Policy, Systems, & Environmental Change Approaches

The Massachusetts Community Health and Healthy Aging Funds focus on policy, systems, and environmental (PSE) change approaches.

  • Policy change approaches may include a law, regulation, procedure, administrative action, incentive, or voluntary practice of governments and other institutions.
  • Systems change approaches may include change that impacts all elements, including social norms of an organization, institution, or system.
  • Environmental change approaches may include change of the physical, social, or economic environment.

These PSE change approaches are different from direct service or programmatic approaches. The Community Health Fund does not fund initiatives that focus only on direct service delivery. PSE change approaches make long-lasting change within communities to make healthy choices practical and available to all residents. Learn more about PSE change approaches from the DPH program, Mass in Motion.

Fundable PSE Change Approaches

Below is an example of a PSE change approach that the Community Health Fund would potentially fund:

ExampleAddressing racial inequities in homelessness
Initiative FocusAddressing the disproportionate number of African-Americans experiencing homelessness
Lead PartnerA regional housing coalition
The IssueThere are a disproportionate number of African-Americans experiencing homelessness. This has been associated with the relationship between the disproportionate rate of incarceration of Black people, as well as inequitable eviction practices that disproportionately affect this population. Negative health outcomes, such as heart disease, diabetes, and poor mental health are disproportionately high among the homeless population.
The SolutionA regional housing coalition is developing and implementing internal policies, focusing on the relationship between incarceration and homelessness and advocating for policies that reduce barriers to either protect Black people from losing their housing, or obtaining housing. The regional housing coalition will:
(1) Create protections to preserve tenants living in low-income housing, including proper counsel and financial assistance for eviction court proceedings.
(2) Create partnerships alongside local houses of corrections to create wrap-around services for those re-entering after being incarcerated.
(3) Create tools and shift institutional practices across healthcare and housing coalition members to accommodate individuals of diverse backgrounds.
(4) Develop and implement an internal diversity and equity initiative to work towards a more diverse staff and board.
(5) Expand data collection to include more detailed information about race, ethnicity, language spoken, etc. in the housing coalition system.
(6) Conduct a community-based study with Black people who have experienced homelessness and use this data to directly affect policy and practice changes.
(7) Other potential policy and system recommendations the coalition will advocate for are: mandatory affordable housing units for new developments; an affordable housing coalition to aid policy makers in making decisions and a municipality-wide tenants’ rights policy outlining protections for vulnerable tenants.
Health Outcomes AddressedHousing stability/homelessness; mental illness and mental health
Social Determinants of Health AddressedHousing
Root Causes of Health AddressedRacism; structural and institutional barriers