Community Experiments in Public Health Law and Policy Angela K. McGowan, Gretchen G. Musicant, Sharonda R. Williams, and Virginia R. Niehaus
Introduction Community-level legal and policy innovations or “experiments” can be important levers to improve health. States and localities are empowered through the 10th Amendment of the United States Constitution to use their police powers to protect the health and welfare of the public.1 Many legal and policy tools are available, including: the power to tax and spend; regulation; mandated education or disclosure of information, modifying the environment — whether built or natural (e.g., zoning, clean water laws); and indirect regulation (e.g., court rulings, or deregulation).2 These legal and policy interventions can be targeted to specific needs at the community level and are often relatively low-cost, but high impact interventions. As every community is different, effective laws and policies will vary. This freedom allows states and localities to, as Justice Louis Brandeis argued, truly serve as “laboratories of democracy.”3 To improve the health of a community in the 21st century, we must go beyond traditional health care approaches and work with new partners and sectors. The County Health Rankings4 initiative is a resource that shows the breadth of factors that influence health and provides data to allow counties to begin to assess their overall health (see Figure 1). Health behaviors, social and economic factors, and environmental factors all impact a county’s score and ranking within its
state. Counties with the strongest health care systems and resources often are not the healthiest overall. To assist in building a culture of health in our nation,5 the Robert Wood Johnson Foundation (RWJF) honors communities addressing health by focusing not solely on health care access and quality, but the wider environment, including transforming neighborhoods, schools, and businesses, and addressing inequities. In 2013, the RWJF Roadmaps to Health Prize (now the Culture of Health Prize)6 was first awarded to six communities, including Minneapolis and New Orleans. Prize winners approached health from a broad perspective and, similar to the County Health Rankings, focused on addressing social and economic factors. These prize winners committed to sustainable changes and policy-oriented solutions, shared a belief in the importance of equal opportunity, leveraged efforts from leaders, partners and community members, used resources wisely, and measured and shared results.
Examples from Minneapolis and New Orleans This article describes examples of how Minneapolis and New Orleans are using innovative public health legal and policy approaches and novel partnerships to promote healthy eating and active living, reduce exposure to secondhand smoke, and prevent violence.
Angela K. McGowan, J.D., M.P.H., organized this session as a result of her position as a Senior Program Officer with the Robert Wood Johnson Foundation. She is now a Program Director and Centers for Disease Control and Prevention assignee to the Office of Disease Prevention and Health Promotion at the U.S. Department of Health and Human Services. Gretchen G. Musicant, M.P.H., is the Commissioner of Health at the Minneapolis Health Department. Sharonda R. Williams, J.D., is the City Attorney for the City of New Orleans. Virginia R. Niehaus, J.D., M.P.H., is a Public Health Law Fellow in the Robert Wood Johnson Foundation and Network for Public Health Law Visiting Attorney Program with the City of New Orleans Health and Law Departments.
10
journal of law, medicine & ethics
McGowan, Musicant, Williams, and Niehaus
The City of Minneapolis is a leader in healthy living. The Minneapolis Health Department (MHD) has led initiatives to improve access to healthy food, increase opportunities for physical activity, reduce exposure to secondhand smoke, and address youth violence. It utilizes a multilayered approach to making healthy living easier.
The City of New Orleans and the New Orleans Health Department (NOHD) have gone through significant transformation since Hurricane Katrina in 2005. NOHD transitioned its focus from providing primary care services to assessing and improving population-based health. The City launched a number of initiatives to improve population health, including
To assist in building a culture of health in our nation, the Robert Wood Johnson Foundation (RWJF) honors communities addressing health by focusing not solely on health care access and quality, but the wider environment, including transforming neighborhoods, schools, and businesses, and addressing inequities. In 2013, the RWJF Roadmaps to Health Prize (now the Culture of Health Prize) was first awarded to six communities, including Minneapolis and New Orleans. Prize winners approached health from a broad perspective and, similar to the County Health Rankings, focused on addressing social and economic factors. These prize winners committed to sustainable changes and policy-oriented solutions, shared a belief in the importance of equal opportunity, leveraged efforts from leaders, partners and community members, used resources wisely, and measured and shared results.
