February 2020: Proof that it's possible to push farther upstream


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Vol 3 Issue 2

Dear friends,

Just last week I spoke with future Upstreamists in my own backyard: medical, nursing, and public health students at the 24th Annual UCLA Health Care Symposium. In past years, we’ve had vital conversations at the symposium about the need to move upstream at all levels of health improvement — by addressing not only individual needs, but also the forces that drive health inequity for communities and entire societies. In other words: population health, community health, and societal health. 

It’s a big vision. But when I spoke with the students this year, I had the chance to tell them: It’s happening.

We understand — and many of these inspiring young students intuitively grasp — that coordinated action to improve health and its upstream drivers requires action at all three levels. More and more, our work at HealthBegins is to help health systems and community partners understand and act on that imperative.

What’s remarkable is that now we’re seeing tangible early progress in this space, in communities as far-flung as Texas, Montana, and Virginia. For example:

  • Just last year we supported the American Hospital Association’s flagship Hospital Community Cooperative program, through which 10 communities across the country advanced more than 300 milestones to improve individual and community health.
  • Recently we helped the Virginia Hospital and Healthcare Association form a statewide learning collaborative to help hospitals move upstream to improve the health of populations and communities.
  • Last Monday my colleague Sadena Thevarajah and I joined leaders in South Carolina to launch an initiative to design a statewide strategy to improve social determinants of health by working at all three levels.
  • Beyond health systems, community partners like the YMCA of the USA are making early progress in advancing population and community health using a method called Community Health Detailing. (Check out the latest episode of the HLTH Matters podcast with Y of the USA Vice President Katie Adamson!)

What this tells me, and what I told the students, is that addressing health inequity even at its deepest sources is possible, especially when we do it in partnership.

To that end, I’m thrilled to share an upcoming chance to move our collective work up a level further, to the structural determinants that shape health across society. Next Wednesday, March 4, HealthBegins is hosting a free webinar: “Redlining & Health Equity: How Health Systems Can Help Dismantle Structural Racism.” We’re honored to be joined by PolicyLink Founder in Residence Angela Glover Blackwell, along with Josie Williams, director of community engagement at the Greensboro (N.C.) Housing Coalition, for what promises to be a powerful — and actionable — discussion on structural determinants of health.

Join us! (Or, if you can’t make it, sign up to catch the recording after.) As always, we’re excited to be with you on the journey upstream.


Rishi Manchanda

Don’t miss next week’s webinar!

Redlining & Health Equity: How Health Systems Can Help Dismantle Structural Racism
Wednesday, March 4, 10:30 a.m. PT / 1:30 p.m. ET
Hospitals and health systems are increasingly looking to move upstream to improve care and outcomes. As these industry leaders work to improve individual social needs and community-level social determinants of health, some trailblazers are looking even further upstream — to the structural determinants of health equity.

This webinar will address one of the most pervasive forms of structural racism: redlining. We’ll hear national leaders, including PolicyLink founder Angela Glover Blackwell, explain historic and ongoing impacts of redlining on community health, with real-life examples. And we’ll share concrete suggestions on ways health systems and partners can help dismantle, mitigate, and prevent redlining.

Join us for this important conversation about bold ways your upstream work can help #UndoRedlining.

Register here


  • Rishi Manchanda, MD, MPH, President, HealthBegins
  • Angela Glover Blackwell, Founder in Residence, PolicyLink
  • Josie Williams, Director of Community Engagement, Greensboro Housing Coalition
  • Sadena Thevarajah, JD, Managing Director, HealthBegins

By the end of the webinar, participants will be able to:

  • Describe the history of redlining in America
  • Identify the impact of redlining on current efforts to improve social determinants of health and equity
  • Detail at least three ways health systems and community partners can help dismantle and prevent redlining 

Cost: This webinar is free!

Can’t attend the live event? By registering, you will be able to access a recorded version of the webinar later.

Questions? Email us at info@healthbegins.org.

Have a topic that you’d love to see us cover in a webinar? Please tell us at info@healthbegins.org.


From The Upstreamist, the HealthBegins Blog:From Transactional to Transformational: The Next Level of Upstream Care

“Give a man a fish and you feed him for a day; teach him to fish and you feed him for a lifetime.” But what if he can’t afford the lesson? What if the pond is polluted? Why not teach a woman to fish? This post calls us to drive change on all levels of scale.

When Moving Upstream, Don’t Go Chasing Waterfalls

With so many emerging initiatives and projects to address social needs and social determinants of health, the opportunity to improve the lives of patients and communities is more real than ever. But we face a real risk of squandering this opportunity.

Time to Manage Upstream Programs Like Investments

Through partnerships and collaboratives, healthcare organizations are launching programs to address social needs and social determinants of health. We have budgets and plans to reach specific goals, but is the way we’re spending our resources putting us on a path to achieve long-term goals for community health? At the moment, the answer is no. In this post, Rishi Manchanda outlines why it’s time to view upstream interventions as investments for long-term financial, health, and social impact.

Upcoming Events: Find HealthBegins Here

Upstream Opportunities

If you have fellowships, events, or other opportunities you’d like us to share, please email us at info@healthbegins.org.

Upstream News

Curated highlights of happenings affecting upstream care. Links are not endorsements.

Supreme Court Allows ‘Public Charge’ Rule to Take Effect Nationwide
The Hill

Past Racist ‘Redlining’ Practices Increased Climate Burden on Minority Neighborhoods
Scientific American

As SDoH Efforts Take Off, Payers Try to Carve Out Their Role
Healthcare Dive

Evidence-Based Community Health Worker Program Addresses Unmet Social Needs and Generates Positive Return on Investment
Health Affairs

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