Implementing mobilizing for action through partnerships and participation (MAPP) to achieve a 21st century city health department

Problem- Major budgetary shortfalls in the 2008-9 financial crisis left New England's second largest city's Division of Public Health (DPH) depleted of staff and services. A citywide Task Force recommended developing partnerships to design a 21st century data driven health department.

Methodology- The DPH embarked on a coordinated community approach with the local hospital, an academic health center and healthy communities coalition, and a leadership committee to implement MAPP. Quantitative data consisting of premature mortality, morbidity and disparity as well as youth health risk survey data were catalogued. Next, qualitative data were collected through disseminating the quantitative data to the community using health fairs, focus groups, town hall meetings, summer festivals, and church group meetings where attendees were asked their opinion about the data. Additionally, an electronic survey was fielded and resulted in over 2000 responses. This resulted in a draft community health assessment (CHA). Finally, over 90 different health related stakeholders participated in 2 seminal workshops where participants used the CHA to craft an improvement plan.

Results- This process resulted in identifying 5 priority domains: 1) healthy eating/active living, 2) behavioral health, 3) primary care and wellness, 4) injury/violence prevention, 5) health equity/health disparities.

Conclusion: With skilled facilitation and MAPP as a guide, a wide range of stakeholders are able to provide input and develop a comprehensive health improvement plan. By using this collective impact strategy we have developed a model for other communities and their health departments as they confront the need to do more with fewer resources.