Jonathan Morgan was a part of the last round of Faculty Lunches with the Dean, and this post summarizes the work he shared with the group. He is playing an interesting and important role in the Healthy Places NC (HPNC) initiative by the Kate B. Reynolds Charitable Trust.
The Trust launched HPNC in 2012 with the goal of investing $100 million in 10-15 economically distressed counties to improve local health outcomes and quality of life. HPNC started with Beaufort, Halifax, and McDowell, and it gradually has been adding other counties. The initiative is distinctive because the health improvement activities are driven by local residents rather than the foundation. According to the Trust:
“[W]e are not driving the bus. We’re on it as a willing partner and supporter, but we’re relying on communities to define what it is they want to accomplish and what success will look like. We’re not coming in with funds tied to predetermined outcomes but instead are offering our ability to provide connections, training, research and, in some cases supportive funds.”
In addition to supporting traditional health care organizations such as hospitals, for example, HPNC has been enhancing recreational activities for kids, increasing physical activity among all residents, and making healthy food options more accessible.
Not surprisingly, the Trust wants to know whether its $100 million investment is making a difference, and that is where Jonathan comes into the picture. Two years ago he was invited to join a team of public health researchers at Duke University’s Division of Community Health who had been hired by the Trust to evaluate HPNC. Jonathan was added to the team because they wanted a researcher with expertise in economic and community development—issues that can be important determinants of health, especially in distressed communities like those targeted by HPNC.
The ultimate question involves causation and how much change and progress can be attributed to the work of HPNC. It is challenging to determine because any number of other variables might explain changes in a community over time. For that reason the evaluation is using multiple approaches: in-depth interviews, a local stakeholder survey, social-network analysis, and county-specific case studies. Jonathan and his colleagues are trying to detect forward movement in community leadership, organizations, networks, and any work being done to improve health and well-being.
Jonathan is taking the lead on an in-depth case study of McDowell County, particularly its efforts to address food and nutrition issues. Part of HPNC’s place-based strategy is to build local leadership capacity that will continue when the program is over. How do you measure the intangible impact of bringing together local stakeholders in ways that are unprecedented for these communities? Will the work be sustained when money from the Trust is no longer available? What is the impact of the opioid epidemic, which keeps coming up and may not have been on the Trust’s radar screen in the beginning? (Here is a video that provides an overview of HPNC in McDowell County.)
This project is another example of the range of the School’s work in North Carolina and beyond. In addition to helping to understand the impact of HPNC, a bold initiative, I am confident that Jonathan is learning things that will inform all of his future work in community and economic development. It will increase the impact of his work, and that is a terrific outcome for the School regardless of where the HPNC bus ends up in the participating counties.