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Policy Framework
It is widely recognized that having no job or a job that pays a low wage puts people at risk of living in poverty. Less well known, though also well documented, are the dangers that low-wage work and unemployment pose to health by exposing people to physical hazards and psychological stressors that satisfactory employment could prevent. Lacking a good job can affect a person’s health not only through economic hardship but more directly — for example, by increasing the likelihood of workplace injury.
A joint project of the California Endowment and The Rockefeller Foundation launched in 2000, California Works for Better Health (CWBH) established four community-based collaboratives to develop interventions designed to improve health through better jobs. The project’s goal has been to increase low-income people’s access to regional economic opportunities and, ultimately, to improve their health indicators. MDRC is evaluating the initiative and has provided technical support for the employment interventions implemented by the partners in each of the collaboratives.
Agenda, Scope, and Goals
The principle guiding CWBH is “better jobs, better health.” In this context, a good job is one in a safe environment that pays a living wage and offers health benefits. Several populations of people lack good jobs: the unemployed, workers who earn less than a living wage, workers whose job is threatened by a weak or unstable local economy or sector, and the underemployed (that is, workers who earn less than what would be expected given their education and training). CWBH’s ambitious objective has been to improve health in high-poverty neighborhoods of four California cities through grassroots efforts to improve access to local job opportunities. Such efforts have included initiatives to reduce employment barriers (for example, through job skills preparation and vocationally oriented instruction in English as a Second Language) and to encourage employers to recruit more effectively from local communities.
The evaluation of the initiative’s implementation seeks to address such questions as:
- How have the local collaboratives generated goals and strategies for improving employment and health indicators?
- What types of capacity, support, partnerships, and resources were required for sites to implement their proposed strategies?
- What strategies and interventions showed the greatest potential to help low-income people get good jobs?
- What progress did each of the four CWBH regions make in implementing their Theory of Change (TOC) proposals? How successful were they in realizing their TOC outcomes?
Design, Sites, and Data Sources
CWBH has operated collaboratives in four regions of California with high concentrations of low-income people:
- Fresno
- Los Angeles
- Sacramento
- San Diego
The research agenda for all four CWBH sites involves two core components. The implementation research seeks to determine how well the regional collaboratives have implemented the initiative’s key interventions — policy advocacy, community organizing, and employment service provision — in order to secure employment advancements and health improvements for their target communities. The outcomes research examines participation and placement numbers in collaborative-sponsored activities and is intended to gauge whether CWBH organizations have been able to build and promote participation in programs to help remove barriers to employment for residents of targeted communities, while also helping to connect these populations to the formal workforce development system and to jobs. There has also been an effort to understand health status of these residents and to note any changes in health status during the study period; however, the scope of the research does not assess direct effects of the CWBH interventions on the health status of targeted populations.
The CWBH evaluation uses a nonexperimental research design that employs mixed-methods to collect data for both the implementation and outcomes research. The primary data collection methods include field research, participant tracking, and participant surveys.
What's Next
- Two waves of a survey of a subset of CWBH participants will be completed in 2008.
- A special topics paper examining creative responses to local needs will be completed in 2008.
- A final report will be issued in 2008.
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