A Little Healthy Competition in the Interests of Healthy Communities

Competitions and prizes are everywhere in philanthropy these days, with the goal of finding breakthrough ideas, scaling ideas that work, and spreading best practices. We've written about the pros and cons of this approach to philanthropy, as not all competititions are well conceived. But overall, there's no question that many are stirring the pot in different fields in a good way. 

RelatedThe Perils of All These Prizes

Among the latest entrants to the fray is the Aetna Foundation, with its new Healthiest Cities & Counties Challenge

The recently announced challenge is a partnership of the Aetna Foundation, the American Public Health Association and the National Association of Counties. It has a geographically-focused goal: to encourage small to mid-sized U.S. cities and counties to develop—and share—interventions that improve community health and economic vibrancy.

Though it has run small-scale prizes before, the Healthiest Cities & Counties Challenge is a new strategy for Aetna Foundation. "It's the first time we're doing a prize at this level of government, and investing this much," says Garth Graham, MD, president of Aetna Foundation. "A lot of health outcomes are predicated on geography, and a lot of that is based on city and county dynamics."

With $1.5 million in cash rewards as incentive, the contest seeks whole-community solutions that look beyond any single disease, in an effort to raise overall health and well-being. And Aetna wants to make headway against the all-too-common health disparities found in communities with lower average incomes.

Communities with larger populations could win a top prize of $500,000, while smaller communities could win $250,000. The remaining $750,000 would be awarded to runners-up. Aetna will accept program proposals from the thousands of towns and counties that qualify, and provide pilot funding to 50 competitors, starting in September 2016 and running for two years.

We have written before about funders taking the whole-community view of health and well-being, focusing on the idea that health is the result of complex relationships and factors within towns or immediate surroundings.

So what does this whole-community thinking mean in terms of participating programs? Aetna wants local county and city health organizations to use a "health in all policies” approach to build scalable models and practices that promote inclusive and economically vibrant communities. Built into the challenge are mechanisms to share these best practices.

Categories include nutrition and exercise, the built environment, clean air and smoking, housing and public safety, and economic activities.

Aetna, like most foundations, typically follows the standard grantmaking process: assess a proposed or established program, and if it looks effective, write a check in support. Why the pivot to this challenge format?

Like a lot of competitions, team play is a big part of the story. According to Graham, Aetna hopes the prize will stimulate the formation of new partnerships between healthcare organizations and stakeholders throughout communities. Rather than funding a single organization's program or proposal, the challenge is designed to reward collaborative solutions that don't rely on any single organization or sector.

Aetna is looking beyond the current challenge, hoping that the strengthened relationships between community health stakeholders  will persist long after the prizes are distributed.

"We took a long look at different funding strategies, and the prize concept allows multiple parties to be involved," says Graham. "It's not about any actual person who wins the prize, but the stimulation of bringing people together and getting excited about a concept."