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Building a Robust, Inclusive and Effective Health Advocacy Ecosystem

Image: The City of Dayton, KY received the Everette Varney Smoke-free Indoor Air Excellence Award for their exceptional leadership and collaborative efforts in promoting the health of their citizens by enacting a comprehensive smoke-free workplace ordinance.

Policy impacts everything we do from the streets we drive on, the quality of the air we breathe, or how much we pay out of pocket at the doctor’s office. As Interact for Health looks to tackle root causes of health injustice in our community, we started to look at the landscape around health policy and evaluate the role we can all play in ensuring that policies promote good health – not hinder it.  
 
In the spring of 2023, Interact for Health partnered with Innovation Network to ask nearly 100 organizations across Ohio, Indiana, and Kentucky in spring 2023 “What will it take to build a robust, inclusive, & effective health advocacy & policy ecosystem?” The "advocacy ecosystem" we are describing is a network of people, organizations, and strategies that work together to influence public policy and create change.  
 
Results from the survey are shared in the new report, “Building a Robust, Inclusive and Effective Health Advocacy Ecosystem.” The report makes visible the current state, strengths, and challenges of the advocacy ecosystem and provides recommendations on how we—as funders, non-profits, and policymakers—might come together to improve the effectiveness of our advocacy ecosystem.  
 
“Oftentimes when we think of advocacy, we think of individual people or organizations, but in reality, all of our organizations are working to support each other. This report gave us a unique opportunity to give visibility to the diverse group of organizations that are doing this work and help us better understand what is needed to move forward collectively for greater policy impact,” said Ashlee Young, Vice President of Policy and Engagement at Interact for Health.

Our Ecosystem  

The first step to evaluating the advocacy ecosystem is to understand who is doing this work and where it’s taking place.  

• Over half of the organizations surveyed have an annual budget of $1M or more.  
• One third of organizations engage in advocacy or policy as their primary activity. 

• The top three focus areas are mental health, health coverage and access, and substance use. 
• The top three advocacy tactics used are communications and messaging, public education, and coalition-building. 

Our Community 

To make changes to the health of our community, we must identify those most impacted by policies that hinder good health so they can lead the solutions. The most effective, sustainable strategies are developed by those who best understand the problems. “We are a member-led organization. Our members who are directly impacted people shape our policy priorities, strategies, and lead public events through chapter meetings and campaign meetings. ” - Survey respondent.  

• While just over half of organizations engage and/or represent people who identify as Black, Indigenous, and People of Color (BlPOC), they are less likely to focus on and use their resources for advocacy and policy efforts. When these organizations do use advocacy tactics, they are less likely to target decision-makers and more likely to target local branches of government.  
  
  
• Three-quarters of organizations report that < 50% of their leadership is BIPOC.​ 
  
  
• The top three groups with lived experience that organizations engage and/or represent are people with low incomes, children and youth, and people who live with a mental health condition.

Our Future 

A robust advocacy and public policy ecosystem thrives when diverse partners are skilled in a broad spectrum of strategies and tactics. With an understanding of who makes up the advocacy ecosystem and how it interacts with our communities, funders, advocacy organizations, and decision-makers can better identify the role they can play in strengthening the effectiveness of the ecosystem:  

• Enhance Collaboration: Build stronger partnerships among stakeholders. This involves creating platforms for collaboration, sharing resources, and building trust. Better collaboration can lead to more coordinated and impactful advocacy efforts. “The most important needs that must be met to strengthen the health advocacy and/or policy field are increased coordination across groups and improved resources for lobbying and public education.” - Survey respondent  
   
• Invest in Communities: Invest in capacity building for community leaders and organizations led by those with lived experience. Grassroots engagement is critical for driving meaningful change. 
   
• Sustain Investments: Long-term funding is key to creating lasting change. Oftentimes, funders want to see immediate outcomes, but sustained investment is necessary for building and maintaining the capacity of the advocacy ecosystem to drive change. 
   
• Leverage Data and Evaluation: Implement data collection and evaluation methods to guide advocacy efforts. Use data to identify health disparities, track progress, and refine strategies for greater impact. 
   
  We know proven policies that build healthier communities. And we believe there is a path to creating a strategic, coordinated approach to advancing health justice through policy change in our community. We all have a role to play in shaping effective advocacy strategies and fostering lasting change. If you would like to offer feedback on this report or next steps for evaluating the advocacy ecosystem, please email kadcock@interactforhealth.org and ayoung@interactforhealth.org.

read the report Brief

read the full report

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