY Community-Clinical Linkages, Food and Nutrition Security, Social Connectedness
Food as Medicine Collaborative / San Francisco Dept. Public Health San Francisco, CA Food and Nutrition Security
Community Resource Hubs / Atlanta Regional Collaborative for Health Improvement (ARCHI) Atlanta, GA Community-Clinical Linkages
Health Promotion Council of Southeast PA Philadelphia, PA Tobacco-Free Policy
Maryland Living Well Center of Excellence Salisbury, MD Community-Clinical Linkages, Food and Nutrition Security, Social Connectedness
Community Connections / Reading Hospital West Reading, PA Community-Clinical Linkages
Proviso Partners for Health Maywood, IL Built Environment, Food and Nutrition Security, Tobacco-Free Policy
Healthy Here Coalition / Presbyterian Healthcare Services Albuquerque, NM Built Environment, Community-Clinical Linkages, Food and Nutrition Security
Access Health Stark County Canton, OH Community-Clinical Linkages, Social Connectedness
Live Well Allegheny REACH Coalition / Allegheny County Health Department Allegheny County, PA Built Environment, Community-Clinical Linkages, Food and Nutrition Security
Avondale Children Thrive Collaborative/ The Community Builders Cincinnati, OH Community-Clinical Linkages, Food and Nutrition Security, Tobacco-Free Policy
Lancaster County Health and Wellness Commission / Upper Midlands Rural Health Network Lancaster, SC Tobacco-Free Policy
West Louisville Outdoor Recreation Initiative / Wilderness Louisville, Inc Louisville, KY Built Environment, Social Connectedness
Page last reviewed: June 17, 2022