Vaccines are considered one of the most important public health innovations of the 20th century, with many impressive effects: they save lives, prevent and limit the effects of many diseases and some cancers, eradicate certain diseases, increase quality of life, and have contributed to major gains in life expectancy.

Yet adult vaccination rates in the US remain low, especially for underserved groups (PDF), including people with low incomes, people who are under- and uninsured, Black communities, Hispanic communities, and immigrants. And adult vaccination rates have continuously dropped since the COVID-19 pandemic.

As health officials are increasingly challenged to keep communities healthy, implement successful immunization campaigns, and lessen stress on hospital systems, community foundations can be effective partners for meeting these goals.

What are community foundations?

Community foundations are public charities that traditionally support local or regional nonprofits by facilitating and pooling donations for the nonprofits to use to address community needs.

They’re one type of community-based organization (CBO) the Urban Institute supported through the Centers for Disease Control and Prevention’s Partnering for Vaccine Equity (P4VE) program. The program, for which Urban is one of several national intermediaries, provided financial and educational supports to CBOs working to promote adult COVID-19 and flu vaccine uptake in underserved communities by leveraging the power of public health partnerships and the influential roles of community health workers.

Urban has supported 28 CBOs over three years through the P4VE program. One such organization is the Legacy Foundation, a community foundation and P4VE partner serving Lake County, Indiana. Legacy’s experiences leveraging its funding, networks, programming, and volunteers promote vaccine confidence and build an equitable, accessible, and inclusive community provide important lessons for future community health initiatives.

How do community foundations support vaccine uptake and other public health efforts in underserved communities?

Through our work with the Legacy Foundation and other CBOs, we’ve learned that community foundations are uniquely well positioned to advance health equity in communities by using five key strategies.

1. Building community trust through partnerships. The Legacy Foundation leveraged its extensive networks, including other CBOs, donors, actors in the health field (such as the local health department, hospitals, and clinics), small businesses, and community members, to prioritize and align programming and funding with residents’ needs.
   
   To identify where vaccination services were most needed, for example, Legacy harnessed its partner’s program data to complement the county census and local vaccination data. This partnered approach determined that residents of the northeast communities of Lake County were least likely to be vaccinated or boosted for COVID-19. Equipped with these data, the Legacy Foundation team members engaged these communities’ residents in an open, ongoing dialog through community volunteer canvasing and events to identify barriers and beliefs limiting vaccine uptake.
   
   With a history of active and consistent community engagement, the Legacy Foundation is a trusted leader and informational source in Lake County. Residents have benefited from that engagement by gaining access to accurate information about vaccines, COVID-19, the flu, and other public health issues affecting the community. Partners also benefit by using Legacy’s networks to expand their reach in these communities. Partnerships like Legacy’s help align future public health programing with community priorities.
    
2. Actively engaging with donors. As a funder, the Legacy Foundation balances residents’ needs and donors’ interests by supporting community-driven initiatives while meaningfully engaging with those who give to the foundation. Through an ongoing learning process, Legacy collects and shares information heard through its volunteers, trusted messengers, and community members to liaise residents’ needs to donors, who, in turn, can confidently invest their funding for greater impact. This ensures opportunities to address community needs are actionable and relevant to funders.
    
3. Supporting ongoing community learning. The Legacy Foundation plays an important role in fostering community learning. After conducting a community interest survey, Legacy provided tailored community events related to cultural humility for community leadership, inclusive grant writing, nonprofit marketing, health equity, and various cultural approaches to health and well-being.
   
   These events, which were offered virtually and in person through partnerships with the Lake County Purdue Extension and the Urban League of Northwest Indiana, were open to Indiana nonprofits and Lake County residents for free or low cost. By offering accessible and relevant educational events, community foundations can be influential messengers and strengthen residents’ abilities to find, understand, and use health information to increase community health and disease prevention.
    
4. Bring effective and innovative health programming to new venues. Offering community health services outside traditional medical settings can help people more easily access and engage with such resources, and the Legacy Foundation has provided vaccines and health promotion materials in unique spaces thanks to their local partnerships. 
   
   The Legacy team was invited to attend a sorority event in partnership with the American Heart Association, where they offered health literacy materials and vaccinations, and a local jeweler invited the team to host an in-store vaccine event during the holiday season. The latter resulted in more than 60 COVID-19 and flu vaccines being administered, suggesting these new partnerships and perhaps unassuming spaces could be effective for improving vaccine uptake amid continued COVID-19 and vaccination fatigue.
    
5. Promoting community engagement in government. Community foundations facilitate meaningful engagement between community members, government entities, and elected officials to ensure community voices are represented in decisionmaking. Similarly, the Legacy Foundation has offered learning labs to help Lake County residents take a proactive role in their local government and improve their knowledge of the legislative processes, from their local city council to their state government.
   
   By plugging into these various levels of government, the Legacy team highlighted the wraparound services available to residents and informed government officials of the community’s vaccine beliefs and service needs. This two-way information sharing is an important way community foundations can increase the visibility of residents’ needs and the efficacy of community health programing.
    

As the field of public health continues to shift after the pandemic, community health partnerships and approaches will shift too. As trusted, reliable partners, community foundations, such as the Legacy Foundation, can ensure community health initiatives are aligned with residents’ needs and advance public health.