Figure 1 The County Health Rankings and Roadmaps Model
Fit NOLA and NOLA for Life. In June 2014, NOHD received national accreditation from the Public Health Accreditation Board. Healthy Eating and Active Living More than one-third of adults and 17% of children in the United States are obese, which can lead to heart disease, stroke, type 2 diabetes, and cancer.7 It is critically important for communities to take action to encourage healthy eating and physical activity. Minneapolis and New Orleans are leaders in this area. minneapolis Through a community engagement process in 2008, it became evident that the Minneapolis Comprehensive Plan did not adequately support the demand for more farmers markets, community gardens, local food processing, and urban farming. MHD supported staff within the planning department to write an Urban Agriculture Plan that sets a framework for agriculture as an urban land use. The City Council adopted the plan and updated zoning codes to ease the way for urban agriculture. The City also formed a food council to make ongoing recommendations to the Mayor and City Council.
2014 public health law conference: intersection of law, policy and prevention • spring 2014
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In 2008, policymakers considered local ordinance changes for corner stores born out of a concern that some were magnets for criminal activities and most stocked few healthy foods. The staple foods ordinance requires a minimum amount of staple foods, such as eggs and perishable produce.8 After a 2009 assessment indicated poor compliance with the ordinance, MHD initiated the “Healthy Corner Store Program” to provide food safety and handling training, store enhancements, produce procurement options, and customer engagement. This combination of policy and technical assistance has resulted in increases of produce sales at participating stores.9 In 2014, the City Council amended the ordinance to enhance the quantity, variety, and quality of food in stores that accept federal food assistance payment, including large gas stations, dollar stores, and pharmacies. MHD will provide coaching and assistance in 2015 before the ordinance goes into effect in 2016. new orleans In 2011, New Orleans joined First Lady Michelle Obama’s Let’s Move! campaign to end childhood obesity within one generation. In 2012, Mayor Landrieu launched Fit NOLA to improve the physical and nutritional fitness of those who live, learn, work, and play in New Orleans. Fit NOLA operates under a collective impact model, in which NOHD coordinates a partnership of over 190 organizations working toward the shared goal of becoming one of the top 10 fittest cities in the U.S. by 2018, the City’s 300th anniversary, through increasing access to fitness programming, nutritional information, and healthy food.10 As part of the Fit NOLA effort, in 2012 the Blue Cross and Blue Shield Association (BCBSA) and Partnership for a Healthier America (PHA) awarded a Play Streets Grant to develop five recreation events at local parks and playgrounds.11 Similarly, in 2013 the City launched the Fresh Food Retailer Initiative, a financing program to increase the number of fresh food markets in low-income, underserved communities. Retailers can apply for forgivable and low-interest loans to establish stores that offer affordable, healthy foods in these areas.12 An example is Jack and Jake’s, a fresh food market that received assistance under the initiative. It is slated to open in spring 2015 in Central City, a neighborhood where life expectancy averages 66.3 years and 42% of the population lives in poverty.13 In 2014, NOHD conducted a Health Impact Assessment (HIA)14 on this store to gather information on the types of food and programming the store should offer to best serve and maximize health benefits for residents of Central City. This was
12
