Community-Based Organizations Working to Advance Health Equity

Smiling women interact at an outdoor community health event with tents and other attendees in the background.

Understanding funding, resource, and policy challenges facing health equity-focused CBOs

Client

Pfizer Multicultural Health Equity Collective and National Collaborative for Health Equity
Dates

November 2024 – December 2025

Problem

Community-based organizations (CBOs) face systemic barriers that limit their ability to advance health equity.

CBOs are vital to improving health outcomes for historically underserved populations. They provide culturally responsive services and connect communities to broader health systems. Yet, these organizations often operate under severe resource constraints and face systemic challenges in securing sustainable funding, building capacity, and influencing policy.

The Pfizer Multicultural Health Equity Collective and National Collaborative for Health Equity sought to understand these barriers to inform strategies that strengthen CBOs’ role in advancing health equity across the United States, Puerto Rico, and tribal nations.

Solution

NORC conducted a national survey of health equity-focused CBOs to identify and understand barriers and opportunities for their work.

NORC designed and implemented a comprehensive research approach, beginning with a literature review to identify existing resources and gaps in CBO health equity work. We convened a Community Advisory Board of eight CBO leaders to ensure the study reflected real-world challenges and priorities. Guided by their input, NORC developed, tested, and administered a national web survey in English and Spanish that was completed by 491 health-focused CBOs across all nine U.S. Census divisions, Puerto Rico, and tribal nations. The survey captured organizational demographics, funding sources and stability, capacity needs, and policy engagement. This advisory board-informed survey design and quantitative analysis yielded actionable insights to guide funders, policymakers, and community partners in strengthening health equity efforts.

Result

Findings highlight the need for stable, longterm funding, robust capacity-building resources, and meaningful inclusion of CBOs in public policy decision-making.

CBO funding barriers lead to concerns about longterm stability

Thirty-seven percent of CBOs lack funds for planned programming over the next 12 months.
Nearly 60 percent of CBOs are concerned about longterm financial stability.
Both large and small CBOs reported barriers such as limited staff time for fundraising and difficulty accessing high-net-worth donors.

Public policy influence hindered by gaps in trust

CBOs reported that federal, state, and local policy decisions directly influence their programmatic priorities.
While most organizations view policy engagement as essential, only 40 percent believe policymakers trust their expertise.

CBOs seek support for building capacity

CBOs identified top priorities for organizational support, including grant-writing training, data collection tools, and opportunities for collaboration.
Helpful staff resources include data collection and analysis skills, best practices for storytelling, and fundraising skills.

These findings underscore the need for flexible funding models, capacity-building initiatives, and stronger partnerships between CBOs and policymakers to advance health equity. The final report provides actionable recommendations for stakeholders to strengthen CBO resilience and impact.