Giving Compass’ Take:
• Glenn E. Schneider and Nikki Highsmith share lessons from the Horizon Foundation’s Healthy Eating Active Living (HEAL) initiatives aimed to improve Howard County, Maryland.
• Can this framework translate across communities? What are the health needs of your community?
• Learn more about effectively funding health.
In 2010, the Horizon Foundation staff took a routine look at local health data and noticed some troubling trends. Data indicated that most deaths in our community were related to heart disease, cancer, stroke, and/or diabetes. Trends showed increasing rates of hypertension and high cholesterol, alongside increasing rates of unhealthy weight. Worse yet, data also showed that local school-aged children had similar rates of unhealthy weight as those in neighboring counties and throughout the state. For an independent, place-based, health-focused philanthropy like ours, this was grim news.
The Horizon Foundation is based in Howard County, Maryland, and we focus our work on its approximately 321,000 residents. In any given year, Howard County has one of the highest median household incomes in the nation. About 95 percent of our residents are high school graduates, and a majority have bachelor’s and other higher-education degrees. According to Money magazine, two of our cities are among the best places to live in America, and our county has won awards for its open spaces, parks, sports culture, recreation facilities, and library system. Evidence suggests that these health determinants should provide relative protection against disease, and yet our local data indicated otherwise.
In response, the foundation launched a suite of Healthy Eating Active Living (HEAL) initiatives in 2012. Our plan included efforts to reform the school system’s wellness policy; reduce sugary drink consumption; improve school food; increase participation in federal school meals programs; enhance pediatricians’ skills related to the prevention, diagnosis, and treatment of childhood obesity; and make healthier food and drinks more widely available for children and families. Concurrently, we have been working to make physical activity more routine by improving equity in sports participation and increasing physical activity in schools and childcare facilities. We also routinely advocate for “complete streets”—properly designed roads and pathways that allow all walkers, bicyclists, transit users, and motorists to jointly use and safely get from one point to another. Over the years, we learned some useful lessons.
- Plan for evaluation from the beginning: If it’s worth doing HEAL work, it’s worth measuring its impact.
- Shrink the change: In their 2010 book Switch: How to Change Things When Change Is Hard, Chip and Dan Heath describe how complex behavioral-change processes require intentional efforts to make hard changes more manageable—what the authors refer to as “shrinking the change.”
- Advocate for HEAL policy and system change: Investing in advocacy allowed the foundation and our grantees to properly build strong coalitions, organize residents on the ground, engage in social marketing and media advocacy, and win long-lasting improvements in our HEAL environment.
- Work with state and regional partners to make HEAL changes more “sticky”: At least 57 percent of our residents work and/or spend significant time outside the county.
Read the full article about HEAL efforts by Glenn E. Schneider and Nikki Highsmith Vernick at Stanford Social Innovation Review.
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