The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments

Abstract

Background: The relationship between policy networks and policy development among local health departments (LHDs) is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments.

Methods: This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer) in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models.

Results: All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD). Connectedness was highest among local health officials (density = .55), and slightly lower for chief science officers (d = .33) and chiefs of policy (d = .29). After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic) and tenure were the most significant predictors of formation of network ties.

Conclusion: Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

Keywords: big cities health coalition; network research; policy networks; public health systems; urban health.

Figure 1

Policy involvement (a) and passed ordinances (b) among local health departments (LHDs) in the Big Cities Health Coalition (BCHC). Note: These figures illustrate the involvement of 17 large urban health departments in the United States in policy activities, as well as how many cities passed ordinances in particular health topics.

Figure 2

Ordinance adoption across the networks. Nodes sized by betweenness centrality within a policy area (column heading) and position type (row). ATOD: Alcohol, Tobacco, and Other drugs. LHO: Local Health Official. CSO: Chief Science Officer. CP/SD: Chief of Policy/Senior Deputy.