By Patrick Glass
- The first webinar in our Accelerating Policy Change series featured speakers from public health law, planning, community leadership, and advocacy, who discussed the strengths of local and state policy processes and detailed some local policy wins.
- Did you miss the first webinar? Watch the recording.
- Keep reading for highlights and lessons learned from our webinar The Power of Local & State Policy Solutions.
Sharing Policymaking Expertise from Across the United States
In the face of uncertainty at the federal level of government, local and state governments continue to be a hub of policy innovation and implementation that improve population health outcomes and advance community interests. ChangeLab Solutions' recent webinar Accelerating Policy Change: The Power of Local & State Solutions explored how state and local changemakers can better navigate existing legal landscapes, engage communities throughout the policy process, and create impactful policy change.
“I’m attending, and highly recommend ChangeLab Solutions webinars to all my colleagues and students. I always learn pertinent and timely information in their webinars.” ―Ellen Breckenridge, assistant professor, UTHealth Houston School of Public Health
Moderated by ChangeLab Solutions CEO Sarah de Guia, this curated conversation featured Daniel Cohen, director of community enhancement, Chesterfield County, Virginia; McKenzie Cowlbeck, executive director, Oklahoma Public Health Association; Tina Ansong, senior planner, ChangeLab Solutions; and Jami Crespo, senior attorney, ChangeLab Solutions. They shared insights on overcoming preemption, leveraging legal authority, and implementing policies in ways that center community needs.
Review the webinar recording, or keep reading for five key takeaways from The Power of Local & State Policy Solutions:
1. State & Local Policies Respond to Community Needs
State and local policies are crucial tools for addressing community needs and driving systemic change because they can directly respond to the realities of the communities they serve in ways that federal policy cannot. They provide tailored solutions that reflect local priorities. Because state and local governments operate closer to the people they serve, they can respond quickly to emergencies or new priorities, creating innovative policies that meet immediate needs while also enabling the long-term changes that are necessary to reduce health inequities.
“Local changes can provide case studies and evidence of success that set the stage for state and even national changes in the future,” explained ChangeLab Solutions' Sarah de Guia during the webinar.
State and local governments can help turn the tide on persistent health inequities by implementing focused policies that address social determinants of health. For example, panelist Daniel Cohen shared how Chesterfield County, Virginia, has taken a proactive approach to increasing affordable housing production, in part by creating a land trust through local legislation. By applying a market analysis of conditions and needs in Chesterfield County, the county has been able to produce affordable housing solutions to meet the unique needs of their community.
Similarly, McKenzie Cowlbeck highlighted how her organization, the Oklahoma Public Health Association, is working to build policy engagement among public health students and professionals in a state where public health authority has faced pushback. By demystifying concepts like where to find laws and the difference between education, advocacy, and lobbying, her organization is equipping public health students and practitioners to push for health-focused policies in Oklahoma.
Related resource: Strategies for Equitable Policymaking
2. Policymakers Must Consider Their Authority to Act
State and local policymakers must understand the sources and limits of their authority to act and make new laws. The Tenth Amendment to the US Constitution grants to states all the powers not specifically assigned to the federal government, giving states broad legal authority to protect the public’s health, safety, and well-being. States can then choose to share this authority with local governments. All states do share their authority, to varying degrees. Some states follow Dillon’s Rule, meaning that local governments can act only if their state has granted specific power for their action. Other states grant home rule authority to local governments, which gives them broad autonomy to govern themselves.
ChangeLab Solutions’ Jami Crespo, who has worked in Congress and in state and local health departments, emphasized that even when legal authority is limited or preempted, local governments still have ways to implement effective policy change. Crespo highlighted a time in her career when state law potentially preempted local legislators from requiring multi-unit housing to be 100 percent smoke-free. Her department worked directly with landlords to educate them on the health and economic benefits of voluntarily making their housing 100 percent smoke-free. Their work resulted in thousands of new units of smoke-free housing.
“Even if you are preempted in certain areas, there is still work you can do to improve health, and it doesn’t always have to cost a lot,” Crespo explained.
