The Drexel Urban Health Collaborative initiated a Policy Surveillance Project (UHC PSP) in 2017 that focused on urban centers with active policy debate. Policy surveillance is an important mechanism for understanding the scope and effectiveness of policies that impact health and health equity. While most public health policy is enacted at the state or federal level, US cities play a crucial role in implementing policies and programs that impact population health. However, not many systems exist that track and seek to understand policies at a city level.

The goal of UHC PSP was to create a system for identifying, documenting, and then disseminating information about trends and case examples of local actions that can impact population health and improve health equity. This project expanded on traditional policy surveillance to monitor programmatic, budgetary, and strategic planning initiatives, as well as traditional policy. This project identifies promising or effective policies and programs from select US cities that could be replicated.

This project began by monitoring four cities - Philadelphia, New York City, Washington, DC, and Los Angeles. Policies and programs related to the social determinants of health – including education, the environment, and housing - were the focus. With a “health in all policies” approach, policies in other sectors can positively influence population health. Between March 2017 and August 2019, over 300 policies and programs were identified. The findings demonstrated that these cities are taking policy-related action in these three areas to positively impact population health regardless of federal policy priorities, often focusing extra attention on disadvantaged communities.

In the second half of 2019, the UHC PSP was expanded to three cities in the Midwest and South Eastern United States: Birmingham, AL, Louisville, KY, and St. Louis, MO. These cities are smaller than the original four and represent different regions of the country. New project partners, teams of researchers, and students from the University of Alabama, Birmingham, University of Louisville, and St. Louis University, in partnership with local community partners (e.g., health departments) have begun monitoring and surveilling their own cities using the methods developed by the UHC.

The expansion of the PSP and engagement of new academic partners provides increased opportunities to examine urban policy and program trends across the US and allows for comparison among cities with different traits. This expansion also creates a mechanism for identifying best practices in urban areas regarding effective policies related to education, housing and the environment. Each of the new project partners is tracking additional topics (e.g., crime or nutrition) that have importance for their area, which will provide further opportunities for research. Future directions of this project include assessing the impact of the monitored policies and programs on health by examining health indicators and outcomes in these urban areas. To learn more, visit the project website or email UHC@drexel.edu.