Core Principles and Values

Health equity means that every person has the opportunity to achieve optimal health and safety. But in many communities with concentrated disadvantage, people have poor health outcomes, which are referred to as health inequities. To advance equity, we must focus on the structural drivers of injustice that shape the health, safety, and wellbeing of entire communities and populations. Oppression and discrimination on the basis of race, class, education, gender, sexual orientation, immigration status, religion, and other characteristics have powerful negative effects on mental health. We seek to change the community conditions tied to these inequities by addressing the policies, practices, procedures, and norms that cause or perpetuate them.

Understanding gender norms within communities is a key element of addressing mental health and wellbeing. Gender norms influence socialization around coping, social connection, and help-seeking behavior, all of which have an impact on emotional and behavioral responses to community environments. For example, we have all heard the phrases “boys don’t cry,” and “guys tough it out” which can discourage boys and men from seeking help when they need it. There are differences across gender in a variety of mental illnesses, emotional conditions, and health behaviors. Prevention requires both changing community conditions to support broader, healthier, and more inclusive perspectives on gender and ensuring gender-responsive support systems.

Upstream prevention is all about taking action before the onset of symptoms to reduce the likelihood of illness or injury occurring in the first place. Usually, efforts to address health inequities focus on treating individuals. This can look like finding housing for a person leaving an emergency department or directing a family to the local food pantry. Upstream strategies promote safe and healthy environments at the individual, family, community, and societal level, such as ensuring that a community has an ample supply of safe, affordable housing. This influences systemic changes that expand opportunity and encourage healthier outcomes. When entire communities or populations are impacted by a condition that erodes health and wellbeing, it is more effective to take action on the community level.

Changing the conditions in which people live, work, play, and learn in a positive way provides more opportunity to be healthy. While many initiatives focus on changing individual behaviors or providing services to improve lives one at a time, community-level systems change has broader and longer-lasting benefits. For example, anti-displacement policies will positively impact more than just the one person or family in danger of being priced out of their neighborhood. Multiple sectors and systems -- like school districts and transportation agencies -- shape these places and have roles in transforming them. Working alongside communities impacted by negative policies, multisector collaboratives can change the systems that produce inequities.

Making Connections coalitions took the first 12 to 18 months to engage with their communities and partners and align their efforts with the priorities of community members. They used this planning period to talk to the population of focus, whether men and boys of color or military servicemembers and veterans, about how to improve mental health and wellbeing. Coordinators found creative and culturally responsive ways for community members to lead this effort and identify community strengths to build on and challenges to address. For example, in Albuquerque and San Diego, young men of color conducted interviews with their peers to identify community needs; in Boston, fathers of color gathered at breakfasts to set goals for themselves and the community. Each coalition approached authentic community engagement in their own unique way, which helped them build shared ownership and connection.

Instead of one-size-fits-all strategies, Making Connections coalitions focus on their community’s unique culture as a strength upon which collective mental wellbeing is grown. Cultural practices and traditions provide unifying experiences that underpin connectedness and wellbeing. Some of the cultural groups that make up Making Connections coalitions include young men of color, military service members, multi-generational groups, and indigenous communities. Culture adds a necessary perspective to the initiative through their specific assessing, convening, planning, strategizing, and evaluating efforts. Culture is also an asset, a means of creating buy-in and fellowship within the community which frames lived experience as a gift rather than an afterthought.

Focusing on the ways in which community conditions can shape or harm mental health and wellbeing, the ‘blame’ for experiencing mental health problems shifts away from the individual. Making Connections groups find it’s helpful for folks to understand the impact of external community conditions on wellbeing and to realize that individuals are not solely responsible for those conditions. Framing mental health in the context of community conditions helps reduce stigma in communities where mental health challenges might be stigmatized; where communities have faced historical and ongoing trauma due to intentional policies and practices such as slavery and genocide; and where people might face barriers to seeking help.

Community members can sometimes feel more comfortable and motivated supporting their peers than they do asking for support. Shoulder-to-shoulder activities rely on peers identifying solutions together – and by working together to improve their community, they can also experience improved wellbeing. These strategies enhance a sense of agency while shifting power and strengthening connections.

When different sectors come together, such as community organizations and local public health departments, it’s important to have a shared understanding of who their efforts will impact. Place-based initiatives usually focus on communities or neighborhoods defined by geographic boundaries. But community can also refer to a group with shared identities, such as immigrants and refugees, or veterans and military service members. Initiatives like Making Connections benefit from coalitions defining their population of focus so that strategies can benefit those who have been negatively impacted by inequitable programs, policies, and systems. This is strengthened when community members can define and find strength in their own connections and shared identity. 

Values like belonging and connectedness, safety, trust, dignity, hope/aspiration, and control of destiny/self-determination make it possible for people and for communities to flourish emotionally. These values are listed in the order that they were experienced in the Making Connection local communities. Understanding these “Pillars of Wellbeing” can also strengthen community conditions by helping us look beneath any one intervention to understand its impact on people's lives. For example, access to safe, stable housing not only protects mental health and wellbeing in ways related to life stability but can also foster a sense of dignity and belonging.