Increasingly, public and private resources are being dedicated to community-based health improvement programs. But evaluations of these programs typically rely on data about process and a pre-post study design without a comparison community. To better determine the association between the implementation of community-based health improvement programs and county-level health outcomes, we used publicly available data for the period 2002-06 to create a propensity-weighted set of controls for conducting multiple regression analyses. We found that the implementation of community-based health improvement programs was associated with a decrease of less than 0.15 percent in the rate of obesity, an even smaller decrease in the proportion of people reporting being in poor or fair health, and a smaller increase in the rate of smoking. None of these changes was significant. Additionally, program counties tended to have younger residents and higher rates of poverty and unemployment than nonprogram counties. These differences could be driving forces behind program implementation. To better evaluate health improvement programs, funders should provide guidance and expertise in measurement, data collection, and analytic strategies at the beginning of program implementation.
Bibliographical noteFunding Information:
An earlier version of this article was presented at the AcademyHealth Annual Research Meeting, New Orleans, Louisiana, June 25, 2017. This work was supported by the Robert Wood Johnson Foundation (Grant No. 77330). The authors thank Oktawia Wojcik and Caroline Young for their thoughtful comments on earlier versions of the article and support of this project more generally
- Determinants of health
- Health promotion/disease prevention
- Public health