Better Together

The Christmas season marks some of the busiest travel days of the year.  The roadways are filled with travelers heading home for the holidays, cars packed to the brim with sparkly packages and tasty goodies to share. The “friendly skies” become rivers flowing with planes taking off one right after the other, heading to destinations where friends and family anxiously await.  The 2022 holiday travel season was marred by an unusual operational collapse of an otherwise beloved and reliable airline at this most critical time for travel.  Over 16,000 of Southwest Airlines flights were canceled in a span of ten days, leaving voluminous accounts of missed holiday celebrations, weddings, funerals and other family gatherings and countless numbers of travelers searching for luggage never to be seen again.  Most of the blame centered on outdated systems used to communicate with Southwest flight crews and the absence of partnerships with other airlines that would have given Southwest a bit of breathing room in a difficult situation. 

Airline partnerships are called “alliances” and they make connections more ample world-wide for the average traveler and mileage gathering and spending easier for the more frequent flyers.  A bigger capacity to “make connections” would have certainly helped the beleaguered Southwest Airlines during their holiday crisis.

The Southwest “meltdown,” as it was referred to in the media, is a cautionary tale about the immense value of “making connections” both literally and figuratively and the vital role partnerships play in industries and organizations designed to serve the public.  “Better together.”  Partnerships allow for greater capacity, more ideas, more innovation and in crisis, more solutions from a deeper well of resources than one business or organization can offer on its own. Really good partnerships can change the world. Their value in doing the hard work of enhancing the quality of life for members of any community has been proven over and over again.  Human beings are wired for connection and the power of collective effort is what drives progress, purpose and the building of human infrastructure so that all people can flourish. In the introduction to Jean Oelwang’s book, Partnering: Forge the Deep Connections that Make Great Things Happen, Simon Sinek describes it this way, “To advance something greater than ourselves we must learn to partner.”  Partner is not a thing, but an action.

Partnering in public health work is not only wise, it is mandatory.  Public health is tasked with addressing nearly every concern related to people and their wellbeing.  Caring for the health of all people cannot be done in a vacuum and public health’s willingness to stand shoulder to shoulder with other organizations, sharing the awesome responsibility of protecting the health of all people, makes it a leader in every community it serves.  “Life turns on good relationships.  All of life.” The words of Lord Hastings of Scarisbrick make clear the idea that relationships form and have always formed the very foundation of our lives together.  The noble work of public health is threaded with strands of systems and missions and values designed to encourage relationship building.  Public health serves many functions, but its ability to build and foster deep, connecting and beneficial relationships may be its super power.   

This “public health super power” shores up programs and practices that simply would not have the same impact if it were not for a partnership with public health. In a similar vein,  programs with their genesis in public health would not have the broadest reach possible in the community without accompanying partners.  With “better together” as a mantra, public health has an indomitable willingness to reach out its hand to those with similar missions in support of the health and wellbeing of all people.  Shared public health programs like the one done in partnership with North Platte Public School’s Kids Klub called Marathon Kids, featured in our last blog, is just one example.  We are excited to tell you about more of these local program partnerships in the future.  

So essential are partnerships to the work of public health that they form part of the public health infrastructure, the support necessary for public health to “protect and provide fair and just opportunities for all.”  “Community partnership development” is number two in the set of Foundational Capabilities set forth by the Public Health Accreditation Board. Jean Oelwang describes the “Deep Connection” of partnering in simple terms.  “They (partners) help each other do something much bigger in life than they could ever do alone.” An example of relationship building, fostering connection and doing greater things together are two public health processes known as Community Health Assessment and Community Health Improvement Plan, otherwise known as CHA/CHIP.  

Community Health Assessments or CHA (pronounced “chaw”) are intricate bodies of work designed with the goal of identifying the most pressing health concerns in a community. In the jargon of public health, these assessments must involve “multi sector collaborations that support shared ownership of all phases of community health improvement, including assessment, planning, investment, implementation and evaluation.”  In layman’s terms, the Community Health Assessment reflects the same vision as public health as a whole; meeting people where they are with the hope of improving their health and wellbeing by creating and sustaining diverse relationships that allow for a greater impact on the community. While the Community Health Assessment is facilitated by a local, state or tribal health department, it belongs to the community.

The CHA process initiates the implementation of the Community Health Improvement Plan, or CHIP. The two processes actually work together with fluidity, like two tributaries of the same river, building in size and shape and depth the closer they come to the sea.  They are mutually dependent processes, the work of one the complement to the work of the other.  The breadth of the work of helping people thrive is wide.  It takes the depth of the partnerships working toward a shared vision to make “community health improvement” possible.

The Community Health Assessment and Community Health Improvement Plan demonstrate the beautiful blend of art and science that is public health.  Data collection and analysis, data sharing with partners, and solid research represent the science of public health.  The CDC specifically identifies the science of the CHA this way; “a state, tribal, local or territorial health assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis.” 

During the process, however,  diverse groups of people from the community are brought together in what are known as “focus groups,” or “priority groups”. Each individual in each group brings unique ideas, perspectives, values and stories to the table, all in service of a healthier community.  The gathering of people together with a shared purpose is the art.  Public health becomes a companion and a guide, serving as a bridge between art and science. 

The value of the CHA/CHIP process is found in its ability to blend science and art, both of which are needed to address the growing number of health concerns affecting the public.  The growing expanse of what can be defined as “public health” will continue to require robust, diverse and innovative partnerships.  It will require forming Oelwang’s “Deep Connections,” especially in the context of health equity, defined as “the realization by all people of the highest attainable level of health.”  Again, “better together.”  The belief, the desire and the systems in place in public health and its ability to form and foster deep connections with partners may be its super power, but the work of whole human health is vast, and as business leader Jim Roth once said, “There isn’t a single superhero; no individual is strong enough.”  Especially when it comes to the most pressing health issues, including health equity, things like CHA/CHIP help form a league of superheroes who can do the work…together.

According to a 2018 analysis of Community Health Assessments and Improvement Plans, the National Institutes of Health found that health departments engage a “broad array of partners” to most effectively address community health priorities. Common partnerships included hospitals and health care, non-profit service organizations, education, business and faith-based organizations.  Small health departments like West Central District Health Department more frequently listed a wider range of partner types than did larger health departments.  The analysis concluded that it is the collaborative nature of the CHA/CHIP process that best addresses the needs of a community.

The CHA/CHIP process can seem highly technical and intimidating to those outside the field of public health. By inviting community partners to co-identify the priorities and then co-create the solutions,  a common language develops through the process that improves communication and information sharing. For individual citizens, a way to look at CHA/CHIP is as something that is ever evolving as the definition of “health” evolves. It is a plan that acknowledges the interconnectedness of people and through partnerships, the needs and the solutions become accessible and available to everyone.  

Partnering is defined by the depth of the commitment the partners have to each other and to the clarity of the vision of a better world they share.  Partnering may not have allowed Southwest Airlines to completely come out of their system failure unscathed, but they certainly would have been better positioned to serve the flying public that depended on them. The Southwest “meltdown” was costly. Over $825 million is the estimate of the monetary loss to the airline. The loss in human terms to their customers in missed connections, missed opportunities, and missed moments with loved ones cannot be quantified.  By building coalitions of people who share a wholehearted desire to work in the service of others, the kind found in the CHA/CHIP process, heights can be reached and hardships overcome in the way that has and will always speak to the best in us.  “Better together.”