The need to address the problems facing young people represents an
enormous challenge to parents, health professionals and community
leaders. Many groups and organizations have been working on these
issues for years, often making important contributions for the children
they serve. Yet the experience of several decades suggests that, with
rare exception, none of these entities working alone is likely to
have more than a marginal impact on a city's overall child health
statistics. Generally, they have succeeded either in improving statistics
in only a single, categorical area of concern or have succeeded in
improving the health and safety of children in a small geographic
area or neighborhood. None has been sufficiently broad based to significantly
improve the health and safety of young people across an entire city
or metropolitan area.
Community leaders have come to realize that real change requires
a clear understanding of underlying causes of problems, a common
vision of what to do to solve them, and a collective effort strategically
carried out.
The purpose of the Robert Wood Johnson Foundation's Urban Health
Initiative (UHI) is to determine whether a concerted, collaborative
effort could bring about region-wide improvements in multiple measures
of youth health and safety.
In May 1995, the Robert Wood Johnson Foundation invited community
leaders in 20 cities to become involved in the initiative by applying
for two-year planning-and-development grants. The Foundation requested
that the applications be submitted in the form of a "single
letter of interest" from each community. The process of preparing
a single letter was designed to stimulate the establishment of "collaborative
thinking" from the beginning, with organizations that may not
have previously worked together agreeing to work together to craft
a response.
Of the cities responding to the Foundation's challenge, eight were
selected to receive funding. They were Baltimore, Chicago, Detroit,
Miami, Oakland, Philadelphia, Richmond and Sacramento. Each site
was provided with approximately $200,000 per year for two years
of planning and development, with the knowledge that up to five
of the eight sites would be funded for up to eight years of implementation.
The National
Program Office was based at the University of Washington’s Evans
School of Public Affairs until 2005. At that time, the NPO became
an independent 501(c)3 organization, The Institute for Community
Change.
The Urban Health Initiative was designed to be non-prescriptive,
allowing communities to craft implementation plans based on local
conditions, without assumptions, mandates or imperatives set forward
by the Foundation. Thus, during the two years of planning, each
site was expected to identify local project leadership, build community
collaboratives, establish priorities, select interventions and work
with local communications consultants to design a communications
strategy in concert with the development of an implementation plan.
Site plans were submitted to the NPO on September 15, 1997.
The final five UHI sites--Baltimore, Detroit, Oakland, Philadelphia
and Richmond--were selected in November 1997 following plan reviews
and site visits. Grants averaging $1.2 million per year for four
years were awarded to begin January 1, 1998. At the end of 2001,
these communities were approved for an additional four years of
Foundation funding.
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