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Assessing the Progress of The California Endowment's Building Healthy Communities Initiative

FSG was engaged to conduct a strategic review of the Building Healthy Communities place-based initiative for The California Endowment.

Young people from 14 communities across California are involved in Building Healthy Communities, a 10-year initiative launched by The California Endowment in 2010. Many are the children of immigrants, living in neighborhoods that are racially and ethnically diverse, rich in cultural assets, but challenged by poverty and health disparities. Even in places like Santa Ana, California, one of the wealthiest counties in the state, there are few places to play outside and more places to buy beer than there are to buy fresh food. But young people in the communities are passionate about creating social change and working actively to improve conditions for health in their communities. 

The California Endowment hired FSG to conduct a strategic review of Building Healthy Communities 3 years after launching the initiative to learn how the pillars of the strategy were being implemented, what was working well, and what wasn’t.

One of the initiative’s key pillars is youth empowerment and youth organizing. The foundation helped expand existing youth organizing efforts and to develop new ones. In some cases, service providers, who were accustomed to working with youth as beneficiaries, began to see how they could include youth in the process, helping them identify both problems and potential solutions.

Recognizing that each organization had its own history, context, and implementation, which all varied tremendously from neighborhood to neighborhood, FSG invited local researchers to act as community liaisons for the strategic review, helping the evaluation team build trust. These liaisons provided critical input on the design of the evaluation and feedback on the findings and recommendations. This community support made data collection easier and helped the team interpret the information in a way that reflected community members’ values and experiences.

The evaluation itself was adaptable and flexible. FSG used interviews and focus groups with young people and nonprofit leaders to identify the principles that illustrated good practice. When the community’s dominant language was Spanish, the interviews and focus groups were conducted in Spanish rather than English. The lessons from all these sessions helped Endowment leaders determine how to expand their work even further.

The evaluation revealed that youth were quite eager to be involved in Building Healthy Communities. In fact, some spent as much, if not more, time working on Building Healthy Communities priorities as they did their school assignments, even though they participated in primarily unpaid volunteer work with modest stipends and travel reimbursements.

Moreover, these youth proved to be an incredible asset. Policymakers listened to them. They were effective when they shared their lived experiences on the wrong side of a broken system and when they spoke up with potential solutions.

Insights from the strategic review were designed to help The California Endowment achieve long-term goals, but they also spurred some short-term changes as well. One key change is that TCE and youth organizations have become more deliberate in addressing youth wellness and supporting the varied needs of young leaders. The California Endowment has made several other adjustments to its strategy and its implementation, and the results of the review will serve as a baseline for future evaluations.

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About The California Endowment

The California Endowment is the largest private, statewide health foundation in the United States. Its mission is to expand access to affordable, quality health care for underserved individuals and communities, and to promote fundamental improvements in the health status of all Californians.

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