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Accomplishments, Challenges and Lessons Learned

In January 1995, The California Wellness Foundation’s (TCWF) board of directors approved a five-year $20 million grantmaking program titled The Health Improvement Initiative (HII). The overall goal of the HII was to improve the health of Californians by increasing public recognition of the importance of factors, other than health care, in determining the health of California residents and by building new collaborative approaches to improve population health. Population health recognizes that the health of all of us in turn affects the health of each of us. Such elements as the neighborhood’s history, levels of employment, types of housing available to residents, services, policies and the safety of neighborhoods are all relevant in this broader population health context. Specific goals of the HII included: promote awareness of the broad determinants of health; shift the current focus and investment in health toward prevention; establish comprehensive, integrated systems of preventive services; and demonstrate that population health improvements can occur in real-world settings.

The HII consisted of three integrated components: the Public Education and Policy Program, the Health Partnership Program and the Initiative Support Program. Grantmaking in the Public Education and Policy Program focused on public opinion polling, nonpartisan policy analysis, policy education and public education about population health. The Health Partnership Program, the centerpiece of the HII, enabled 15 geographically diverse California community/county-based health partnerships to design and implement local health improvement plans. The health partnerships were diverse in terms of history as collaboratives, governance structure, lead fiscal agency, health problems addressed and populations served. The Initiative Support Program was responsible for building a learning community in support of population health improvement. This was accomplished through the systematic organization and delivery of technical support services. Finally, the Initiative evaluator was charged with enhancing the efforts of the health partnerships and supporting grantees through a continuous quality improvement evaluation and assessing HII implementation and impact.

This report outlines the accomplishments, challenges and lessons learned during the HII’s five-year period that ended in June 2001. Goals and objectives are presented for each portion of the Initiative followed by staff analysis of what was actually accomplished. This report is organized according to the goals and objectives of the Health Improvement Initiative. At the conclusion of the three components, we reflect upon the accomplishments, challenges and lessons learned about the Initiative as a whole.

Alicia Procello and Gary Nelson, Program Directors
The California Wellness Foundation