“Small but measurable gains—stemming the tide of decline relative to other distressed cities—were a great outcome, given...the depth and breadth of the problems.”—Evaluator Beth Weitzman, PhD
“This was going to be the biggest deal since Head Start—it was going to transform these places.”—James Knickman, PhD, RWJF
Dates of Program: 1996–2005
Field of Work: Improving child health and safety outcomes in urban America through comprehensive reform of local decision-making and funding systems.
Problem Synopsis: In 1992, the acquittal of four Los Angeles police officers charged in the videotaped beating of Rodney King, a Black motorist stopped after a high-speed car chase, sparked riots. The six days of death and destruction forced institutions across the country, including philanthropies, to reexamine their efforts to address the complex problems of big cities.
The Robert Wood Johnson Foundation concluded that while it had made numerous grants to urban organizations, relatively few had gone to the nation’s largest cities—and those that had were of insufficient size and duration to have an appreciable effect on the huge health challenges confronting major urban centers.
Synopsis of the Work: In response, RWJF launched a 10-year initiative in five cities to define the community’s most pressing child health and safety problems and marshal public and private resources to address them. The aim was to implement new strategies, policies, and funding mechanisms on a scale large enough to change child health and safety statistics citywide.
The five cities—Baltimore; Detroit; Oakland, Calif.; Philadelphia; and Richmond, Va.—took different approaches. However, all worked to expand participation in after-school programs. Improving preschool care, strengthening home visitation programs, and increasing support for youth at risk for violence were among the other strategies.
The program changed how leaders in the five cities thought about children’s health, and gave them new tools for making health-related policies.”—Evaluator Beth Weitzman, PhD
An evaluation team from New York University led by Beth Weitzman, PhD, compared outcomes in the five cities against those in nine cities with matching demographics. The researchers based their analysis on site visits, household surveys, and government data on child health and safety.
They found that the five cities made some measurable gains relative to the comparison cities—but that the gains were small. “Judged by the ambitious expectations of its designers, the impacts of [the program] fall short,” the evaluators wrote in the American Journal of Evaluation. The evaluation won the 2010 award for best evaluation from the American Evaluation Association
The national program office took a more upbeat view. Headed by former Seattle Mayor Charles Royer, it reported that four of the five cities “either achieved scale in one or more of their strategies, or demonstrated that they were on a trajectory to reach scale within a reasonable period of time.”
According to the national program office:
- The sites together leveraged more than $200 million in annual support for their strategies.
- The four sites on track to reach scale “secured major meaningful system reforms that changed policies” to support site strategies.
- Four of the five sites “markedly improved the ability of their cities to secure, analyze, and utilize data” in decision-making related to policies and investments that affect children.
Report examines 10-year, $63 million program to improve health outcomes for children in 5 major US cities
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
RWJF examines the types of competitive foods - foods and beverages schools offer outside of meal programs - available in our nation's school...
Progress and lessons learned from two programs that seek to advance the impact digital games can have on health.
Joint Commission Resources in Oak Brook Ill., oversaw development and testing of an online course and support materials to improve communica...
The rapid rise of antibiotic resistance can be tracked using ResistanceMap, an online tool that visually highlights regions of the country w...
Report examines, compares and contrasts Massachusetts and Utah health insurance exchanges.
Report examines issues states will face as they integrate Medicaid into the exchange.
This poll shows most Americans believe the quality of U.S. health care is average at best. More than half of American adults surveyed barely...
Want to improve health? Start with where we live, work, learn and play.
Health care reform may create incentives to spur the growth in HDHPs and CDHPs, a move that might help hold costs down?at least for a time.
The authors suggest repairing the health care system by realigning provider incentives, increasing the availability of information with whic...
While the ACA is aimed primarily at improving individual health by increasing access to health insurance, it also contains a number of provi...