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The California Wellness Foundation’s Health Improvement Initiative was a commitment to improve population health, an outcomes based way of understanding the health and quality of life of large numbers of people. At the conclusion of this investment the question must be asked, was population health within the state of California improved? It was clear at the onset that the Initiative’s five-year time frame would yield few measurable population health improvements. Instead, the evaluation captured intermediate outcomes, concentrating on systems change at the community level and the provision of direct preventive health services. Overall, grantees in the Public Education and Policy Program and the Health Partnership Program found the most success addressing systems change on two levels: service integration – providing comprehensive, integrated services responsive to the needs of the community, and policy development – developing and implementing new policies that promote population health. Health promotion and/or disease prevention direct services were provided to 94,383 individuals or groups. Most of these services will be sustained beyond the HII funding period. Grantees of the Initiative Support Program made important contributions to the Initiative by creating a learning community where relationships, peer support and dedication to health improvement will be sustained.

The Health Improvement Initiative was an important undertaking to change the emphasis from a personal health care orientation to a population perspective among service providers and other sectors of the community. As we look to the future, the HII’s lessons learned have been extended to both state and national forums, and we believe the population health debate, both in California and nationwide, will continue to be influenced by HII publications, grantees and those who contribute to population health improvement efforts. The Foundation thanks the dozens of organizations and hundreds of individuals who made the Health Improvement Initiative an exciting, productive, engaging and informative experience. It is our hope that all those involved with the Initiative will continue to work toward improving population health in California.