Can a collective-impact initiative improve well-being in three US communities? Findings from a prospective repeated cross-sectional study

Abstract

IntroductionCommunities are seeking to learn if and how they can improve the well-being of their residents. We therefore examined the impact of a community-led, collective-impact initiative, deployed through Blue Zones Project by Sharecare, aimed at improving health and well-being in one set of US communities.MethodsWe used data from cross-sectional surveys of the Well-Being Index (2010–2017) to assess how the Life Evaluation Index (LEI) in Hermosa Beach, Manhattan Beach and Redondo Beach in California (Beach Cities) changed over time and how this change compares with change for similar cities (Beach Cities-like) and for the USA as a whole. We examined types of interventions, perceived impacts, and relationships between intervention type and change in LEI.ResultsThe Beach Cities experienced greater increases in LEI than Beach Cities-like communities and the nation. The entire portfolio of interventions was positively associated with change in LEI in the Beach Cities (+1.12, p=0.012), with process-oriented interventions most closely associated with improvement.ConclusionsCommunity-led collective action that leverages community engagement and activation, strategic use of programming and large-scale built-environment and policy change can improve health and well-being at scale.

Urban Governance, Multisectoral Action, and Civic Engagement for Population Health, Wellbeing, and Equity in Urban Settings: A Systematic Review

“…According to the OECD classification, five studies reported data from a large metropolitan area ( 28 , 31 , 37 , 38 , 41 ). Sobral, Richmond, Rennes, Bristol, Ljubljana and Sosnowiec were classified as medium-sized urban areas ( 27 , 30 , 32 , 42 ); Barcelona, San Francisco, Lisbon, Detroit and Amsterdam were classified as metropolitan areas ( 33 , 36 , 40 , 42 ); and Noarlunga, Gulfport, Hermosa Beach, Redondo Beach and Manhattan Beach as small-size urban areas ( 29 , 34 , 43 ). Matsapha and Vancouver were classified as other urban settings ( 35 , 39 ).…”

“…As a lone process, multisectoral action to advance the construction of a healthy city was addressed in six (35%) studies ( 30 – 32 , 35 , 36 , 41 ). Five studies assessed both multisectoral action and health governance ( 27 , 29 , 33 , 38 , 39 ); three reported data on multisectoral action and civic engagement ( 34 , 37 , 40 ), and the same amount of studies assessed only civic engagement ( 28 , 42 , 43 ).…”

“…The radar charts in Supplementary Figure S1 allow for a visual comparison of the proportion of the targeted population among the studies ( Supplementary Figure S1A ), the focus of the studies ( Supplementary Figure S1B ), and the dimensions of indicators that were used ( Supplementary Figure S1C ). The general population was the target in 14 studies ( 27 , 29 – 33 , 35 – 37 , 39 – 43 ). Children were included in only three strategies ( 37 , 38 , 41 ) underserved populations in another three ( 30 , 34 , 41 ), youth in two ( 37 , 41 ), ethnic groups in two ( 30 , 34 ), and women ( 41 ), and the elderly ( 36 ) in one each.…”

Association of Population Well-Being With Cardiovascular Outcomes

“…The Life Evaluation Index using the Cantril Ladder was used to measure impact. In a before-and-after comparative analysis with US communities and with the nation, the intervention communities experienced improved Life Evaluation Index scores following the intervention …”

“…Living in a community with high well-being may buffer the negative impact of stressful events and reduce the risk for illness and disease throughout the life course. Importantly, although well-being is associated with economic status, which can be challenging to address from a health system lens, well-being is also mediated by other factors in the community that are modifiable through community engagement and action in combination with public policy . Previous work has identified several high well-being counties that are among the counties with the highest poverty levels in the US.…”