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No Estimate, Big Problem: Measuring the Health Impact of Community Development Projects

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2020-04-27

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Coles, Eric. 2020. No Estimate, Big Problem: Measuring the Health Impact of Community Development Projects. Doctoral dissertation, Harvard T.H. Chan School of Public Health.

Abstract

The Local Initiative Support Corporation (LISC) has undertaken comprehensive community development across the country for decades. Despite a general acknowledgment by staff that their work impacts the health of the communities they serve, they have never measured and quantified their health impact. As LISC prioritizes health under a new CEO and seeks new partnerships with healthcare organizations, no estimate of impact too often implies no impact. I undertook my doctoral project to answer the question: How can LISC measure and communicate their health impact through social determinants of health research? Although academic literature offers an abundance of definitions, diagrams, and support for the vital significance of social determinants of health, there is no precedent on how to quantify the health impact of community improvement. I devised a novel quantitative approach to estimate the correlational health impact of LISC’s work across projects that improve education, income and/or employment. I interviewed LISC staff to determine how the data should be used by the organization. I found a large need of estimates of health impact, yet trepidation to use such a novel measure in the field of community development which is less familiar with public health concepts. Based on this research, I developed a calculator in the form of an Excel spreadsheet that LISC staff, as well as other community development organizations, can use to estimate the health impact of a given project. I recommended that LISC seek further input from healthcare partners and community stakeholders, and to eventually roll the calculator out to internal and external staff. The idea of social determinants impacting health is long overdue in general policy and practice circles. I hope this work contributes to utilizing the knowledge we already have on what affects our health.

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Social determinants of health, public policy, practice, impact measurement

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