Targeting for Prevention: The Logic of Funding an Ambitious Health Data Project

Improving public health data is a growing point of interest for both domestic and global health funders. These organizations are increasingly backing projects to increase the amount of information available on matters like health disparities and the social determinants of health. As well, funders are keen to plug some surprisingly large gaps in basic knowledge about health.

For example, at the global level, millions of people die every year without any record of their cause of death—a problem that Bloomberg Philanthropies is tackling through an ambitious partnership with the Australian government, as we've reported.

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In the United States, an interesting public-private collaboration aims to improve local health data that involves the Robert Wood Johnson Foundation and Centers for Disease Control (as well as its philanthropy arm, the CDC Foundation). It's called the 500 Cities Project, and its stated goal is "to provide city- and census-tract-level small area estimates for chronic disease risk factors, health outcomes, and clinical preventive service use for the largest 500 cities in the United States." 

The logic behind this ambitious project, as with Bloomberg's work on causes of death and other health data efforts, is that more information is needed to better direct health resources, especially when it comes to prevention and emerging health problems. And while 500 Cities is touted as a "first-of-its-kind data analysis" project on local health, it's worth noting that law enforcement agencies have long been using hyper-local crime data to better deploy policing resources. So-called COMPSTAT programs in many cities, starting with New York in 1995, have been credited with better pinpointing high-crime areas and enabling more effective steps to reduce crime. The 500 Cities effort imagines something similar: "For example, city planners and elected officials may want to use this data to target neighborhoods with high rates of smoking or other health risk behaviors for effective interventions."

All in all, this sounds like a smart and obvious idea—so much so that it's surprising it wasn't done earlier. In fact, though, the groundwork for 500 Cities was laid in 2015, with an $875,000 grant from RWJF—a foundation that's long been enamored of the power of data to improve health. That initial funding backed the development, creation and execution of the project and served to “bring together various sectors and disciplines in thinking about” how to use the health data derived from the project. RWJF continued its financial support of the 500 Cities Project in 2016 with another grant for over $101,000.

After a couple of years of what was undoubtedly a complex and mammoth undertaking, the 500 Cities Project recently launched its interactive data portal, which allows users to explore and download local data on such topics as the prevalence of high cholesterol, obesity, and diabetes, as well as things like how often people have been to the doctor, the extent of insurance coverage, binge drinking, and even sleep habits. All this information will be helpful in reducing preventable illnesses and risky behavior—assuming that public health officials and others make use of the data. The challenge with database projects isn't just building them and keep them updated; it's drawing users and ensuring that such data has impact. Not all projects like this succeed, unfortunately. The good news in this case is that the database was designed with the involvement of likely end users. 

Meanwhile, RWJF is moving forward with other important data projects, too. A few years ago, RWJF, along with other funders including the Kresge, W.K. Kellogg, and Blue Cross and Blue Shield foundations, backed the BUILD Health Challenge, an ambitious national program fostering and supporting collaborations between communities, sectors, and health institutions in an effort to “give everyone a chance to be healthy,” with a focus on low-income, urban neighborhoods. Data is key to this effort, and as we've reported, BUILD has lately gained steam, pulling in new funding partners. 

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When it comes to expensive big data projects, whatever the issue area, one question that sometimes arises is: "Why not focus on actual programs that help people?"

There are at least two answers to that question: First, it's not an either/or choice, and many of the funders that are backing ambitious data projects, like Bloomberg and RWJF, are also supporting grassroots work addressing immediate problems. Second, when it comes to many areas, there remains a lot we don't know, and that's certainly true of health. More knowledge, including better data, often holds the key to more effective action.

Again, though, the caveat is that fancy new data will have limited impact if it ends up being ignored. We'll be keeping an eye on the 500 Cities Project, where the data portal helpfully tracks the number of views, to see just how much use this data gets.