Policy surveillance provides an opportunity for public health researchers and practitioners to identify gaps in policy and program coverage as well as best practices in leveraging policy for public health interventions.

The Birmingham Policy Surveillance Initiative (BPSI) applies policy surveillance methods to the city of Birmingham, Alabama, by systematically collecting information on policies adopted by the Birmingham City Council. Starting in October 2019, BPSI has identified 443 policies and programs with population health implications. BPSI is part of a larger project led by the Urban Health Collaborative at Drexel University’s Dornsife School of Public Health. The Urban Policy and Program Surveillance Project seeks “to identify best practices in select cities around the United States that are employing promising or effective policy, programmatic, and budgetary initiatives to promote health equity.”

Key Takeaway 1: The need for policy surveillance

Increasingly, public health researchers and practitioners are acknowledging the role of policy in population health. Despite this visibility, the specific ways in which policies influence population health remain largely understudied. Moreover, few systems exist to track or facilitate greater understanding of policies. Thus, monitoring and evaluation of policy has been identified as an essential service of public health law. Policy surveillance is a research practice which “generates data to evaluate laws and policies, measure the progress of legal campaigns, and provide public access to legal information.”

Key Takeaway 2: The Policy Surveillance Process

Students and staff working with the BPSI monitor agendas, recordings, and minutes from the Birmingham City Council. Any policy or program with potential implications on population health – either directly or indirectly through social determinants of health – is documented in an internal database. Information collected includes funding, partnerships, framing of the policy, sponsors, and more. Policies and programs are further categorized by their relation to six areas of focus for the BPSI: crime reduction, economic development, education, environment, housing, and prevention and wellness. Project staff meet regularly to review identified policies and programs and address discrepancies.

Key Takeaway 3: Results of BPSI to-date

Initial policy analyses, written by graduate student interns, are available on selected topics through the Lister Hill Center for Health Policy. Examples of analyses include recommendations for the municipal government to address gun violence, an assessment of health services in Birmingham City Schools, an analysis of placed-based internships for postsecondary education, and an overview of Birmingham’s implementation of urban walking trails. Opportunities for further analysis exist across the six areas of focus, including identifying gaps in policy and program coverage, assessing the financial impact of identified policies and programs, and reviewing municipal COVID-19 interventions. These analyses can be used to inform local policymakers’ decisions regarding the allocation of resources and implementation of programs, thus paving the way to greater health equity in the city of Birmingham. Additionally, the BPSI team intends to develop a web-based portal for researchers, advocates, and other stakeholders to access the information collected.

Read Our Article in the Journal of Public Health Management and Practice:

• Preliminary Findings of the Birmingham Policy Surveillance Initiative

We Recommend:

• A Transdisciplinary Approach to Public Health Law: The Emerging Practice of Legal Epidemiology
• The Growing Field of Legal Epidemiology 
• Advancing Legal Epidemiology: An introduction 

---

Matthew Fifolt, PhD, is Associate Professor in the Department of Health Policy and Organization at the University of Alabama at Birmingham.

 

Sean McMahon, MA, is Program Manager for the Lister Hill Center for Health Policy at the University of Alabama at Birmingham.

 

Tessa Graham, MPH, is Program Manager for the Office of Public Health Practice at the University of Alabama at Birmingham.

 

Lisa McCormick, DrPH, is Professor in the Department of Environmental Health Sciences at the University of Alabama at Birmingham.