the first documented HIA in the state of Louisiana. A full report on the HIA is forthcoming in early 2015. Exposure to Secondhand Smoke Smoking is the leading preventable cause of premature death and disease in the United States. Exposure to secondhand smoke is responsible for nearly 42,000 deaths each year, most of which are due to heart disease and lung cancer.15 Minneapolis and New Orleans are working to reduce exposure to secondhand smoke. minneapolis In 42 high-rise apartment buildings of the Minneapolis Public Housing Authority, smoking was previously prohibited in common areas, but allowed in the 5,000 apartments. In 2008, MHD approached the building management and resident councils to pursue a smoke-free policy. Motivated by significant smoking rates among its elderly and disabled residents, high maintenance costs associated with smoking, and national pressure for public housing to be smoke-free, the housing authority adopted a smoke free policy in 2011. MHD and community organizations supported implementation by educating residents in multiple languages and linking them to cessation services. Thirty-seven of the buildings are now smoke-free. An initial evaluation by Hennepin County indicates significant reduction in smoking and secondhand smoke exposure. In 2013, the Minneapolis Youth Congress also worked with MHD to evaluate youth tobacco use. They studied tobacco trends and strategies, collected stories, opinions, and data, and developed policy recommendations. In 2014, the City Council adopted an ordinance based on their recommendation that Clean Indoor Air laws should prohibit e-cigarette use in the same places as cigarette smoking.16 new orleans In January 2015, the New Orleans City Council unanimously passed and Mayor Landrieu signed into law a new, comprehensive smoke free ordinance.17 The city’s former ordinance was superseded by state law in 2007. State law prohibits smoking in many public places, but does not prohibit smoking in standalone bars, gambling facilities, or outdoor locations.18 Effective April 22, 2015, the new ordinance bans smoking in bars, casinos, and other gambling facilities, and a number of outdoor places, including outdoor workplaces. It also prohibits electronic smoking devices in places where smoking is prohibited. The Mayor’s Office, NOHD, and Law Department are now collaborating with the City Council on implementation, including education and enforcement efforts. journal of law, medicine & ethics
McGowan, Musicant, Williams, and Niehaus
The enactment of this ordinance was made possible, in part, by momentum in the community for change. As of June 2014, nearly one-in-five bars in New Orleans were voluntarily smoke-free.19 State law required public post-secondary education institutions to develop and implement smoke-free policies by August 1, 2014.20 However, the majority of public and private institutions decided to go not just smoke-free, but tobacco-free.
Conclusion
Violence Prevention Initiatives minneapolis In 2006, Minneapolis, grappling with a rise in youth violence, responded by taking a public health approach and creating a multiyear action plan, the Minneapolis Blueprint for Action to Prevent Youth Violence.21 An Executive Committee co-chaired by Mayor R.T. Rybak was established to oversee implementation and address primary, secondary, and tertiary prevention. As a result, the city forged closer relationships with schools, sponsored pop-up parks in high crime areas, created jobs programs for gang affiliated youth, sponsored parenting education for parents of teens, and supported enactment of a state Youth Violence Prevention Act. This has resulted in a 60% reduction in juveniles involved in violent crime between 2006 and 2013.22
References
new orleans New Orleans has long struggled with one of the nation’s worst murder rates, with 174 murders in 2009.23 In 2012, Mayor Landrieu launched NOLA for Life, a cutting edge comprehensive murder reduction strategy, as a top priority. Under this initiative, the City doubled available summer jobs for youth, partnered with local organizations to offer job training and placement services, held events to interrupt violence and connect individuals with services, worked with the community to clean-up crime hot spots, expanded the homicide unit, and established a Multi-Agency Gang Unit. In 2013 overall crime and murder in New Orleans were down.24 To date, the NOPD-led Multi-Agency Gang Unit has indicted 100 individuals, and 1000 young people, ages 16-30, have competed for over 300 available jobs and participated in job readiness boot camps.25 NOLA for Life continues to grow. In November 2014 Mayor Landrieu announced the NOLA for Life Mentoring Initiative to provide guidance and support to 15-18-year-old males in New Orleans most at risk of becoming involved in violence.26
