Arizona's Successful Initiative: Influencing Local Health Policy Where People Live, Work, Learn and Receive Care

In a statewide effort to encourage local health departments (LHDs) to take a leadership role in shaping health policy within the environments in which they live, work, learn and receive care, the Arizona Department of Health Services (ADHS) launched the Health in Arizona Policy Initiative (HAPI) in 2010. The HAPI program is a collaborative approach that pooled resources and staff across the ADHS Division of Public Health Services. LHDs are to develop evidence-based policy, system and environmental strategies related to Worksite Wellness, Healthy Community Design, School Health, Clinical Community Linkages and Nutrition Procurement.  ADHS provides ongoing training to LHD HAPI policy managers on how to advance population health through the implementation of policy, system and environmental (PSE) approaches. PSE training focuses on health policy development, PSE evaluation and sustainable strategies. 

HAPI is a three- year project.  In the second year of implementation, an evaluation was conducted.  Interviews with Public Health Officers in the third year explored the impact of HAPI on overall LHD approach to public health policy.  Counties most often addressed healthy community (40%) and school policy (48%).    Across the four stages of policy development, 39% of counties were in the formation stage, 25% were in the enactment stage, and 33% of counties reported reaching the policy implementation or maintenance modification stage.  

The success of HAPI is attributed to the synergistic effect of local collaboration, leadership, and the concerted, sustained effort of ADHS to provide LHDs with funding, guidance on evidence-based strategies, and technical support for health policy efforts.