Multisector approach to health equity through systems change, community engagement, and evaluation

In 1992, Cambridge, MA undertook a seminal community health assessment, “Health of the City,” spawning decades of planning, policy development, innovative programming and collaborations, and evaluation. Today, Cambridge is one of the healthiest cities in Massachusetts, despite wide diversity in income and education levels among a population that is approximately 26% foreign-born. Significant progress has been measured in the areas of healthy eating, active living, and supporting and strengthening families. For over 20 years, coalitions like the Healthy Children Task Force and the Men of Color Task Force have galvanized partnerships, innovation, and progress in the development of BMI and fitness report cards, culturally appropriate, healthy school menu items, and men's health programming. Inclusive collaboration among public health, government, business, academia and residents effectively guides policies and environmental approaches like a 2008 trans fat ban, progressive urban planning, and services for underserved families. A new multisector Food and Fitness Policy Council will guide future directions impacting citywide wellness. With its health department embedded in a larger healthcare delivery system, Cambridge is uniquely positioned to address some health issues seamlessly. This arrangement enables school nurses to communicate directly with students' PCPs through EMR; a new school-based concussions clinic benefits from clinical staff's access to athletics programs. Similarly, the Men's Health League connects men to clinical care, while also offering community-based wellness programming. Integration of services, a proactive data-driven approach, and a highly networked and collaborative environment provide a strong foundation for achieving health equity for all residents.