Evolution not Revolution: Strategy, Learning, and Evaluation in The California Endowment’s Building Healthy Communities Initiative

Published: December 2023

Type: Teaching Case


Teaching cases are used for learning among advanced practitioners because they help us to explore the nuances and tensions of complex work rather than falling into truisms, single perspectives, or advocating for one-size-fits-all approaches.

This teaching case focuses on how learning and evaluation can guide those in philanthropy seeking to rise to the demands of more inclusive approaches to social change, especially with communities that have been historically marginalized.

The case centers on the work of The California Endowment (TCE), whose mission is to expand “access to affordable, quality health care for underserved individuals and communities and to promote fundamental improvements in the health status of all Californians.” It explores the role of learning and evaluation in TCE’s Building Healthy Communities (BHC) initiative and Beyond 2020 efforts, and specifically its role in supporting the goal of advancing health equity in communities across California.

As the case documents, BHC required a critical mix of responsive, collaborative, and community-driven leadership, technical skills, and an expansive base of learning and knowledge to feed into the practice of long-term and transformational systems change. TCE’s Learning and Evaluation (L&E) function aimed to support an evolving BHC strategy while deepening TCE’s commitment to working alongside communities.

Near the initiative’s midway point, Dr. Hanh Cao Yu was hired as TCE’s Chief Learning Officer. This case identifies the approaches employed by Dr. Yu and her team to lead the foundation’s L&E efforts, challenging TCE to deepen its expressed commitments to shift power and to truly center community voice.