Kaiser Permanente Community Fund FAQ

A Capacity-Building Grants are most appropriate for organizations that have an interest in addressing social determinants of health, but have yet to develop their strategies or partnerships.  These grants can provide up to $50,000 for a maximum of 12 months.  Grant funds can support staff time, focus groups, community convening, facilitators, training, consultants, travel, conferences and related expenses.  By the end of the grant period, organizations will be expected to have developed a clear strategy for addressing one or more social determinants of health; to demonstrate a clear understanding of how their work fits within the social determinants framework; have developed partnerships with other organizations (where necessary), with clearly defined roles and responsibilities for each partner; and be prepared to seek more substantial funding to implement their strategy.

Implementation Grants are similar to what KPCF has funded in previous years.  These grants are most appropriate for organizations that have already fully developed their strategies to improve community health using a social determinants approach; have clearly defined the roles and responsibilities of each partner (collaborations are generally preferred to stand-alone efforts); can articulate how they plan to evaluate the community impact their project would achieve; can articulate their strategy to fully fund and sustain the initiative; and identify the community need for the program and community assets that will be mobilized to ensure its success.  Implementation Grant periods will run up to 36 months.  While we have never set an explicit limit on the amount of funds that can be requested, previous KPCF awards have averaged in the $160,000 to $200,000 range.

A One of the projects that we funded in 2006 was Proyecto Esperanza / Project Hope, which was launched by the Latino Network.  The project seeks to build social cohesion, financial self-sufficiency and health knowledge, while simultaneously reducing risks of intra-family violence.  The Network focuses on the Rockwood neighborhood of east Multnomah County, whose residents experience high rates of poverty, violence and social isolation.  The Latino Network is using community health workers to organize charlas, or circles of strength, involving 15-20 women each who gather weekly to cook, learn and share knowledge.  A portion of our grant funding is goes toward micro-loans of $100 to $500 to help women start home businesses.  This project builds on the success of similar community-based initiatives, which have helped reduce violence and improve mental and physical health status.

The Community Partners Reinvestment Program (CPR) of the Volunteers of America offers another good example.  VOA works with 18-25 year-old offenders before and after their release from prison to ensure a successful reintegration into community life.  The program focuses on four areas: 1) creating and implementing an individualized intervention model that effectively addresses criminogenic risk factors such as attitudes and beliefs, substance abuse, mental health issues, antisocial peers, family and education/employment; 2) increasing pro-social involvement with and connection to the community; 3) resolving systemic fragmentation that has allowed released offenders to fall through the cracks; and 4) educating policy makers and community stakeholders to drive systemic change to reduce the cycle of recidivism.  Nationally, offenders in this age group experience a 48% to 65%, while 78.9% of CPR participants had not been convicted of any crime, and 90.1% had not been convicted of a felony.  Keeping young men out of prison and in stable employment confers substantial health benefits for themselves and their families over the long term.

A We appreciate the value of direct medical services in mitigating the health effects of adverse social conditions. However, the Kaiser Permanente Community Fund is more interested in addressing the conditions that contribute to excess illness and injury than we are in supporting projects that treat adverse effects after they occur. As the Institute of Medicine has noted, “Interventions to improve access to medical care and reduce behavioral risk have only limited potential for success if the larger societal and economic context in which people live is not improved.”

Q What is the timeline for the Fund's decision making process?

A Letters of Inquiry are due by July 2. We will be able to inform applicants as to whether or not the Fund's Advisors have chosen to invite a full proposal by the end of August. Full proposals will be due in early October. Final grant decisions will be made in early December. The earliest that funding will be available will be mid-January, 2009.

A Academic institutions can contribute a wealth of expertise and resources to the development, implementation, and evaluation of projects designed to address the social determinants of health disparities. Historically, however, the balance of power between academic institutions and the communities in which they work has been skewed toward the academic partners. In recent years, a number of private funders and public health professionals have sought to correct this imbalance by supporting programs in which the needs, assets, and methodologies are defined by the community, rather than a university faculty member. Such an approach is more likely to yield results that are culturally relevant to the community, and whose benefits can be sustained. In order to help ensure that the community is an equal partner in proposed projects, the Kaiser Permanente Community Fund will welcome proposals from community-university partnerships provided that the proposal is submitted by a community-based organization, rather than the academic institution.

A Many scholarly and professional associations, as well as independent public health researchers, have published widely on the topic. Some of the most influential texts include: Social Determinants of Health, by Michael Marmot and Richard Wilkinson, Oxford University Press, 1999. As pioneers in the field, Marmot and Wilkinson have demonstrated that the health status of populations correlates strongly with differences in socio-economic status and the accumulation of advantages or disadvantages experienced during the life course. Related links:

Read an excerpt for free at Amazon.com.

Read a recent article published by Marmot and colleagues in JAMA, “Disease and Disadvantage in the United States and England” (free).

In 2001, the Institute of Medicine published “Health and Behavior: The Interplay of Biological, Psychological and Societal Influences,” which examined the complex ways that the social environment affects the health status of communities. Read a summary of this report.

Another key IOM report on this subject was “Promoting Health: Intervention Strategies from Social and Behavioral Research”.

The Community Guide to Preventive Services summarizes what is known about the effectiveness, economic efficiency, and feasibility of interventions to promote community health and prevent disease. The Task Force on Community Preventive Services makes recommendations for the use of various interventions based on the evidence gathered in rigorous scientific reviews of published studies. The Community Guide has reviewed several strategies to address the social determinants of health, and has made their findings available at their Web site.

San Francisco Burden of Disease & Injury Study: Determinants of Health by Murray & Lopez  

Prevention Institute's Strengthening Communities: A Prevention Framework for Eliminating Health Disparities

Policy Link is a national research and action institute advancing economic and social equity.  Much of their work supports community-based efforts to improve conditions that influence health.  One excellent resource they’ve published is Why Place Matters: Building a Movement for Healthy Communities, which provides specific examples of such initiatives.

The Robert Wood Johnson Foundation's Commission to Build a Healthier America has published "Overcoming Obstacles to Health," which articulates strategies to improve our nation's health by addressing factors outside of the health care system.