As we work towards a healthier nation, sharing lessons and successes from communities around the country is crucial. These success stories from Minneapolis and New Orleans demonstrate the impact that fostering new partnerships and collaborations and using law and policy in innovative ways can have on the fight to address social determinants of health and build a culture of health in our communities. 1. U.S. Const., amend. X; Jacobson v. Massachusetts, 197 U.S. 11 (1905). 2. Institute of Medicine, For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges (Washington, D.C.: The National Academies Press, 2011): at 58. 3. New State Ice Co. v. Liebmann, 285 U.S. 262 (1932) (“a single courageous State may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country...”). 4. University of Wisconsin Population Health Institute, “County Health Rankings,” available at (last visited January 28, 2015). 5. Robert Wood Johnson Foundation, “Building a Culture of Health, 2014 President’s Message,” available at (last accessed January 28, 2015). 6. University of Wisconsin Population Health Institute, “RWJF Culture of Health Prize,” available at (last visited January 28, 2015). 7. C. L. Ogden, M. D. Carroll, B. K. Kit, and K. M. Flegal, “Prevalence of Childhood and Adult Obesity in the United States, 20112012,” JAMA 31, no. 8 (2014): 806-814, available at (last visited January 28, 2015); Centers for Disease Control and Prevention, “Adult Obesity Facts,” available at (last visited January 28, 2015). 8. Title 10, Chapter 203.20 of the Minneapolis Code of Ordinances. 9. Minneapolis Health Department, Testing an Evaluation Model for Assessing the Efficacy of the Minneapolis Healthy Corner Store Program (September 2013), available at (last visited January 28, 2015). 10. City of New Orleans, Fit NOLA, available at (last updated January 28, 2015). 11. City of New Orleans, City of New Orleans Awarded Blue Cross Blue Shield Partnership for a Healthier America Play Streets Grant, Press Release, November 14, 2012, available at (last visited January 28, 2015). 12. City of New Orleans, “Fresh Food Retailers Initiative,” available at (last updated January 28, 2015); City of New Orleans, Mayor Landrieu Announces Fresh Food Retailer Initiative Loan to Project to Redevelop Schwegmann’s Site, Press Release, February 14, 2013, available at (last visited January 28, 2015). 13. Joint Center for Political and Economic Studies, Orleans Parish Place Matters Team, Center on Human Needs at Virginia Commonwealth University, Virginia Network for Geospatial Health Research, Place Matters for Health in Orleans Parish:
2014 public health law conference: intersection of law, policy and prevention • spring 2014
13
JL ME SUPPLEMENT Ensuring Opportunities for Good Health for All, A Report on Health Inequities in Orleans Parish, Louisiana (June 2012), available at (last visited January 28, 2015); The Data Center, “Central City Statistical Area,” available at last visited January 28, 2015). 14. Human Impact Partners, Health Impact Assessment Fact Sheet, available at (last visited January 28, 2015). 15. Office of the Surgeon General, Public Health Service, U.S. Department of Health and Human Services, The Health Consequences of Smoking – 50 Years of Progress (2014), available at (last visited January 28, 2015). 16. Title 11, Chapter 234 of the Minneapolis Code of Ordinances. 17. Article II, Chapter 66 of the New Orleans City Code. 18. 2006 La. Acts 815 (effective Jan. 1, 2007); La. Rev. Stat. Ann. §§ 40:1300.251–1300.263. 19. Healthier Air for All, Smoke-Free Venues, available at (lasted visited January 28, 2015). 20. 2013 La. Acts 211; La. Rev. Stat. Ann. § 40:1300.263. 21. City of Minneapolis, Minneapolis Blueprint for Action to Prevent Youth Violence (August 2013), available at (last visited January 28, 2015). 22. Results Minneapolis: Youth Violence Prevention (October 22, 2014), available at (last visited January 28, 2015). 23. B. McCarthy, “New Orleans Murder Rate Remains Highest in the Nation,” Times Picayune, May 24, 2010, available at (last visited January 28, 2015). 24. City of New Orleans, NOLA for Life: Comprehensive Murder Reduction Strategy (September 2013), available at (last visited January 28, 2015). 25. City of New Orleans, “NOLA for Life,” available at (last visited January 28, 2015). 26. City of New Orleans, Mayor Landrieu Announces NOLA for Life Mentoring Initiative, Press Release, November 21, 2014, available at (last visited January 28, 2015).
