Measuring what matters: Empowering Local Communities with Timely Information

We know that health is not just about health care and that a range of factors (wider social determinants) affect our health and well-being. This great short film produced by Sudbury Community Health Centre in Ontario highlights the case in point: 'Let's start a conversation about health... and not mention health care at all'

 A number of the  social determinants affecting health are linked to social capital, such as the social networks and support we have access to, the extent to which we get along with our neighbours, whether we engage in community activities, the extent to which we feel safe in our community, how much we trust the people around us….you get the idea. 

 So whilst we can seek to measure some of the more tangible health outcomes such as GP and hospitals consultations, rates of disease, levels of physical activity, etc. - simply measuring these things doesn’t tell us much about the wider factors that influence health and well-being in communities.

I met with Sandy Ciske and Louise Carter from the Seattle and King County Public Health Department who are both involved in the Communities Count Project

Every three years, Communities Count reports on 38 social, economic, health, environmental and cultural indicators across King County in Washington State. Sandy explained that main audience for the data was policy makers, but that the reports are also aimed at public agencies, foundations, human service funders, non-profit agencies, community-based organizations, and residents.  

King County has a population of 1.9 million and Sandy explained that there are, “huge disparities in health across the county”. Whilst the County has one of the highest life expectancy rates across the US, there is an 8 year gap between the highest and lowest life expectancy across the county. Other examples of health inequalities can be seen in the smoking rates,  which is 12% across the county but as high as 30% in some areas within the county.

In order to agree what and how should be measured, the Communities Count project held community forums to enable residents to identify what matters and what should be measured. They also had an advisory group that provided guidance on how best to measure the selected indicators. Sandy explained that the indicators were, “focused around prevention and changing community conditions and the wider determinants of health – looking at root cause issues”.

The indicators are organized into the following six categories:

• Basic Needs & Social Well-Being
• Positive Development Through Life Stages
• Safety and Health
• Community Strength
• Natural and Built Environment
• Arts and Culture

Within this, I was able to spot a number of social capital indicators being measured e.g.

• Participation in life enhancing activities.
• Social support
• Neighborhood cohesion.
• Involvement in community organizations
• Community service (volunteering)

The intention is that the reports are a resource for informed decision-making and action. They have helped local areas identify where the problems are and Sandy told me about some of the ways the data had been used. 

"The data highlighted issues in communities that people didn’t realise were there and prompted them to do something about it. In one area, the data allowed the council to see what they should be investing in…they realised that rather than putting  money into more flowerpots to make downtown look pretty, they should be investing in youth programmes”. 

In another area where low rates of reading to young children were identified, they invested in more library resources and set up schemes to encourage parents to read with their children. In another area where low rates of school readiness among Latino children were identified, the council put resources into building capacity via a community based organisation so the Latino children were better prepared for school. Other communities have (as you might expect) used the data in  grant applications to gain funding for initiatives to address some of the issues highlighted.

In terms of implementing the changes and addressing some of the issues highlighted in the data, we agreed on the need to 'break down silos' and the need for integrated working across sectors. Sandy said, "when it comes to talking about disparities, language and the way concepts are framed is really important in terms of getting people [policy makers, funders] to listen. Talking about ‘fairness’ and ‘opportunity’ tends to get their attention more that just talking about ‘problems’ or ‘needs". 
 I also noticed the sub-title of the 2008 Communities Count report is "A Report on the Strengths of King County Communities" -  clearly displaying an asset and strength based approach to the work.  
On the issue of language, Sandy pointed me to the work of FrameWorks Institute whose mission is "to advance the nonprofit sector's communications capacity by identifying, translating and modeling relevant scholarly research for framing the public discourse about social problems."

Plenty of food for thought for those of us seeking to influence or seek support (financial or otherwise).