Thrive: Facilitating a community-led approach to advance health equity

Problem & Relevance: Life expectancies differ across zip codes, with communities of color and low-income communities experiencing severe health disparities. Using a Freierean model of community learning, the Tool for Health and Resilience in Vulnerable Environments (THRIVE) enables community-driven efforts to address community health and health equity.

Methods: The practice-informed THRIVE framework helps community residents to: 1) develop a critical consciousness of the determinants of health, the intersections among clinical health outcomes, exposures, and behaviors, and how these are socially and environmentally determined; 2) assess the current state of the determinants of health; and 3) translate the assessment output into a policy action plan to improve health and equity across the lifespan. Since no two communities share the same conditions and resources, the resulting strategies and activities are highly specific to each community's social, political, and economic context.

Results: THRIVE has been implemented in sites with high proportions of Latino residents, including Hidalgo County, NM and California's San Joaquin Valley. The tool increases community knowledge of the determinants of health and health disparities, and also functions as a vehicle to prioritize, at the environmental level, interventions supporting good health, including: teen centers, farmers' markets, mentoring programs and a community center.

Conclusions: As a practice-informed model of community change, THRIVE has been shown to help residents to identify and prioritize activities and initiatives. As social, economic, political and cultural contexts differ from place to place, the robustness of the framework has enabled the development of specific and appropriate solutions.