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Neighborhood Health Initiative

The Department of Population Health launched the Neighborhood Health Initiative as a community-based, collaborative approach to improving the health of an entire neighborhood and its residents. With planning and management that includes local leaders and residents, the initiative addresses both medical barriers to health (like access to care and patient navigation) as well as social barriers to health (such as access to housing and high-quality food).

The Neighborhood Health Initiative deeply involves local community leaders and residents in identifying and addressing risk factors and medical and social barriers to good health.

Key Components

The three key components of the initiative are:

  • A household-level assessment: Community health workers go door-to-door to survey neighborhood residents about their health needs, assets and priorities. This information guides clinical and community engagement activities to improve health.
  • Community-centered and value-based primary care: The initiative is anchored by a neighborhood primary care clinic staffed by a multidisciplinary team that collaborates to identify and manage patients’ physical, mental and social needs. Working with the clinic team, community health workers follow up with residents to address their specific health and social needs.
  • Community-Driven Initiatives: Residents have an opportunity to identify high-priority health barriers and propose interventions to overcome them through a Call for Ideas facilitated by Community-Driven Initiatives. Ideas are evaluated by community members and Dell Med faculty and staff, and then a multidisciplinary team works with residents to implement the ideas that are most sustainable and impactful.