title: Addressing health disparities by building organizational capacity in the community: a case study of the Wai'anae Coast Comprehensive Health Center.
abstract: Native Hawaiians and other residents living in economically disadvantaged communities suffer disproportionately from many health conditions, especially chronic diseases. Reversing this trend requires a comprehensive approach encompassing more than just improvement in healthcare delivery. Indeed, societal changes at multiple levels must occur, including environmental, systems, and policy change, in order to bring about sustainable improvements in community health and wellness. A key strategy to accomplish these upstream changes is an increase in the capacity of community-based organizations to provide leadership in health advocacy, support community health promotion, prioritize resource allocation, and participate in community health research. In disadvantaged communities where health disparities are the most severe, community health centers (CHC) are well positioned to take a pivotal role in these efforts. This report is a case study to describe processes taking place at Hawai'i's largest CHC to build organizational capacity and bring about upstream changes that improve community health and wellness. Ongoing processes at the CHC include (1) Institutional: commitment to address health disparities, expand the CHC research infrastructure, and develop a comprehensive worksite wellness program (2) Collaborative: development of a network of community partners committed to the common goal of improving the health and wellness of community residents, and (3) Systems and Policy: activities to strengthen the CHC's and community's ability to influence systems changes and policies that reduce health disparities. Preliminary results are encouraging although the processes and timelines involved require a long-term commitment in order to affect tangible results that can be measured.
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (MO).
authors.forename: May
authors.initials: M
authors.lastname: Okihiro
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (MO).
authors.forename: Vija
authors.initials: V
authors.lastname: Sehgal
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (MO).
authors.forename: Tiana
authors.initials: T
authors.lastname: Wilkinson
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (MO).
authors.forename: Kelli-Ann
authors.initials: KA
authors.lastname: Voloch
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (MO).
authors.forename: Rachelle
authors.initials: R
authors.lastname: Enos
authors.affiliation: Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (MO).
authors.forename: Joyce
authors.initials: J
authors.lastname: O'Brien
mesh_terms: D035843:Biomedical Research / Q000193:education; D057191:Capacity Building; D003151:Community Health Centers / Q000458:organization & administration; D019058:Community Networks; D055812:Community-Based Participatory Research; D003254:Consumer Advocacy; D006254:Hawaii; D006291:Health Policy; D054624:Health Status Disparities; D006801:Humans; D011204:Poverty Areas; D064890:Social Determinants of Health