journal of law, medicine & ethics
Introduction Community-level legal and policy innovations or “experiments” can be important levers to improve health. States and localities are empowered through the 10th Amendment of the United States Constitution to use their police powers to protect the health and welfare of the public.1 Many legal and policy tools are available, including: the power to tax and spend; regulation; mandated education or disclosure of information, modifying the environment — whether built or natural (e.g., zoning, clean water laws); and indirect regulation (e.g., court rulings, or deregulation).2 These legal and policy interventions can be targeted to specific needs at the community level and are often relatively low-cost, but high impact interventions. As every community is different, effective laws and policies will vary. This freedom allows states and localities to, as Justice Louis Brandeis argued, truly serve as “laboratories of democracy.”3 To improve the health of a community in the 21st century, we must go beyond traditional health care approaches and work with new partners and sectors. The County Health Rankings4 initiative is a resource that shows the breadth of factors that influence health and provides data to allow counties to begin to assess their overall health (see Figure 1). Health behaviors, social and economic factors, and environmental factors all impact a county’s score and ranking within its
state. Counties with the strongest health care systems and resources often are not the healthiest overall. To assist in building a culture of health in our nation,5 the Robert Wood Johnson Foundation (RWJF) honors communities addressing health by focusing not solely on health care access and quality, but the wider environment, including transforming neighborhoods, schools, and businesses, and addressing inequities. In 2013, the RWJF Roadmaps to Health Prize (now the Culture of Health Prize)6 was first awarded to six communities, including Minneapolis and New Orleans. Prize winners approached health from a broad perspective and, similar to the County Health Rankings, focused on addressing social and economic factors. These prize winners committed to sustainable changes and policy-oriented solutions, shared a belief in the importance of equal opportunity, leveraged efforts from leaders, partners and community members, used resources wisely, and measured and shared results.
Examples from Minneapolis and New Orleans This article describes examples of how Minneapolis and New Orleans are using innovative public health legal and policy approaches and novel partnerships to promote healthy eating and active living, reduce exposure to secondhand smoke, and prevent violence.
Angela K. McGowan, J.D., M.P.H., organized this session as a result of her position as a Senior Program Officer with the Robert Wood Johnson Foundation. She is now a Program Director and Centers for Disease Control and Prevention assignee to the Office of Disease Prevention and Health Promotion at the U.S. Department of Health and Human Services. Gretchen G. Musicant, M.P.H., is the Commissioner of Health at the Minneapolis Health Department. Sharonda R. Williams, J.D., is the City Attorney for the City of New Orleans. Virginia R. Niehaus, J.D., M.P.H., is a Public Health Law Fellow in the Robert Wood Johnson Foundation and Network for Public Health Law Visiting Attorney Program with the City of New Orleans Health and Law Departments.
10
journal of law, medicine & ethics
McGowan, Musicant, Williams, and Niehaus
The City of Minneapolis is a leader in healthy living. The Minneapolis Health Department (MHD) has led initiatives to improve access to healthy food, increase opportunities for physical activity, reduce exposure to secondhand smoke, and address youth violence. It utilizes a multilayered approach to making healthy living easier.
The City of New Orleans and the New Orleans Health Department (NOHD) have gone through significant transformation since Hurricane Katrina in 2005. NOHD transitioned its focus from providing primary care services to assessing and improving population-based health. The City launched a number of initiatives to improve population health, including
To assist in building a culture of health in our nation, the Robert Wood Johnson Foundation (RWJF) honors communities addressing health by focusing not solely on health care access and quality, but the wider environment, including transforming neighborhoods, schools, and businesses, and addressing inequities. In 2013, the RWJF Roadmaps to Health Prize (now the Culture of Health Prize) was first awarded to six communities, including Minneapolis and New Orleans. Prize winners approached health from a broad perspective and, similar to the County Health Rankings, focused on addressing social and economic factors. These prize winners committed to sustainable changes and policy-oriented solutions, shared a belief in the importance of equal opportunity, leveraged efforts from leaders, partners and community members, used resources wisely, and measured and shared results.
