Municipal Health Policy Development, Planning and Implementation: Addressing Youth Risk Factors through Participatory Governance

Article excerpt



In 1988, the Institute of Medicine (IOM) issued a report entitled "The Future of Public Health," This report echoed the resurgence on the international scene of the concept and practice of citizenship participation in municipal governance; and recognized the shift from expert dominated health planning to participatory community health planning. In the report, IOM called for public health policy development and practice to be evidence-based, to involve citizens' participation, should be advanced through partnerships, and should be based on cooperative relationships with grassroots organizations. The IOM report was directed at Local Public Health Agencies (LPHA)/Local Public Health Departments (LPHD). Like much of urban public health literature, the IOM report failed to acknowledge the public health functions of municipal authorities which do not have designated public health agencies under their jurisdiction.

As urban public health problems have increased in number and intensity within the years, cities without Public Health Departments have developed innovative community oriented strategies to address public health problems facing youths. Examples of intractable urban health problems affecting youths are gang violence, academic failure, substance use, and favorable attitudes towards antisocial behavior. The Pomona Youth and Family Master Plan (YFMP) was developed to address three community identified and prioritized youth risk factors, including community disorganization, academic failure, and favorable attitudes towards antisocial behavior.

The YFMP is a textbook example of research-based municipal participatory health policy development, planning and implementation. This case study outlines and analyzes the unfolding of the policy process from problem to policy decisions, to the development of a municipal master plan and the ultimate actualization of The Pomona Youth and Family Master Plan. Implications for policy making and implementation, community health partnerships and the concept of citizenship are also discussed.

The Pomona Youth and Family Master Plan (YFMP)

The Pomona Youth and Family Master Plan (YFMP) is a road map for the positive development of Youths and Families in Pomona, California. The plan emerged from decades of frustration with intractable community problems such as gang violence, poor academic achievement, teen substance use, and high rates of teen pregnancy. The formal planning process for this municipal master plan was initiated on February 28, 2005 through the adoption of City Council Resolution No. 2005-13.

The city council resolution adopted The Community That Cares (CTC) strategy as the organizing framework to guide the planning and implementation of a municipal Master Plan for Youth and Families. The CTC focuses on tested and effective programs, policies and practices that address pre-determined priority risk factors by increasing protective factors. The CTC process is a five-step evidence driven strategic planning process that includes: 1) Preparing Community Board Readiness, 2) Assessing Risk and Protective Factors, 3) Identifying Resources and Gaps in Services, 4) Identifying Best Practices Programs, Strategies and Policies, and 5) Developing an Evaluation plan. The Plan that emerged was developed through a partnership between the city government and the Pomona Unified School District(PUSD) working in collaboration with other community stakeholders including faith-based organizations, businesses, institutions of higher learning, community based organizations, chamber of commerce, and the youth of the city. The process included a needs assessment, community analysis of the data, prioritizing of the risk factors, and development of a plan to address three selected priority factors including community disorganization, academic failure, and favorable attitudes towards antisocial behavior.

The Pomona Youth and Family Master Plan is comprised of the following Community Action Components: Community Mobilization; Establishment and Fostering of Collaboration and Partnerships involving service providers and Pomona Youth ; Development, Enhancing, and Co-ordination of existing programs and services that address the selected three priority risk factors; Resource Brokerage; and Community-Based Participatory Evaluation Research to implement the evaluation plan. …