Bridging the Gap Between Transformative Practices and Traditional Public Health Approaches

Area of Science:

• Public Health
• Community Health
• Health Equity

Background:

• A 2018 report identified Waterloo-Cedar Falls, Iowa, as the worst U.S. city for Black Americans, prompting community-wide calls for action.
• This designation highlighted the urgent need for innovative public health leadership to address systemic inequities.

Purpose of the Study:

• To integrate diverse community efforts and perspectives toward understanding and transforming systemic inequities.
• To develop data-driven, community-informed strategies for health improvement.

Main Methods:

• Employed a participatory action approach utilizing dynamic system mapping and systemic strategy design.
• Engaged stakeholders in developing a system map visualizing drivers of inequity, resilience, and community strengths.
• Utilized developmental evaluation for rapid learning and adaptation throughout the process.

Main Results:

• A "theory of context" was established through a community system map, integrating local stories and data.
• High-impact engagement opportunities were identified based on the system map and community resources.
• Systemic strategies were co-designed across sectors to foster critical shifts toward a healthier community.

Conclusions:

• Participatory systems mapping is a promising adaptive approach for public health departments to address social determinants of health and inequity.
• This methodology enables collaboration with nontraditional partners and the implementation of targeted strategies.
• Adaptive strategies support local public health systems in identifying community health improvement initiatives aligned with Public Health 3.0 principles.