THRIVE enables communities to determine how to improve health and safety, and promote health equity. It is a framework for understanding how structural drivers, such as racism, play out at the community level in terms of the social-cultural, physical/built, and economic/ educational environments. We call these community-level indicators the community determinants of health. In addition to being a framework, THRIVE is also a tool for engaging community members and practitioners in assessing the status of community determinants, prioritizing them, and taking action to change them in order to improve health, safety, and health equity. As a framework, THRIVE is widely applicable to local, state, and national initiatives to inform policy and program direction. As a tool, THRIVE can be used in a variety of planning and implementation processes, from neighborhood-level planning to community health needs assessments (CHNA) and community health improvement planning (CHIP) processes.


The U.S. Office of Minority Health funded the initial development and piloting of an earlier version of the tool in three U.S. locales (2002-2004). The California Endowment provided resources for the initial research and conceptualization of the THRIVE factors. ZeroDivide (formerly the California Community Technology Foundation) provided resources for subsequent modifications to reflect language that is more community friendly. From 2010-2015, the U.S. Office of Minority Health provided funding to the National Network of Public Health Institutes (NNPHI) and Prevention Institute to update THRIVE and expand its reach through training for NNPHI's member public health institutes and dissemination through NNPHI's membership and networks.

Between 2012 and 2015, 12 public health institutes were trained to use THRIVE. The 12 institutes in turn conducted THRIVE trainings in their communities, and integrated THRIVE into ongoing organizational processes and programmatic efforts. The institutes offered professional trainings to participants from a variety of sectors and residents from low-income communities of color, including youth, and residents who are immigrants and refugees with limited English proficiency. Through the use of THRIVE, institutes formed multi-sector coalitions; deepened their understanding of, and commitment to, addressing community determinants of health through comprehensive, multi-sector strategies; built a foundation for future action plans and activities; developed long-term action plans; and engaged in local and state policy and practice change initiatives.

Read more about Prevention Institute's THRIVE partnership with the National
Network of Public Health Institute

Read more about the development of THRIVE and the pilot sites

Tools & Services

  • THRIVE Advances a Shared Understanding of Social Determinants of Health: A Louisiana Case Example

    After the Louisiana Public Health Institute (LPHI) participated in a THRIVE training-of-trainers, LPHI staff applied the concepts of THRIVE to spark organizational change. They created a health equity workgroup and expanded the focus of their ongoing initiatives and coalition to include community environments. They trained community activists on THRIVE and saw quick outcomes with the development a community garden.  

  • THRIVE Empowers Youth to Improve Community Safety: A California Case Example

    The staff of Public Health Institute brought THRIVE to Planada, California to engage youth to address pedestrian safety. After using Photovoice to assess community conditions related to pedestrian safety, the group decided to focus on promoting safe routes to school. To advance safe routes to school, the youth engaged in a multi-faceted campaign, including efforts to create policy change.