MMHA 6200 Week 7 Coalition Stake Map Paper Example

Coalition Stake Map: What Seven Partners Gain, Give and Risk in the East-Side Asthma Effort

Student Name

Walden University

MMHA 6200: Creating Healthy Communities

Instructor Name

Month Day, Year

Coalition Stake Map: What Seven Partners Gain, Give and Risk in the East-Side Asthma Effort

Introduction

Seven organizations would need to work together for Lakeshore Community Hospital, a composite nonprofit hospital, to reduce children's asthma emergency visits in the east-side rental corridor through home remediation. A list of partners would say who is at the table. This stake map says why each would stay: what it gains, what it contributes, what it risks and what the hospital would forfeit if it withdrew. Roussos and Fawcett's review of community health partnerships links their success to clear roles, shared ownership and partners who see something in it for themselves (Roussos & Fawcett, 2000). The map is built to make those roles and benefits explicit, and to identify the partner most likely to sink the effort.

The Grid

Table 1 shows the seven partners.

Table 1

Stake Map for the East-Side Asthma Coalition

The Partners Most Likely to Stay

The tenants' association and the legal aid tenant clinic have the clearest reasons to stay, because the program serves their core missions. The tenants' association gains repairs in its members' homes and a voice in how the program operates; it contributes the trust that brings families into the program. Its risk is that members who request repairs face retaliation, which is why the legal aid clinic's contribution matters: advice and, where needed, representation for families whose landlords respond to repair requests with rent increases or non-renewal. Without legal aid, the tenants' association would be asking its members to take a risk alone.

The community development corporation gains contracts and a way to fulfill its mission of improving older housing; it contributes licensed repair crews who know how to work in pre-1950 buildings. Its risk is financial: if repair costs exceed estimates, it absorbs the loss. The program should therefore pay for repairs on a cost-reimbursement basis with a ceiling, rather than a fixed price per home.

The county healthy homes inspectors gain a stream of referrals to high-risk homes and contribute both assessment skill and enforcement authority. Their risk is workload; their budget does not grow with referrals. The school district's family resource centers gain healthier students and contribute a second referral route, so that families can enter the program without an emergency visit. Their staff time is the main cost, and a simple referral form keeps it small.

The Partner Who Could Sink the Effort

The small-landlord association could sink the effort. Its members own most of the corridor's buildings, and remediation cannot happen without their access and cooperation. Its members gain repairs paid partly by others and fewer code citations, which matter to owners with thin margins. They contribute access to units and their own share of repair costs. But they risk more than any other partner: the program will find defects that might otherwise have gone unreported, and inspectors in the coalition hold enforcement authority. A landlord who joins could, in effect, invite a citation.

The hospital would forfeit access to most corridor homes if the association withdrew, and the program would shrink to the few owner-occupied buildings and the units of landlords willing to act alone. To keep the association in, the coalition should agree, in writing, that defects found through the program will be handled first through repair, with enforcement used only when an owner refuses to act within an agreed time. That agreement asks something of the inspectors, who must accept a repair-first approach, and something of the tenants' association, which must accept that some defects will take weeks to fix rather than being cited immediately. Krieger and Higgins describe partnerships between public health and housing agencies, using both assistance and enforcement, as one of the most promising approaches to unhealthy housing (Krieger & Higgins, 2002); this agreement is the corridor's version of that balance.

The Hospital's Own Stake

The hospital is not a neutral convener. It gains fewer repeat emergency visits, a community benefit activity it can report and a reputation for addressing the conditions behind its patients' illnesses. Anchor institution strategies describe hospitals using their resources as employers, purchasers and investors to improve community conditions (Koh et al., 2020), and the hospital's stake in the coalition includes these roles. Its risks are program costs and public accountability: if the program fails, the hospital's community benefit claim will be questioned.

Using the Map

The map will be reviewed with each partner before the coalition's first meeting, so that each can correct how its stake is described. The landlord association's agreement on a repair-first approach should be negotiated before any other commitments, because without it the rest of the coalition has little to work on. And the map will be revisited after the first six months, when partners' actual gains and costs can replace the estimates in the grid. A partner whose gains have not materialized by then is a partner likely to drift away, and the coalition should know that before it happens rather than after.

References

Koh, H. K., Bantham, A., Geller, A. C., Rukavina, M. A., Emmons, K. M., Yatsko, P., & Restuccia, R. (2020). Anchor institutions: Best practices to address social needs and social determinants of health. American Journal of Public Health, 110(3), 309-316. https://doi.org/10.2105/AJPH.2019.305472

Krieger, J., & Higgins, D. L. (2002). Housing and health: Time again for public health action. American Journal of Public Health, 92(5), 758-768. https://doi.org/10.2105/AJPH.92.5.758

Roussos, S. T., & Fawcett, S. B. (2000). A review of collaborative partnerships as a strategy for improving community health. Annual Review of Public Health, 21, 369-402. https://doi.org/10.1146/annurev.publhealth.21.1.369