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Learning From New York City: A Case Study of Public Health Policy Practice in the Bloomberg Administration

Isett, Kimberley Roussin PhD, MPA; Laugesen, Miriam J. PhD; Cloud, David H. JD, MPH

Journal of Public Health Management and Practice: July/August 2015 - Volume 21 - Issue 4 - p 313–322
doi: 10.1097/PHH.0000000000000225
Original Articles

Objectives: To ascertain any lessons learned about how public health reforms undertaken in New York City during the Bloomberg Administration were shepherded through the public policy and administration gauntlet. The question is, how feasible is this approach and would it work outside of New York City?

Design/Setting/Participants: Using a theoretically grounded case study approach, 3 initiatives were examined that were proposed and/or implemented during a 10-year period of the Mayoralty of Michael Bloomberg (2002-2011): transfats restrictions, clean bus transportation policies, and a sugar-sweetened beverages tax (as a counterfactual). The investigation began by performing a comprehensive public documents search and was followed with interviews of 27 individuals involved in the selected policy initiatives. Interviews were coded in Nvivo using an iterative, grounded methodology.

Results: Using a theoretical lens, the case study illustrates that the multifaceted role of leadership was not confined to the executives in the City or the Agency. Instead, leadership extended to other administrative officials within the agency and the Board of Health. Second, New York City used reorganization and coordinative mechanisms strategically to ensure achievement of their goals. This included creation of new departments/bureaus and coordinating structures across the City. Evidence of the explicit use of incentives, as initially anticipated from the theoretical framework, was not found.

Conclusions: While some aspects of this case study are unique to the context of New York City, 2 approaches used in New York City are feasible for other jurisdictions: harnessing the full scope and breadth of authority of the agency and its associated boards and commissions, and remobilizing existing workforce to explicitly focus on and coordinate targeted policies for issues of concern. Questions for further consideration are posed at the conclusion of the article.

This study aimed to ascertain any lessons learned about how public health reforms undertaken in New York City during the Bloomberg Administration were shepherded through the public policy and administration gauntlet.

Georgia Institute of Technology, School of Public Policy, Atlanta (Dr Isett); and Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York (Dr Laugesen and Mr Cloud).

Correspondence: Kimberley Roussin Isett, PhD, MPA, Georgia Institute of Technology, School of Public Policy, 685 Cherry St, Atlanta, GA 30332 (isett@gatech.edu).

This work was funded by a grant from the Robert Wood Johnson Foundation.

The authors declare no conflicts of interest.

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.