Diversity of Local Health Policy Networks

Successful health policy work requires input from many sectors. We sought to develop a typology of network composition and structure for health policy networks in urban areas in the United States. We collected network data from local health departments and their policy partners through a web-based survey in 15 cities belonging to the Big Cities Health Coalition (BCHC). The BCHC is a project of the National Association of County and City Health Officials (NACCHO) and includes America’s largest metropolitan health departments. The data set includes 385 respondents across the 15 cities working in five policy areas: Core Local Funding, Tobacco Control, Obesity and Chronic Disease, Injury and Violence Prevention, and Infant Mortality. City networks included between 12 and 54 local organizations including non-profit agencies (25%), government agencies (22%), and schools/universities (17%). The composition of policy networks varied by city, with a few patterns emerging (e.g., fewer organization types involved in infant mortality). We developed exponential random graph models (ergm) to predict the probability of ties forming among organizations of different types for each policy area and for the overall policy networks. While there were some consistent patterns (e.g., government agencies were central) across cities, significant predictors of tie formation varied by city. The composition and structure of local health policy networks varies widely across urban areas in the US. Cities may wish to consider network composition and patterns of connections in other large metropolitan areas as they work to develop stronger policy networks.