GiveBetter x SF

Public Health Advocates

Health-policy advocacy, community systems change, emergency resilience and prevention

Research time: ~18 min on GPT-5.6 Sol Medium
  • Research — organization and evidence review.
  • Modeling — cost-effectiveness analysis.
  • Historical estimate for research done before time tracking.

Published: 10 September 2026.

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Summary

What do they do? The full legal entity includes childhood-trauma policy, emergency resilience, alternative response, youth advocacy, state legislation, climate justice and Stockton health work. More

Why this approach interests us

  • PHAdvocates helped win Medi-Cal coverage of the evidence-based Diabetes Prevention Program and reports more than a dozen state laws.

Our main reservations

  • Current programs disclose no incremental health denominator, policy counterfactual or next-gift plan; FY2024 audit flags going concern and an internal-control deficiency.

What do you get for your dollar?

A $100,000 prior-weighted illustration is $78.8M donor and $93.8M illustrative gross resources per 10 QALYs. Central is $301M. A 5%-weight favorable case supplies 88.24% of modeled benefit. Inspect the model, assumptions and scenarios.

modeled ordinary gift
$78.8M — donor cost per 10 signed modeled QALYs; 40% null, 10% harm
central
$301M — donor cost per 10 modeled QALYs
favorable
$4.46M — 5% weight; 88.24% of weighted benefit
bay / sf
20% / 2% — statewide priors; SF nested
rfmf
Unverified, unpriced — financial need acute; health-producing room operationally risky

1. What do they do?

The full legal entity includes childhood-trauma policy, emergency resilience, alternative response, youth advocacy, state legislation, climate justice and Stockton health work.

Change state and local policy

Sponsor legislation and coach communities.

Build prevention systems

ACT, emergency resilience and alternative response.

Support local health equity

Youth, climate, nutrition, activity and breastfeeding campaigns.

Scope of this review. All $7.533M expense is charged. Only a DPP-coverage policy-equivalent is quantified; other pathways receive zero QALYs.

2. Monitoring and information sharing

Adults at high diabetes risk

Randomized trial and 10-year follow-up. 58% lower incidence at ~3 years; one-third lower at 10 years; ~4-year delay.

Our assessment. Medi-Cal implementation and current PHAdvocates contribution unmeasured.

16 nonpharmacologic prevention studies

2024 systematic review. Median DPP-based ICER $27,077/QALY.

Our assessment. Design and delivery heterogeneous.

Whole organization

IRS 990 and federal single audit. FY24 $7.533M expense, $743K surplus, $2.010M net assets; going-concern and internal-control flags.

Our assessment. Full expense; deployability discounted.

3. Qualitative assessment

PHAdvocates helped win Medi-Cal coverage of the evidence-based Diabetes Prevention Program and reports more than a dozen state laws.

Key reservations

  • No current attributable completers or health outcomes
  • Historical win is not marginal use
  • Most current pathways are zero-credit
  • Audit flags going concern and significant deficiency
  • Gross resources incomplete
  • Bay/SF shares assumed

Benefits not included in our estimate

  • Trauma policy
  • Emergency preparedness
  • Alternative 9-1-1 response
  • Youth and social-media policy
  • Climate justice
  • Nutrition, activity and breastfeeding
  • Convening, research and empowerment

4. What do you get for your dollar?

Weighted $78.8M donor / $93.8M gross per 10 QALYs.

Historical Medi-Cal DPP coverage is used as a mechanism benchmark, not a current outcome. Completer scale, attribution, QALY, gift and realization factors are priors.

A better life is our comparison unit of 10 additional quality-adjusted life years (QALYs), potentially spread across people. These are uncertain estimates, not measured returns or verified donation offers.

How we calculate the estimate

CENTRAL: 500 equivalent completers × 5% attribution × .05 QALY × ($100K/$7.533M) × 25% deployability × 80% realization
.0033186 gift QALY; $301.3M/10

Model inputs and assumptions
Annual DPP-coverage-equivalent completers
500 (range: 50 harm / 0 / 500 / 2,500). Scenario only; no current PHAdvocates participant outcome. Very low.
Organization attribution
5% (range: 2% / 0 / 5% / 15%). Government, coalition, providers and advocates share causality. Very low.
Finite QALY per completer
.05 (range: −.005 / 0 / .05 / .10). Trial anchors direction and persistence; values are not derived by combining the separate per-participant cost and review ICER. Very low; sensitivity.
Deployability × realization
25% × 80% (range: 15×70 / 20×75 / 25×80 / 50×90). Restricted funding, going concern, internal control and unpriced use. Low.
Gross-resource proxy
1.25× advocacy plus $2,250/completer (range: 1.10–1.50×). Historical efficacy-trial proxy; price year/perspective not matched; not current Medi-Cal marginal cost or a lower bound. Very low.

Illustrative $100,000 unrestricted gift

  • Harm 10%: Net harm. −.000007 QALY
  • Null 40%: Not defined. No positive QALY
  • Central 45%: $301M donor / $377M gross. .003319 QALY
  • Favorable 5%: $4.46M donor / $6.92M gross. .224004 QALY
  • Weighted: $78.8M donor / $93.8M gross. .012693 QALY
  • No favorable: $636M donor. .001571 QALY

Uncertainty. The favorable tail dominates; values are priors, not confidence intervals or observed outcomes. With zero gift deployability, QALYs are zero and cost/geography ratios are null.

5. Funding and previous grants

Obtain audit remediation, runway, current policy targets, partner attribution, next-$100K staffing, and linked uptake/outcomes.

Financial need appears acute; health-producing marginal RFMF is unverified, unpriced, and operationally risky.

This review does not establish a verified marginal funding offer or a complete history of grants.

Donate

Opens the organization’s giving page. A general donation may not fund the specific activity modeled here; confirm allocation with the recipient.

6. Sources

  1. Our Work. Public Health Advocates. Official portfolio. Published: Current; retrieved: 2026-09-10.
  2. Donate. Public Health Advocates. Official unrestricted donation. Published: Current; retrieved: 2026-09-10.
  3. Diabetes Prevention Program. Public Health Advocates. Official policy case. Published: Historical case; retrieved: 2026-09-10.
  4. Diabetes Prevention Program. California DHCS. Official benefit rules. Published: Current; retrieved: 2026-09-10.
  5. What Is the National DPP?. CDC. Government evidence summary. Published: 2024-05-14; retrieved: 2026-09-10.
  6. Cost effectiveness of nonpharmacological prevention programs for diabetes. PubMed. Systematic review. Published: 2024; retrieved: 2026-09-10.
  7. Cost-Effectiveness of the National Diabetes Prevention Program. Springer/Applied Health Economics and Health Policy. Historical efficacy-trial cost context. Published: 2020; retrieved: 2026-09-10.
  8. Public Health Advocates, EIN 95-4723901. IRS/Federal Audit Clearinghouse via ProPublica. 990 and audit flags. Published: FY2024; retrieved: 2026-09-10.

Annual expenses: years and sources

Average annual expenses (three consecutive fiscal years): Not available. Organization size is separate from the modeled cost-effectiveness of a donation.

Public Health Advocates

Three years of organization-level expenses have not yet been verified for this report. No other organization or fiscal sponsor budget has been substituted.