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For the Sake of All

Intervening on social determinants of health to address health disparities at the regional level requires commitment from a broad set of institutions and stakeholders across sectors. Fostering this cross-sector collaboration to improve health and well-being is one of the primary goals of For the Sake of All, a community-academic partnership in St. Louis, MO. Since 2013, the initiative has engaged in data presentation, research translation, strategic communication, and extensive engagement with community members, policymakers, and other key stakeholders around six recommendation areas. These recommendations were made in the For the Sake of All report released in May 2014 and include increasing investment and policy attention in the areas of early childhood development; school-based health and health care; economic opportunity; mental health; safe, inclusive neighborhoods; and chronic and infectious disease prevention and management. In the aftermath of the fatal shooting of Michael Brown in Ferguson, MO, For the Sake of All emerged as a key resource for understanding and addressing the underlying regional inequities that have resulted in long-standing disparities in health and other life course outcomes.

For the Sake of All has helped to shape the conversation about health and other disparities in the St. Louis region in the wake of Ferguson, but conversation alone will not change conditions. Ultimately, coordinated efforts across organizations, institutions, sectors, and geographic boundaries are necessary to bring both policies and practices in line with the evidence-based and community-informed recommendations contained in the For the Sake of All report.  

For the Sake of All has already begun to facilitate such coordinated action. In September 2015, over 60 key stakeholders from government, philanthropy, education, health, nonprofits, advocacy, and academia came together for Part 1 of “Evidence into Action: Next Steps For the Sake of All,” a convening co-hosted with the Institute for Public Health at Washington University in St. Louis. These leaders prioritized strategies from among the six areas of recommendation through daylong, small-group discussion sessions. Their priority lists were narrowed down to eight strategies:

  1. Increase quality of early childhood programs and increase knowledge and utilization of existing resources.
  2. Increase access and support for Child Development Accounts.
  3. Build capacity around the coordinated school health model.
  4. Establish school-based clinics in high-need areas.
  5. Develop a regional data center to collect, analyze, and share mental health data.
  6. Address violence as a public health issue.
  7. Establish a coordinating organization to advocate for development, tax, and zoning policies for inclusive, affordable housing.
  8. Address social and economic barriers to health in medical settings.  

During Part 2 of “Next Steps For the Sake of All: Evidence into Action,” an event co-hosted with Forward Through Ferguson and the Institute for Public Health in February 2016, over 100 stakeholders developed initial implementation plans to move these strategies into action. Led by professional facilitators from BJC HealthCare’s Center for Clinical Excellence, 13 leaders from the healthcare, education, philanthropic, and mental health sectors in St. Louis formed a school-based health center (SBHC) work group and began plans to sustain and expand health and mental health services within high need area high schools.

School-based health centers provide physical, mental, and preventative health services to address the needs of students. They are typically operated in partnership with health care providers such as Federally Qualified Health Centers (FQHCs) or hospitals.

With regular meetings between April and December 2016, the SBHC work group now consists of 80 stakeholders, representing 40 organizations from diverse sectors including business, community organizations, funders, government, healthcare, nonprofits, higher education, and primary and secondary education. The group’s goals are to sustain the existing SBHCs (i.e., the Mercy Clinic at Roosevelt High School and The SPOT at Jennings High School) and to open two new centers in high schools within high need areas. Stakeholders include:

Affinia Health Center
BJC Healthcare
Community Member
Comtrea
Deaconess Foundation
Family Care Health Center
FOCUS St. Louis
Forward Through Ferguson
Hazelwood School District
Maternal Child Family Health Coalition
Mercy
Mercy Clinic at Roosevelt High School
Missouri Department of Health and Senior Services
Missouri Department of Social Services
Missouri Foundation for Health
Missouri State Board of Education
Missouri Wonk
Monsanto Fund
Myrtle Hilliard Davis Health Center
People's Health Center
Places for People
Ready by 21 St. Louis
Riverview Gardens School District
Rockwood School District
Saint Louis Community Foundation
Saint Louis Integrated Health Network
Saint Louis University
SSM
St. Louis County
St. Louis Economic Development Partnership
St. Louis Public Schools
St. Louis Public Schools Elected Board of Education
St. Louis Public Schools Foundation
St. Louis Regional Health Commission
St. Louis Regional Systems of Care
The SPOT at Jennings High School
United Way
University City School District
Washington University in St. Louis
Wyman

 

 

 

 

 

 

 

 

 

 

 

 

Demand for SBHCs is quite strong throughout the St. Louis region. However, thorough evaluation of district, school building, provider, and community capacity needs to be considered prior to opening a SBHC. As evidenced in the currently operational centers across the country, financial sustainability can be a challenge. Thoughtful analysis and business planning must be conducted in order to ensure that SBHCs achieve their intended outcomes and become lasting interventions within schools.

We are currently drafting a Request for Proposals (RFP) process to help schools identify the best partners for SBHC implementation, outline roles, and plan for the multiple components of opening an evidence-based, financially sustainable SBHC.

We anticipate that we will soon make a formal announcement of one, possibility two, new SBHCs opening in area high schools next school year. We are excited about the significant collaboration on the part of several institutions and organizations to improve student health and well-being, and we are looking forward to the positive impact this will have on student health and academic achievement.