Bridging Gaps: Provider Perspectives on Integrating Systems for Health Equity

Brittany R Schuler ¹, Stacey L Shipe ², Astrid Uhl ¹

⁰School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Ave., Ritter Annex 549, Philadelphia, PA 19122, USA.

International Journal of Environmental Research and Public Health +

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April 26, 2025

View abstract on PubMed

Summary

Community-based organizations (CBOs) face system barriers impacting child and family health equity. Addressing multilevel factors like policy, community, and organizational support is crucial for equitable service delivery.

Area Of Science

Public Health
Health Equity Research
Community Health Systems

Background

Health equity is influenced by intersecting factors within community-based organizations (CBOs).
Providers in underserved areas are key access points for child development, mental health, and behavioral support.
System-level barriers impede service delivery and access for vulnerable families.

Purpose Of The Study

To explore provider perspectives on barriers to service delivery in CBOs.
To identify factors hindering health equity for children and families.
To inform system-level changes promoting equitable child and family health outcomes.

Main Methods

A narrative qualitative design was employed.
In-depth interviews were conducted with 21 health and mental health professionals from child- and family-serving CBOs.
Ecological and strengths-based frameworks guided the examination of provider insights.

Main Results

Key themes emerged at macro (policy, racism), community (environment, cohesion), organizational (stress, fragmentation), and family levels (needs, access).
System fragmentation and lack of provider support were significant organizational barriers.
Barriers related to basic needs, parenting support, and service access were identified at the family level.

Conclusions

A multilevel approach is essential, prioritizing rights-based policies and community cohesion.
Strengthening CBO capacity can address social determinants of health.
System integration and enhanced CBO support are vital to mitigate structural barriers and advance health equity.

Keywords:

children and families community organizations health and mental health professionals low socioeconomic status qualitative social work