Strengthening policymaking capacity in a local public health department: A community academic partnership

Purpose: A medical school (MS) and a local public health department (LPHD) partnership assessed the health policy making capacity of the LPHD and defined a model framework for policy development in a LPHD.

Methods: Qualitative research included 7 methods for assessing issues related to capacity, barriers, systems, stakeholders, trends and priorities:

1. Legal review examining the authority of the LPHD;

2. Case study of successful lead poisoning policy development including 10 in-depth interviews;

3. Survey of 60 LPHD employees pertaining to staff experience, training and attitudes (response rate 38%);

4. Focus groups with 24 LPHD staff;

5. Focus group with 10 MS faculty;

6. Key informant interviews with four city leaders;

7. Phone consultations with five leaders of pubic health agencies.

Results: Key findings include:

• LPHD has broad authority to protect public health through state constitutional policy power, state statutes and city ordinances.

• 96% of staff are interested in using policy as a tool for health improvement, however 30% had no training in policy or advocacy.

• Important factors for successful policymaking include: a catalyzing event, LPHD leadership, compelling and accessible data/research, shared vision, media coverage, funding, and mobilized grassroots community leaders.

• Barriers for policy development by LPHD employees: lack of time, funding, and training and bureaucratic limitations of narrowly defined roles.

Conclusions: A core function of public health is policy development that supports individual and community health. As LPHDs seek to implement strategies aimed at population-level policy change, they will require leadership, training and resources.