Texas Health Resources joins national health equity collaborative, launches initiatives to address social determinants of health in Erath County


Soraya Marashi


Texas Health Resources has been selected as one of 20 teams in the nation to participate in the American Hospital Association’s (AHA) Hospital Community Collaborative. The national collaborative aims to provide proven insights and resources to create effective collaborations between hospitals and community organizations with the mission of advancing health equity.

Texas Health’s team, including Erath County United Way and Tarleton State University, has been supporting the Erath County Community Bridges Program. The program focuses on launching initiatives to decrease depression and anxiety, increase access to healthy food, and enhance resource navigation services in specific high-needs areas in Erath County.

Marsha Ingle, senior director of community health improvement at Texas Health Resources, said addressing the target communities’ social determinants of health would be especially critical to advancing health equity in these areas. 

“We really want to transform health outcomes by really serving as a proactive and collaborative catalyst to improve health throughout a person’s life span. And we do that by kind of going upstream … So it’s not treating the symptoms, but it’s going back and treating what’s really causing the problems. Health doesn’t happen in a bubble, it happens in an environment and we need to know what’s going on in that environment before we can address health.”

She highlighted how failing to address a person’s lack of access to healthy food, for example, can ultimately lead to negative health outcomes.

“… If you don’t know where your next meal is coming from, that really increases anxiety … not knowing where you’re going to eat next, or if you’re going to eat next, it really can compound the depressive feelings. So these kind of feed into each other. So when one is present, it interacts with the others. [Resource] navigation services are a very key thing, especially in the rural areas … the people that need the services don’t know how to access the services. There’s so many ways the social determinants of health really impact a person’s health. And that’s one of the things that’s probably most exciting about this work is really being able to address some of those social determinants of health and seeing the impact that they have.”

Ingle emphasized that Texas’s Health’s participation in the AHA collaborative has been a good fit for the organization, as Texas Health had already been making significant investments and launching health equity-focused initiatives in these high-needs areas through its community health improvement team, such as resiliency training programs in school districts and grocery stores inside high schools. 

“The biggest thing that we learned about participating in this collaborative was really strategies and resources to help strengthen our ability to collaborate with external organizations, to enhance our efforts to go upstream to address those social determinants of health. One of the things that we were excited about is the investment in our staff–giving our staff the resources and tools or access to these tools to help them help these organizations to create a strong collaborative.”

She went on to add how the AHA collaborative has allowed them to tailor strategies for both urban and rural areas.

“When you look across the 12 counties that we serve under [Texas Health’s community health improvement team], there’s really a big difference. There’s a huge difference between Dallas and Tarrant County versus Erath County … You can’t approach them in the same manner because they’re really at different levels. And so, looking through the lens of the AHA Hospital Community Collaboration, it really allowed us to tailor what we had really specifically for [rural areas] … What does the rural population need? And how does that differ from what is needed in the more urban counties?”

Ingle said they identify their target counties and zip codes by analyzing primary and secondary data collected through the Community Health Needs Assessment that is conducted every three years, as well as through focus groups held within the communities and Texas Health’s community impact board and five regional leadership councils. 

She emphasized the importance of going into the communities and speaking to the members in addition to looking at data from the assessment. 

“[The community health needs assessment] … kind of sets our framework around what we need to address … Your health data, your demographics, your social needs, index, all of that is very important. But without the voice of the community, without those focus groups and hearing from the target populations … you’re really missing something. 

… The leadership council is made up of community volunteers … [it’s] where you really get the people that live in those communities … They have the ability to help us understand the data [and] help us prioritize the data … For example, [with] COVID vaccines, there are zip codes in our service area that are significantly behind in the vaccine rate. So we look through that data and say, where are the health disparities? And how do we need to address them?”

Ingle said they were currently in the process of implementing the initiatives in Erath County, as well as taking the strategies learned through the AHA collaborative and applying it to Texas Health’s broader community impact work.

“That collaboration has really built the foundation and is implementing the strategies that they’ve learned, and implementing the programs has already started. In fact, they’ve already seen some initial results, so we’re really excited to see how that collaboration grows. I think one of the things that we’re also interested in in that particular program is, if it’s successful [in Erath County], to replicate that in the counties that are in the southern area for our community impact region, which are Kauffman and Johnson.”