Evaluating and Measuring the Healthy & Equitable City: Lessons from Richmond, CA

This paper reviews the methods and findings from a 24-month evaluation of a healthy community/city effort in Richmond, California. Richmond is one of the most impoverished cities in the San Francisco Bay Area and its largely Latino, Asian and African-American population suffers from multiple morbidities and premature mortality. For the past five years, the city has embarked on a series of healthy planning initiatives, including drafting and implementing a Health and Wellness Element (HWE) as part of the City's General Plan Update. The implementation phase aimed to develop healthy neighborhood pilot projects, with primary schools acting as the anchors for broad interventions addressing the social determinants of health. Local policies and ordinances and a data tracking system were also part of the implementation phase. Participants included city and county government agencies as well as community-based organizations. Using formative evaluation methodologies, I tracked changes among HWE participants, the operations of their organizations, other impacted social justice organizations in the community, and the built and social environment. I report on the impacts the the 2-year healthy city initiative has had on the determinants of health inequities in Richmond and suggest lessons for other places aiming to implement and monitor healthy and equitable city projects.