How community and public policies are organized and enacted?

Communities operate in the context of federal and state policies that can affect local government decisions relevant to health through laws and regulations, through the allocation of resources, and by shaping political will on issues and approaches. Among the more widely recognized policies are those that fund or regulate health care delivery services. But policies in a variety of areas, ranging from education to land use and housing, the environment, and criminal justice, can be relevant to health disparities. Policies can vary significantly across geographic areas and over time in establishing priorities, providing funding, or encouraging collaboration. They can provide important opportunities or constitute barriers to promoting health equity. The policy context shapes the levers that are available to communities to address change.

It seems reasonable to assume that the better informed communities are about the implications of federal and state policy and policy changes, the greater their ability will be to respond effectively to address health disparities and help achieve change in the determinants of health. And, conversely, the more the needs of communities are considered in decision making at the federal and state levels, the more effective those policies will be. In other words, policy makers have the opportunity to lay the groundwork for community success. This policy context (i.e., socioeconomic and political drivers) is highlighted in the report’s conceptual model in Figure

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