Figure 1 The County Health Rankings and Roadmaps Model
Fit NOLA and NOLA for Life. In June 2014, NOHD received national accreditation from the Public Health Accreditation Board. Healthy Eating and Active Living More than one-third of adults and 17% of children in the United States are obese, which can lead to heart disease, stroke, type 2 diabetes, and cancer.7 It is critically important for communities to take action to encourage healthy eating and physical activity. Minneapolis and New Orleans are leaders in this area. minneapolis Through a community engagement process in 2008, it became evident that the Minneapolis Comprehensive Plan did not adequately support the demand for more farmers markets, community gardens, local food processing, and urban farming. MHD supported staff within the planning department to write an Urban Agriculture Plan that sets a framework for agriculture as an urban land use. The City Council adopted the plan and updated zoning codes to ease the way for urban agriculture. The City also formed a food council to make ongoing recommendations to the Mayor and City Council.
2014 public health law conference: intersection of law, policy and prevention • spring 2014
11
JL ME SUPPLEMENT
In 2008, policymakers considered local ordinance changes for corner stores born out of a concern that some were magnets for criminal activities and most stocked few healthy foods. The staple foods ordinance requires a minimum amount of staple foods, such as eggs and perishable produce.8 After a 2009 assessment indicated poor compliance with the ordinance, MHD initiated the “Healthy Corner Store Program” to provide food safety and handling training, store enhancements, produce procurement options, and customer engagement. This combination of policy and technical assistance has resulted in increases of produce sales at participating stores.9 In 2014, the City Council amended the ordinance to enhance the quantity, variety, and quality of food in stores that accept federal food assistance payment, including large gas stations, dollar stores, and pharmacies. MHD will provide coaching and assistance in 2015 before the ordinance goes into effect in 2016. new orleans In 2011, New Orleans joined First Lady Michelle Obama’s Let’s Move! campaign to end childhood obesity within one generation. In 2012, Mayor Landrieu launched Fit NOLA to improve the physical and nutritional fitness of those who live, learn, work, and play in New Orleans. Fit NOLA operates under a collective impact model, in which NOHD coordinates a partnership of over 190 organizations working toward the shared goal of becoming one of the top 10 fittest cities in the U.S. by 2018, the City’s 300th anniversary, through increasing access to fitness programming, nutritional information, and healthy food.10 As part of the Fit NOLA effort, in 2012 the Blue Cross and Blue Shield Association (BCBSA) and Partnership for a Healthier America (PHA) awarded a Play Streets Grant to develop five recreation events at local parks and playgrounds.11 Similarly, in 2013 the City launched the Fresh Food Retailer Initiative, a financing program to increase the number of fresh food markets in low-income, underserved communities. Retailers can apply for forgivable and low-interest loans to establish stores that offer affordable, healthy foods in these areas.12 An example is Jack and Jake’s, a fresh food market that received assistance under the initiative. It is slated to open in spring 2015 in Central City, a neighborhood where life expectancy averages 66.3 years and 42% of the population lives in poverty.13 In 2014, NOHD conducted a Health Impact Assessment (HIA)14 on this store to gather information on the types of food and programming the store should offer to best serve and maximize health benefits for residents of Central City. This was
12
