Why Align?

The United States spends more on health care than any other country, yet Americans live shorter lives and experience poorer health than people of other developed countries. Health inequities are produced by the conditions in which people are born, grow, live, work, and age.

Efforts to align public health, health care, and social service sectors hold great promise for achieving health equity and to address community needs and goals. While a number of these efforts have emerged to create solutions to bridge the health gaps nationwide, there remains a need to clearly understand the current landscape and mechanisms of systems alignment. Robert Wood Johnson Foundation’s Framework for Aligning Sectors provides an opportunity to move the needle on health equity. The Framework is exploring and strengthening the evidence for the conditions that bolster cross-sector alignment and supporting practical on-the-ground efforts nationwide.

Texas Health Institute

Texas is what the United States will be in 30 years. It is home to not only a large and growing racially and ethnically diverse urban and suburban population, but also sizeable border, rural, and refugee communities. At the same time, Texans have witnessed few improvements in population health outcomes over time, with inequities only deepening. Given its breadth and scope of cross-sector alignment efforts, the lone star state provides a unique learning ground to lay the foundation for understanding these initiatives.

Two years ago, building on a decade of experience in health equity, Texas Health Institute (THI) set out to conduct a first of its kind, comprehensive realist evaluation of health equity focused cross-sector alignment efforts across Texas. THI collaborated with twenty cross-sector alignment efforts diverse across geography, size, scope, and maturity to test RWJF’s Framework to understand what works, under what conditions, for whom, and how cross-sector alignment efforts emerge, develop, and are sustained.

  • Read more about the Align for Health Theory of Change at “Framework.”
  • Learn more about our participating cross-sector initiative and current work on the “Coalitions” page.