Overview: The theme of the Boston University Clinical and Translational Institute (BU CTSI) is to create novel approaches to improving the health of disadvantaged at risk individuals through the lessons learned from translational research. We present a banner of our Partner and Affiliates to set the stage for understanding the nature of this commitment. BMC, BACO, BostonHealthNet, and our two VA affiliates are all heavily invested in the care for special populations who suffer poor health and outcomes from a number of “Risks,” including low socioeconomic status, urban environment, mental illness, ethnicity, race, language barriers, homelessness, dementia, gender declaration, sexual orientation, addiction and the extremes of life. The BU CTSI was founded in 2008 to address these inequities through partnership with these communities in research that we consider essential for improvement of health outcomes. In that regard, we have been a dynamic hub that uses objective hub-specific feedback and evaluation for continuous improvement of every program. Our overarching organizational structure enables our entire translational research community to function at the highest level through collaboration.