the first documented HIA in the state of Louisiana. A full report on the HIA is forthcoming in early 2015. Exposure to Secondhand Smoke Smoking is the leading preventable cause of premature death and disease in the United States. Exposure to secondhand smoke is responsible for nearly 42,000 deaths each year, most of which are due to heart disease and lung cancer.15 Minneapolis and New Orleans are working to reduce exposure to secondhand smoke. minneapolis In 42 high-rise apartment buildings of the Minneapolis Public Housing Authority, smoking was previously prohibited in common areas, but allowed in the 5,000 apartments. In 2008, MHD approached the building management and resident councils to pursue a smoke-free policy. Motivated by significant smoking rates among its elderly and disabled residents, high maintenance costs associated with smoking, and national pressure for public housing to be smoke-free, the housing authority adopted a smoke free policy in 2011. MHD and community organizations supported implementation by educating residents in multiple languages and linking them to cessation services. Thirty-seven of the buildings are now smoke-free. An initial evaluation by Hennepin County indicates significant reduction in smoking and secondhand smoke exposure. In 2013, the Minneapolis Youth Congress also worked with MHD to evaluate youth tobacco use. They studied tobacco trends and strategies, collected stories, opinions, and data, and developed policy recommendations. In 2014, the City Council adopted an ordinance based on their recommendation that Clean Indoor Air laws should prohibit e-cigarette use in the same places as cigarette smoking.16 new orleans In January 2015, the New Orleans City Council unanimously passed and Mayor Landrieu signed into law a new, comprehensive smoke free ordinance.17 The city’s former ordinance was superseded by state law in 2007. State law prohibits smoking in many public places, but does not prohibit smoking in standalone bars, gambling facilities, or outdoor locations.18 Effective April 22, 2015, the new ordinance bans smoking in bars, casinos, and other gambling facilities, and a number of outdoor places, including outdoor workplaces. It also prohibits electronic smoking devices in places where smoking is prohibited. The Mayor’s Office, NOHD, and Law Department are now collaborating with the City Council on implementation, including education and enforcement efforts. journal of law, medicine & ethics
McGowan, Musicant, Williams, and Niehaus
The enactment of this ordinance was made possible, in part, by momentum in the community for change. As of June 2014, nearly one-in-five bars in New Orleans were voluntarily smoke-free.19 State law required public post-secondary education institutions to develop and implement smoke-free policies by August 1, 2014.20 However, the majority of public and private institutions decided to go not just smoke-free, but tobacco-free.
Conclusion
Violence Prevention Initiatives minneapolis In 2006, Minneapolis, grappling with a rise in youth violence, responded by taking a public health approach and creating a multiyear action plan, the Minneapolis Blueprint for Action to Prevent Youth Violence.21 An Executive Committee co-chaired by Mayor R.T. Rybak was established to oversee implementation and address primary, secondary, and tertiary prevention. As a result, the city forged closer relationships with schools, sponsored pop-up parks in high crime areas, created jobs programs for gang affiliated youth, sponsored parenting education for parents of teens, and supported enactment of a state Youth Violence Prevention Act. This has resulted in a 60% reduction in juveniles involved in violent crime between 2006 and 2013.22
References
new orleans New Orleans has long struggled with one of the nation’s worst murder rates, with 174 murders in 2009.23 In 2012, Mayor Landrieu launched NOLA for Life, a cutting edge comprehensive murder reduction strategy, as a top priority. Under this initiative, the City doubled available summer jobs for youth, partnered with local organizations to offer job training and placement services, held events to interrupt violence and connect individuals with services, worked with the community to clean-up crime hot spots, expanded the homicide unit, and established a Multi-Agency Gang Unit. In 2013 overall crime and murder in New Orleans were down.24 To date, the NOPD-led Multi-Agency Gang Unit has indicted 100 individuals, and 1000 young people, ages 16-30, have competed for over 300 available jobs and participated in job readiness boot camps.25 NOLA for Life continues to grow. In November 2014 Mayor Landrieu announced the NOLA for Life Mentoring Initiative to provide guidance and support to 15-18-year-old males in New Orleans most at risk of becoming involved in violence.26
