Cultivating a Healthier Policy Landscape: The Building Healthy Communities Initiative.

OBJECTIVE: To identify effective methods for local public health departments to secure policy and systems changes that will achieve health equity and improve health outcomes across diverse populations. METHODS: We reviewed 220 documents from a philanthropic initiative that funded collaborative efforts to improve conditions for health and equity in 14 California communities from 2010 to 2020. We examined the role of factors associated with movement-building approaches-such as organizing, base-building, investing in organizational capacity, and forming alliances-in securing policy and systems changes that foster more equitable community conditions. RESULTS: All 14 sites made progress in implementing policies and systems to improve the social determinants of health, including neighborhood conditions and the built environment, health care access, social and community context, economic stability, and education access. All 14 also shifted processes to be more inclusive of and responsive to community members, who in turn gained capacity to advocate for change and build collective power. CONCLUSION: Local public health leaders can make progress toward health equity by drawing on movement-building approaches to change policies and systems that affect social determinants of health.

A System of Prevention: Applying a Systems Approach to Public Health.

Among public health and health care practitioners, there is growing understanding that individuals make choices about their health not in a vacuum but based on the social, physical, and economic environments surrounding them and the resources available to them. Furthermore, we know that we, as a society, have designed these environments and resource allocation processes and that those in turn can produce better or worse health outcomes. In recognition of this, some practitioners are turning toward systems thinking as a way of understanding the many sectors and factors that influence health, and as a strategy for influencing broad and sustained health interventions. In October 2018, Prevention Institute released System of Prevention, a book that uses graphic design to illustrate Prevention Institute's framework for a systems approach to population health that can achieve health equity. The book draws upon learning in the primary prevention arena and presents it in an innovative format designed to be accessible to the many sectors outside of public health that collectively shape the social and community determinants of health. It aims to spark dialogue and catalyze collaboration among the sectors and stakeholders that can together work for a healthy and equitable future for all communities.