Shift gathered our Community Advisory Council, a group of peer leaders collaborating on a new vision for leveraging health system investment capital, to discuss opportunities for participatory, community-governed funding. The Council builds on the groundwork of our Reimagining Equity series, which interrogated and explored opportunities to shift from institutionally driven structures, decisions, and investment initiatives to center community governance and ownership. Their perspective is wide-ranging and diverse intentionally, bringing to bear experience with specific pain points in accessing funding for locally rooted health equity initiatives aimed to disrupt systemic oppression and top-down mandates. The Council is crafting a bold vision for community-led and participatory investing, specifically focused on the health sector. This work leverages efforts in other sectors that are exploring community ownership models for impact investing, community development, housing and land use, all advancing economic justice centered on When we talk about the “health sector” we are referring to a range of health institutions, including hospitals, health plans, health foundations, public health agencies, and others that hold assets (including funding, data, land, and others) as well as a mandate to create better health outcomes.

Shift, and our Community Advisory Council, believe that better health outcomes are possible through shifting power and decision-making into the hands of communities. This vision takes shape in tangible ways, and the Council is exploring the capacities, tools, networks, and narratives needed to shift systems toward stronger co-governance between health systems and people. The Council has lifted up opportunities including strengthening initial relationship-building for community leaders to participate in financial tables and decision-making; reframing risk to situate risk-taking with the institutions that hold power and resources; and new ways of articulating return on investment (ROI) to enable community wealth-building, ownership, and creative uses of capital for broader health impact. All of these tools demand a review of core assumptions about what funding and health systems can and should deliver on, as well as intentional trust-building that allows all partners to show up authentically and responsibly toward shared commitments of health equity. The Council is active in co-creating new tools and approaches for community-led investing that are available to health systems and community partners interested in the deep and relational work of co-governance. Shift is leveraging these tools and vision toward activating tests of change in the field – we welcome opportunities to work with partners to advance this vision further — get in touch!