10/4/2019 From Emergencies To Equity: The Growing Role Of Hospitals In Community Health | Health Affairs
https://www.healthaffairs.org/do/10.1377/hblog20190930.475240/full/ 2/7
would become known as the Tubbs Fire, ultimately burning more than 36,000 acres in
Sonoma, Napa, and Lake Counties, and killing 22 people. Approximately 5,643 structures
were destroyed, more than half of which were homes in Santa Rosa, the largest city in
Sonoma County. In fact, Santa Rosa lost 5 percent of its housing stock to the Tubbs Fire.
In the tragic aftermath, residents and organizations from a variety of sectors came
together to provide vital services like housing, food, and health care, including trauma
and mental health services. These partners recognized that longstanding policies and
systems had been contributing to poor and inequitable outcomes for vulnerable
populations, particularly low-income communities and people of color. In addition to the
limited production of housing, income inequality and discriminatory practices had been
making affordable housing inaccessible for decades. Many organizations, including
Santa Rosa Memorial Hospital, recognized that even with the best attempts at providing
health care, these issues meant effective housing strategies had to go beyond the
provision of vouchers or even the building of structures. Any real solutions would have to
address the root causes of housing inequity.
The Intersections Initiative
At the same time that the Sonoma disaster response and recovery was under way, the St.
Joseph Health Community Partnership Fund was launching a new kind of initiative
designed to elevate equity and prevention at the community level. The fund's leadership
had come to understand the critical importance of taking on the social determinants of
health—issues like housing, education, and income—to achieve better health for low-
income communities, people of color, and other historically marginalized groups. They
also wanted this new initiative to build on the strengths and resilience of the
communities they serve and to pursue fundamental changes to systems and institutions.
The Intersections Initiative brings together coalitions from seven California communities
served by Providence St. Joseph Health System hospitals with the goal of advancing
health equity by addressing the community conditions that shape health outcomes. The
fund and its partner, Prevention Institute, have been working together since 2016 to
better understand the challenges and opportunities for hospitals and their partners to
intentionally pursue upstream causes of, and solutions to, community-level health
problems.
Centered around those learnings and with hospitals as a partner, convener, and key
strategist, the Intersections Initiative has invested resources toward collaborative
"forming and storming," encouraging coalitions to deeply consider the continuum of
social needs and social determinants and identify approaches that build resilience for