Related resource: Public Health Authority collection
3. Community Engagement Drives Success
Policy change must address the needs and concerns of the communities affected by the policy. Community engagement improves the policymaking process by helping to ensure that policies will effectively meet the needs of community members and have minimal unforeseen consequences. As ChangeLab Solutions’ Tina Ansong explained during the webinar, community engagement is not a one-time event; rather, community engagement must be a sustained effort built on mutual trust, respect, two-way communication, transparency, humility, and shared power. Community engagement must take place when contemplating a new policy approach, when planning how the policy will be implemented, and when assessing the new policy’s efficacy and impact on equity.
“In today’s environment, it is becoming increasingly challenging to dismantle systemic inequities,” said Ansong. “We may see an increasing shift away from labeling these efforts with the end goal in mind — equity — and, rather, shifting the focus toward the process — community engagement — that leads to those outcomes.”
When governments invest in relationships with community-based organizations and community members, they gain access to community-specific knowledge that can yield policies that better reflect community priorities. These partnerships also reduce barriers to participation, helping to ensure that all residents can make their voices heard throughout the policy process. By prioritizing meaningful and ongoing engagement, policymakers can create lasting solutions that address residents’ needs and improve health for all.
Related resource: Supporting Equitable Community Engagement
4. Community Health Needs Cross Political Divides
Despite our fractured political climate, communities across the United States are still coming together to address their own health needs by implementing innovative policies.
Webinar panelist Daniel Cohen shared how Chesterfield County, Virginia, has prioritized housing as an important factor in improving community health. The county created the Maggie Walker Community Land Trust, one of the first land trusts in the country to develop an affordable housing subdivision. Cohen also discussed how Chesterfield County has used 10-year tax abatements to spur housing and commercial development in older corridors of the county. Finally, Cohen stressed the importance of relationships throughout the policy process, suggesting that officials and developers must engage with nonprofits and community leaders to ensure that community needs are met.
In another example, webinar panelist McKenzie Cowlbeck described how the Oklahoma Public Health Association is working to equip public health professionals with the tools and information they need to engage in the policy process. Public health professionals in Oklahoma have faced state efforts to roll back public health authority since 2020. In response, the Oklahoma Public Health Association provided education on the role of policy in shaping health outcomes. Specifically, Cowlbeck and her team created a legislative tracking tool and a Policy 101 series to make policy know-how more accessible to the organization’s membership of more than 1,000 people.
Related resource: Improving Social Determinants of Health collection
5. Sustained Relationships Create Lasting Change
During the webinar, ChangeLab Solutions’ Tina Ansong discussed the importance of sustained relationships between governments, communities, and other interested parties in removing structural barriers and creating lasting change. She talked about her experience working for the City of Champaign, Illinois, which embraced projects such as a City Government 101 training course that educated residents on municipal operations; an open public comment process; and creation of the city’s Office of Equity and Engagement, which developed initiatives to support equitable procurement and minority-owned businesses.
Ansong also shared that neighborhood groups in Champaign built relationships with city staff for help in tackling local challenges — for example, addressing illegal dumping by obtaining small grants for community cleanups. Many of these efforts were not tied to specific projects or comprehensive plans, demonstrating how relationships alone can help build the capacity of communities to create change at the local level.
“These types of efforts hint at the mutual respect and shared decision-making element of inclusive community engagement,” Ansong said. “And this is a big deal for a community of its size, and one that had a long history of structural racism that is still quite obvious today.”
Related resource: Planning collection
Accelerating Policy Change: Join Us for Upcoming Events
We had 1,351 registrants for Accelerating Policy Change: The Power of Local & State Solutions, representing all 50 US states. We found that 95% of attendees who filled out the exit survey reported satisfaction with the webinar, and 60% reported that they were “highly satisfied.” In addition, after the webinar, 96% of respondents agreed or strongly agreed that they were “interested in working with partners to implement better laws and policies in [their] community.”
“In this rapidly changing health policy environment, ChangeLab Solutions is such a vital resource for public health leaders. Don't miss this!” ―Richard Vezina, senior program officer, Blue Shield of California Foundation
Coming soon:
- The second webinar in our Accelerating Policy Change series will cover healthy food systems. Stay tuned!
- Our first regional in-person convening in the Accelerating Policy Change series will take place on Wednesday, April 23, 2025, in Fresno, California. Registration details will be released next week! We hope you’ll join us.
Support Accelerating Policy Change! We have sponsorship opportunities at many levels. Learn more about how to become a sponsor.
This project was made possible in part by support from The Kresge Foundation. We also thank our event sponsor TDE Consulting Group.
3/13/2025