The Pros and Cons of Comprehensive Community Initiatives at the City Level

The Case of the Urban Health Initiative

Funded by the Robert Wood Johnson Foundation (RWJF), the Urban Health Initiative’s (UHI’s) goal is to improve the health and safety of children. The UHI is a collection of campaigns in five large U.S. metropolitan areas. UHI campaigns are catalysts for change, not service providers or funders. Each works with partners inside and outside government to improve the systems—such as education, juvenile justice, health and recreation—that serve children.

This article examines the trade-offs between the city-level and neighborhood-based approaches, looking at UHI as a specific case study. The authors found that the citywide focus often obscured important roles played by neighborhoods in ownership of and participation in comprehensive community initiatives. Instead of fostering rich community relationships, the citywide focus concentrated its efforts within the local government and service providers. Conversely, the citywide focus enabled the UHI sites to quickly bring existing efforts together. These efforts were strengthened by pooled resources, data, technical expertise and visibility. The political clout gained through the citywide approach afforded meaningful changes in policies and programs serving children. The authors conclude that the UHI was a far more geopolitical initiative, although it borrowed features from the neighborhood-based approach.

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