Participatory strategic planning in Alameda County to address health inequities

Alameda County's 2006 health status report indicated that while Alameda County residents are living longer than ever, people of color and low-income residents were found to bear a disproportionate burden of poor health outcomes. Consequently, Alameda County Public Health Department (ACPHD) launched a strategic planning process in March 2006 to create thorough, comprehensive and systematic actions towards tackling the county's disturbing health inequities. Rather than traditional strategic planning methods, ACPHD chose a participatory strategic planning process to include diverse stakeholders throughout the planning and implementation phases. These stakeholders have included all ACPHD staff, County Board of Supervisors, community residents, community based and faith based organizations, other governmental agencies and key public health leaders. Over an 18 month period, we conducted SWOT analyses, social justice dialogues on race, class and gender inequities, all-staff on-line surveys, English and Spanish community forums and retreats. Led by an experienced planner, ACPHD's strategic planning team has been comprised of executive staff, program directors and managers and a cross-section of departmental staff of approximately 20 individuals. This team has participated in planning, developing, organizing and conducting the data gathering activities, leading discussions at community gatherings, data analysis and creating presentation materials. Our participatory planning approach incorporates Technology of Participation (ToP) and Freirian social justice dialogues. After two lengthy retreats in October 2007 and February 2008 with 60+ participants, we finalized ACPHD's strategic directions and related goals to address health inequities. This document is being disseminated to all public health programs and services for consideration and implementation.