As we work towards a healthier nation, sharing lessons and successes from communities around the country is crucial. These success stories from Minneapolis and New Orleans demonstrate the impact that fostering new partnerships and collaborations and using law and policy in innovative ways can have on the fight to address social determinants of health and build a culture of health in our communities. 1. U.S. Const., amend. X; Jacobson v. Massachusetts, 197 U.S. 11 (1905). 2. Institute of Medicine, For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges (Washington, D.C.: The National Academies Press, 2011): at 58. 3. New State Ice Co. v. Liebmann, 285 U.S. 262 (1932) (“a single courageous State may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country...”). 4. University of Wisconsin Population Health Institute, “County Health Rankings,” available at (last visited January 28, 2015). 5. Robert Wood Johnson Foundation, “Building a Culture of Health, 2014 President’s Message,” available at (last accessed January 28, 2015). 6. University of Wisconsin Population Health Institute, “RWJF Culture of Health Prize,” available at (last visited January 28, 2015). 7. C. L. Ogden, M. D. Carroll, B. K. Kit, and K. M. Flegal, “Prevalence of Childhood and Adult Obesity in the United States, 20112012,” JAMA 31, no. 8 (2014): 806-814, available at (last visited January 28, 2015); Centers for Disease Control and Prevention, “Adult Obesity Facts,” available at (last visited January 28, 2015). 8. Title 10, Chapter 203.20 of the Minneapolis Code of Ordinances. 9. Minneapolis Health Department, Testing an Evaluation Model for Assessing the Efficacy of the Minneapolis Healthy Corner Store Program (September 2013), available at (last visited January 28, 2015). 10. City of New Orleans, Fit NOLA, available at (last updated January 28, 2015). 11. City of New Orleans, City of New Orleans Awarded Blue Cross Blue Shield Partnership for a Healthier America Play Streets Grant, Press Release, November 14, 2012, available at (last visited January 28, 2015). 12. City of New Orleans, “Fresh Food Retailers Initiative,” available at (last updated January 28, 2015); City of New Orleans, Mayor Landrieu Announces Fresh Food Retailer Initiative Loan to Project to Redevelop Schwegmann’s Site, Press Release, February 14, 2013, available at (last visited January 28, 2015). 13. Joint Center for Political and Economic Studies, Orleans Parish Place Matters Team, Center on Human Needs at Virginia Commonwealth University, Virginia Network for Geospatial Health Research, Place Matters for Health in Orleans Parish:
2014 public health law conference: intersection of law, policy and prevention • spring 2014
13
JL ME SUPPLEMENT Ensuring Opportunities for Good Health for All, A Report on Health Inequities in Orleans Parish, Louisiana (June 2012), available at (last visited January 28, 2015); The Data Center, “Central City Statistical Area,” available at last visited January 28, 2015). 14. Human Impact Partners, Health Impact Assessment Fact Sheet, available at (last visited January 28, 2015). 15. Office of the Surgeon General, Public Health Service, U.S. Department of Health and Human Services, The Health Consequences of Smoking – 50 Years of Progress (2014), available at (last visited January 28, 2015). 16. Title 11, Chapter 234 of the Minneapolis Code of Ordinances. 17. Article II, Chapter 66 of the New Orleans City Code. 18. 2006 La. Acts 815 (effective Jan. 1, 2007); La. Rev. Stat. Ann. §§ 40:1300.251–1300.263. 19. Healthier Air for All, Smoke-Free Venues, available at (lasted visited January 28, 2015). 20. 2013 La. Acts 211; La. Rev. Stat. Ann. § 40:1300.263. 21. City of Minneapolis, Minneapolis Blueprint for Action to Prevent Youth Violence (August 2013), available at (last visited January 28, 2015). 22. Results Minneapolis: Youth Violence Prevention (October 22, 2014), available at (last visited January 28, 2015). 23. B. McCarthy, “New Orleans Murder Rate Remains Highest in the Nation,” Times Picayune, May 24, 2010, available at (last visited January 28, 2015). 24. City of New Orleans, NOLA for Life: Comprehensive Murder Reduction Strategy (September 2013), available at (last visited January 28, 2015). 25. City of New Orleans, “NOLA for Life,” available at (last visited January 28, 2015). 26. City of New Orleans, Mayor Landrieu Announces NOLA for Life Mentoring Initiative, Press Release, November 21, 2014, available at (last visited January 28, 2015).
journal of law, medicine & ethics
