Invest Health, an initiative managed by Reinvestment Fund and supported by the Robert Wood Johnson Foundation (RWJF), launched in 2016 with a vision to engage 50 small and midsize cities over 18 months to improve outcomes related to health equity through community development system change and investments in the built environment. Eight years later, as of this evaluation report, Invest Health remains active and is completing its final phase.
After its initial phase, Invest Health continued through three additional iterations. This evolution was unplanned, and the extended duration of the initiative and the consistent engagement of many of the original stakeholders in the 50 cities provide a unique opportunity for learning about sustaining participant engagement in a multisite initiative, the longer-term outcomes of Invest Health, and the implications for funders and practitioners in small and midsize cities.
While the goals of Invest Health evolved over time, the initiative consistently aimed to impact community development and the built environment to improve health and equity in the 50 cities. Reinvestment Fund and RWJF also articulated goals related to shifting mindsets, building collaborative infrastructure, creating a learning network, and influencing the broader field. In practice, the site teams worked on a variety of projects, programs, and system change strategies, with many site-level outcomes with many outcomes linked to the connections between community development and health.
This report offers an overview of the kinds of outcomes Invest Health contributed to, including outcomes within the 50 cities and beyond.
The evaluation survey received responses from 147 of these stakeholders. In addition, in final evaluation interviews, participants frequently shared stories of outcomes that the survey or other research did not capture. This suggests that many additional outcomes from Invest Health may exist beyond those documented in the report.
Given the wide array of ways stakeholders across the country that Invest Health touched and the length of the initiative, it was not possible to attribute most outcomes solely to Invest Health. Instead, the evaluation looked at Invest Health’s contribution to outcomes—looking for evidence that the work of Invest Health site teams broadly and their individual stakeholders influenced these outcomes.