Making the Case for Leadership Roles in Partnerships for Policy, Systems and Environmental Change Approaches to Healthy Communities

Background: The Centers for Disease Control and Prevention (CDC) states that chronic diseases are a leading cause of death (70%) in the US each year and have a significant impact on quality of life, and disability. A variety of reports heralded the need to focus on chronic disease; including reports from the Surgeon General’s Office, Institute of Medicine (IOM); and the first-ever White House Task Force on Childhood Obesity. All these reports consistently stated that chronic disease and its associated factors were issues of national importance that require immediate action. These documents outline the need for leadership through broad-based partnerships for preventive public health practice to remedy this problem. A policy, systems and environmental (PSE) change approach to healthy communities includes changes such as: improving the built environment to promote walkability, policies to improve nutrition and physical activity, and legislation to ban smoking. These approaches, however, require specific actions, leadership and political will within communities, and the appropriate level of players within the partnership to enact meaningful change. Leaders with decision-making influence have been called to action to be involved in the process of creating change through partnerships. However, little guidance is given on the roles these leaders should play in the partnership process. Methods: This exploration included a comprehensive review of available resources related to chronic disease, healthy communities, partnerships, coalitions, leadership frameworks, and national models to answer the following questions: What does the research tell us about the roles of leaders in successful PSE change partnerships approaches for healthy communities? Does involvement in these partnerships by leaders with decision making influence increase the effectiveness of PSE approaches? What are the documented results of effective leadership within partnerships that may be applied to healthy community partnerships? Results: The exploration identified a gap in the literature related to leadership roles in partnerships for policy, system and environmental change approaches. Leadership has not been consistently defined or measured, particularly related to leaders in formal positions, such as in city government. There is a need to provide training and resources to leaders to bolster their ability to apply these concepts in successful partnerships. There is an evidence base established for coalitions and partnerships that can be used to support a growing understanding of leadership and partnership success factors. While the hallmarks of successful partnership is reflected in the literature, there is little published on the evidence for a leadership involvement pathway as a stepwise guide for leaders and partnerships to recommend engagement strategies, identify potential leader actions, and create roles best suited to the leader’s resources and influence. Such a pathway may help to establish a methodology for approaching leadership roles in healthy communities’ and PSE change partnerships that may be validated and replicated across communities.Master of Public Healt