Sunset over barn

A healthy population doesn’t come from any one project, or even exclusively health-related initiatives and policies. Health outcomes are influenced by a range of factors that include social determinants like housing, transportation, and economic opportunity. To improve the overall health of an entire community or region, that community must work together across industries, interests, and traditional boundaries.

Systemic change is always an ambitious goal, but one Mid-Michigan initiative is rising to the challenge. THRIVE (Transforming Health Regionally In a Vibrant Economy), is a collaborative effort led by Michigan Health Improvement Alliance, Inc. (MiHIA) and the Great Lakes Bay Regional Alliance (GLBRA). The project includes partners from government, nonprofits, philanthropy, and the business world, united around the belief that a healthy population and a healthy economy are necessarily linked.

Since its inception in 2016, THRIVE has grown from a handful of informal conversations between regional leaders to an organized coalition with shared goals and a strategy for implementation. With Health Fund support, THRIVE created a pair of case studies to track their progress and examine what it takes to coordinate a successful place-based initiative.

STUDY 1:  Cultivating Health and the Economy, Side by Side: A Case Study of THRIVE
STUDY 2:  Going Big: A Case Study About Addressing Big Challenges in Health and the Economy


Here are a few key themes that emerged from the case studies:

Establish broad buy-in

“Maybe one person can’t budge a boulder alone, but get a crowd—or region—together all pushing at once, and it will move.

The THRIVE case studies highlight that Michigan’s leaders and organizations don’t need be in total agreement in order unite behind a common cause. Private corporations, local universities, regional nonprofits—they may be invested for different reasons, but they all have a vested interest in the prosperity, and health of their community. Place-based organizers recognize that complex, intersectional challenges call for equally complex and intersectional reforms, and thus require participation from every sector to be successful. When you get voices from Dow Chemical Company in the same room as representatives from Central Michigan University and local stakeholders, you can start to push that boulder jointly.

This collective buy-in is both the first step to progress and also perhaps the most important piece of the puzzle—success hinges on a shared understanding of the issue.

Flowchart of elements of health system

Find the common denominators

“In a complicated mix of perspective and interests, you need a solid foundation to fall back on. Establishing principles together helped THRIVE stay on track towards its shared goals.”

When tackling a multi-faceted challenge, it’s easy to keep discovering more facets until a plan of action feels impossible. The THRIVE Launch Team agreed on a set of foundational principles that they could all agree were fundamental to their goals. From an upstream focus to an emphasis on learning-oriented work, these core values were a means of assessing and prioritizing the many pathways before them.

With those priorities in mind, THRIVE was able to choose five areas to focus on:

  • Building provider capacity
  • Improving preventative care and mental health
  • Investing in social determinants of health
  • Increasing regional attractiveness
  • Creating jobs

The takeaway: even an initiative seeking broad impact must start with foundational principles and targeted goals.


Chart of the six steps leading up to implementation

Move from abstract to concrete

“Making the tough choices about which challenges to focus on and which to let go is a hallmark of sound strategy—but those decisions should be made with input from many different viewpoints, with an understanding of the key system leverage points and their impacts. “

Of all the challenges THRIVE had to face, this was (and continues to be) the most daunting. How do we implement these lofty ideas? First came the editing process. Priority teams intensely scrutinized proposed interventions, narrowing lists based on evidence base, measurability, and feasibility. Once they were able to narrow the actions to a list of 42, partner ReThink Health was able to evaluate the plan with their robust modelling software. Modelling software led to budgeting, and budgeting led to re-budgeting. THRIVE is currently in the process of matching these intended interventions with funding sources.


Looking Ahead

Step by step, through careful evidence-based evaluation, the collaborative is approaching a final product. Bringing abstract ideas to the real world can be a difficult process, but without it, THRIVE would simply be an interesting thought experiment.

THRIVE’s accomplishments could take years to show up in traditional health and economic indicators, and tying upstream changes to downstream outcomes is an ongoing challenge. But the potential for positive impact is so high, and the alliance between regional voices so valuable. Above all, THRIVE shows us that place-based work has to be rooted in a foundation of trust, patience, and a bright-eyed hope that change is not just possible, but imminent.

Visit THRIVE’s website to read the two case studies in their entirety and keep up-to-date with the project’s future developments.


As recounted in our State of Health series from Issue Media Group, a few organizations have tried their hands at place-based initiatives in Michigan. These programs differ from most in their scope and focus: they usually incorporate numerous simultaneous interventions, centered on one location, with the intention of intensifying impact.

* First photo “two farms in one” by Chris Collins is licensed under CC BY-SA 2.0


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