Strengthening Community-Based Health and Human Services in the Shadow of Structural Inequality: A Critical Case Study of the Collective Impact Model

Many funders of health and human service organizations require collaborative networks that work together to achieve community-wide outcomes. One such model is Collective Impact, an approach that has gained support as a way to promote collaboration and track progress. However, the limitations of Collective Impact imposed on small or community-led organizations may be crippling, given the technical and human capital needed to sustain demands for data collection and reporting. As a result, it is problematic that Collective Impact, which aims to enhance accountability and effectiveness in the decision-making process, is also creating unintended bias and inequity in funding relationships. The purpose of this research is to identify the challenges of using the Collective Impact model within an urban environment plagued by historical and on-going structural inequalities. This is accomplished through a critical case study of a large funder of health and human service organizations in an urban region of the mid-Atlantic. Analysis of primary and secondary data reveal disparate funding to large nonprofit organizations, despite organizational goals for equitable and inclusive funding across the nonprofit sector as part of the Collective Impact model. Consequently, the funding patterns represent a perpetuation of the status quo with problematic implications given the context of the region’s racial structural inequalities and organizational goals. This article concludes with recommendations for more inclusive approaches for funders working with small and community-based health and human service organizations.