Four Principles to Transform Measures Into Community Progress

In challenging times, the right data can guide collective action toward meaningful change.

Now more than ever, local leaders need robust, community-oriented data to make informed decisions that promote health and wellbeing. This is critical as they grapple with changes in the federal data infrastructure, the work to shore up regional health data collaboratives continues, and federal health funding and policies remain in flux.

Communities often depend on data about hospital admissions or unemployment to guide decision-making. These specific data can provide important information but fall short of telling the full story about factors that influence health. To make meaningful investments, leaders need data that help them understand whether neighbors trust local institutions, feel connected and supported, and believe that they are contributing to a shared vision for a prosperous future. Without this deeper understanding, even the best-intentioned investments can miss the mark or cause unintended harm.

Since 2016, RWJF and RAND have worked alongside communities to better understand what helps, or hinders, progress toward health equity and collective wellbeing. Across the United States, many people know why health equity matters, but many leaders need practical resources for how to achieve it. To help bridge this gap, we created the RAND ALIGN for Health and Well-Being Toolkit with and for people working to create systemic change at the local level.

The ALIGN Toolkit uses a series of modules to link the following essential pillars where communities can make change to help health and wellbeing investments stick and have meaningful impact:

• Shifting a community’s narrative toward a vision for positive health and wellbeing;
• Prioritizing measures that provide actionable information for that vision; and
• Aligning investments to efficiently reach that vision.

The ALIGN module, Measuring for Action, can help communities capture local insights, track real progress toward health and wellbeing, and motivate community groups to take action collectively. It module provides four principles to inform this process:

1. Measure positive health and wellbeing.

Traditional health metrics focus on illness, mortality, or healthcare use. While these measures are important, they don’t shed light on wellbeing or reveal the community’s hopes and aspirations. Data that uncover strengths can help communities learn whether they are thriving rather than merely surviving. Examples include how many people report feeling fulfilled, or how connected they feel to one another through parks or programs. Right now, many communities are missing this insight.

2. Make sure data consider all aspects of equity to tell a complete story.

Tracking disparities—or differences based on race, class, gender, and other characteristics—is important but not enough.  Without understanding the reasons for the differences, communities cannot make investments that improve health for all people. ALIGN underscores the importance of looking at community data and answering these questions:

1. Are community members involved in selecting measures and interpreting data?
2. What data do reports or dashboards provide and how does that information help explain the community’s story?
3. Are data presented side-by-side so that communities can make holistic choices about the best ways to make change? In other words, when health data are shared, how are they combined with other factors that influence health such as employment or education?

3. Select measures that speak to more than one sector at a time.

In our data-rich world, reports and dashboards overflowing with measures and indicators can be overwhelming. This makes it difficult for community leaders to wade through data noise and reach the heart of what is really going on, particularly around health equity and wellbeing.  More data do not always mean more insight.  Practice data efficiency. ALIGN calls this “Marie Kondo” (or declutter) your data.  

Consider measures that can speak to more than one sector at a time. For instance, a measure of child emotional wellbeing (vs. a clinical child mental health measure) can engage the health, education, and child care sectors all at once. In the workshops used to develop ALIGN, leaders from participating communities identified their top 10 measures that could appeal to the entire community (e.g., community connection, pathways to prosperity, investments in children) and told a story about health and wellbeing in ways that would rally all sectors.

4. Ensure data sparks forward momentum instead of just looking back.

Too often, measures in community reports are performance based, looking back on something that has already happened or an outcome that is now hard to change. It doesn’t have to be that way. Communities can choose measures that offer insight into factors they can change through collective action. To achieve this, they may find it helpful to identify measures that:

• Respond to flexible, evolving goals. As the community makes progress, move the measure goal post!
• Highlight where health investments can be made outside the health sector.
• Align the entire community behind shared priorities in health and wellbeing.
• Open real dialogue so residents can discuss community health and where investments can be made.

The Right Measurement Makes the Difference!

Data that reflect these principles are powerful. The RAND ALIGN for Health and Well-Being Toolkit can help communities prioritize data that shape narratives of hope, address disparities, encourage collaboration across sectors, and pave the way toward a future where health is no longer a privilege for some but a right for all.

About the Authors

Anita Chandra is the RAND distinguished chair in American social policy, senior principal policy researcher, and a professor of policy analysis at the RAND School of Public Policy.

Leia Carey is program officer, Research-Evaluation-Learning, at the Robert Wood Johnson Foundation.