SDOH builds the second half of the improvement cycle — the half that has collapsed for seventy years across every framework that tried to build it. The system measures whether conditions actually changed for the people a program was trying to help, and learns which strategies produce results.
We work in domains where the data is messy, the stakes are high, and the people doing the work don't have time to fill out forms.
"I didn't read about the improvement cycle problem. I built the systems that kept failing at the same point, across completely different domains."
— Michael Knapp, PhD
Michael Knapp, PhD is a Public Health Informaticist. He founded SDOH, LLC in January 2026 to build outcome accountability infrastructure for nonprofits, governments, and mission-driven organizations — so they can know whether their programs work and what to try next.
Twenty-five years building measurement infrastructure: school improvement systems, supply chain certification, green building benchmarking, real estate sustainability ranking, public health data platforms, book recommendation engines, homeless services software, B Corp certification, professional development standards. Every project was organized around a standard. Not one made improvement the objective. SDOH is the response to that pattern.
PhD from Yale (environmental health). Master's in Environmental Management from the Yale School of the Environment. Founded Green River in 2000 and led it for twenty-four years, building open-source software for homeless services, public health, education, and environmental protection. Transitioned Green River to 100% employee ownership in 2024 through an ESOP-cooperative hybrid he designed.
Serves on the board of Native Plant Trust. Lives in Guilford, Vermont.
Across two and a half decades and a dozen domains, the same pattern: programs that measured but rarely learned, organized around standards that the sponsors of those standards needed more than the people the programs were designed to help.
School improvement software for the National Education Association. Ran for fifteen years in thousands of schools. The Springfield, Massachusetts case study showed the union-management dynamic improved through working together. Student outcomes didn't move meaningfully. The cycle was sponsored, and what got optimized was the sponsor's relationship.
Supply chain certification across two billion pounds of green coffee per year. The compliance system worked. The brand was protected. Whether anything changed for farmers and mill workers was not the focus.
Global Building Information Gateway. 1.4 million observations across 300,000 buildings worldwide. The measurement infrastructure was excellent. The improvement infrastructure was missing.
Real estate sustainability benchmark for 60% of the world's real estate. Investors got comparable scores. The buildings, the tenants, and the surrounding communities got reports.
Open-source platform helping communities, states, hospitals, and insurers serve people experiencing homelessness. Used by 14+ agencies. The data was there. Whether the systems acted on it was someone else's job.
1,900 health indicators with neighborhood-level granularity. HIPAA-certified. Peer-reviewed in the Delaware Journal of Public Health. Sunsetted at the end of 2025 when political urgency faded. Currently being restored — outside state control this time.
In 2016, at the National Science Foundation's Computational Sustainability conference at Cornell, I presented an architecture connecting these projects: a three-tiered recommender system running across schools, supply chains, and buildings. That presentation is the direct ancestor of what SDOH is building now.
The systems above were each excellent at what they were paid to do. None of them closed the loop. SDOH is the loop.