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Assessing the Building Healthy Communities Initiative

A Partnership with The California Endowment


What We Work For

Distilling and sharing learning from 10 years of community power building in California to advance health equity and racial justice.

Building Healthy Communities (BHC) was an innovative 10-year, 14-community initiative of the California Endowment (TCE) to achieve more equitable health outcomes in California. Over a decade, from 2010 to 2020, TCE invested $1.75 billion and partnered with the 14 communities across California and many state-level organizations and alliances. The BHC initiative became a model for community and foundation partnership. It contributed to significant policy change and demonstrated new ways of advancing health equity and racial justice in California. Over the decade, BHC’s “theory of action” became clear: improve health status by building “people power,” transforming policy and public systems, and expanding opportunities in communities that have been historically marginalized. TCE engaged the Center for the Study of Social Policy as a partner to assist in distilling and elevating the learning from its BHC initiative. Our work is designed to contribute new knowledge to the field and prompt action by communities, state and local decision-makers, and philanthropic organizations.

How We Do It

To capture the power building story, CSSP partnered with TCE and a host of local and national evaluators to engage key stakeholders across the initiative: BHC youth and adult residents, foundation staff and board members, and state-wide advocates. Multiple products have been produced as part of this work. 

CSSP’s work was designed to be useful to participating communities and state and local partners and to provide valuable information for the Foundation’s transition planning. These products included a 10-year retrospective report recapping the evolution of TCE’s emphasis on power building and the lessons learned along the way as well as three targeted studies focused on key aspects of Building Healthy Communities:

In addition to reports CSSP has generated to highlight this work, we are also producing sessions for a virtual learning series, titled Learning, Equity, and Power (LEaP), that are aimed at sharing the key findings from these reports and activating decision makers in communities, philanthropy, research, and government.

The Building Healthy Communities Legacy

Building Healthy Communities (BHC) was an innovative 10-year, 14-community initiative of the California Endowment (TCE) to achieve more equitable health outcomes in California. Over a decade, from 2010 to 2020, TCE invested $1.75 billion and partnered with the 14 communities across California and many state-level organizations and alliances

In developing and fostering BHC, TCE consciously built on lessons from the past two decades of “community change initiatives,” both foundation-sponsored and federally funded. But BHC moved beyond prior efforts in several important ways:

  • TCE investments in grassroots organizing and youth mobilization—termed “people power” by participants—far exceeded anything seen in prior initiatives.
  • Partners participating in BHC focused their organizing and advocacy on policy and systems change, rather than programmatic development and implementation. Communities participating in BHC insisted on systems transformation as the essential pathway to positively change the range of conditions identified as the social determinants of health.
  • TCE deployed communication and narrative change strategies more proactively than prior community change initiatives had done—or been able to. TCE sought to influence and shape public opinion as a prerequisite for changing state policies and as support for local activism.

What was the impact of this decade of work, and what lessons were generated by the thousands of people working in 14 communities and statewide?

Research and evaluative studies are answering these questions. Studies include (1) a comprehensive catalogue of BHC’s contributions to state and local policy changes; (2) case examples of how grassroots organizations and statewide non-profits operated as a power building ecosystem to achieve policy change; (3) analysis of the investments fueling the local work and leveraging far larger philanthropic, state, and local investments; (4) examination of how TCE’s board kept a risky, decade-long and continually evolving initiative on track; and (5) documentation of local leaders’ views about the actions and ingredients needed to sustain and evolve what BHC put in motion. This research by independent evaluators has been supported by TCE both to assess impact and to distill BHC’s lessons.

LEaP: Learning, Equity, and Power

“Learning, Equity, and Power,” or LEaP, is a series of four virtual learning sessions presented by CSSP that involves engagement with, and extension of, lessons and insights from selected research and evaluation of TCE’s decade-long BHC initiative. These virtual learning sessions will touch upon one or more of the four key themes adapted from the 10-year retrospective report—Toward Health and Racial Equity: Findings and Lessons from Building Healthy Communities—that CSSP produced. These sessions will speak to the following topics:

  • How foundations can help build community power
  • One foundation’s path to power building and health equity
  • Creating a new health equity dialogue
  • Supporting and embracing youth power

All four events will take place Fall of 2021, and videos from the events will be archived on this page.