Magazine article Public Management

Health Localized: The Global Drive by Local Government to Improve Communities' Health and Quality of Life

Magazine article Public Management

Health Localized: The Global Drive by Local Government to Improve Communities' Health and Quality of Life

Article excerpt


Globally, there is an increasing focus by local governments to incorporate health considerations into all aspects of their programs, policies, and operations. This is the case in a variety of environments, including those for which the organization with the primary public health responsibility exists outside of the general local government structure.

There are many reasons for this evolving alignment. From global and national perspectives, there has been an emphasis on better coordination by international development funders, national governments, and efforts geared toward the Millennium Development Goals and Sustainable Development Goals. (1)

More locally, given public budget uncertainties and increases in service demands, local governments continue to look for ways to offer a wide-ranging portfolio of services in a cost-efficient manner, against the backdrop of increased devolution of responsibilities and the focus on overall local quality of life by residents, businesses, and regional stakeholders.

Also, economically, the focus on health in all local services highlights the continued connection between a population's health and gains in knowledge and capital production, (2) reductions in lost output due to non-communicable diseases, (3) and ability to develop a dynamic, locally based labor force.

Communities around the world are experiencing major population growth as people move from rural areas to urban centers. According to the United Nations World Urbanization Prospects: The 2014 Revision Highlights, in 1950, 30 percent of the world's population lived in an urban environment. By 2050, this proportion is projected to increase to 66 percent.

As urban centers go through this transformation today, it is informative to briefly look back on the urbanization of North American and Western European cities between 1890 and 1920. During this time frame, according to the U.S. Census, the United States went from having 35 percent of its overall population living in urban areas to 51 percent.

Given the increased urban populations of this time, water and sanitation networks were built out to reduce the spread of disease and provide dependable access to water--key components to maintaining public health and sustaining an adequate quality of life. It was at this time that urban reform movements were occurring, including those that emphasized professional city management, with the intent of effectively and equitably providing local services.

With advances in public health knowledge, by the mid-1900s, the profession of public health was well established and, in many jurisdictions, separate governance and funding structures were established to begin or continue to provide core local public health services such as disease and environmental health surveillance, immunizations, and vital health records, among many others. These are the core public health goals offered at the local (and state) levels, often segmented from general local government services.

As urbanization continues, much of it in developing economies, many of those responsible for the administration of local programs and infrastructure assets are reassessing how these services can be structured, not only to achieve direct aims, but also to support the broader development of healthier communities.

ICMA Research Examines Global Efforts

ICMA recently published the report Improving Quality of Life: The Effect of Aligning Local Service Delivery and Public Health Goals (4) that examines the role of local governments from around the world to support public health. (5) The content offered in this section comes from this report. Because many of the services local governments provide are similar--planning, water, and roads-officials can learn not only from nearby jurisdictions, but also from those across an ocean.

The research also considered how local governments are collaborating to advance public health and the outcomes of those partnerships. …

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