MAPP Handbook - The National Association of County and City ...

one entity because of the geographic and ethnic diversity (e.g., people from many
regions of Latin America).
Due to air quality concerns, a group of residents in North Central had already come
together to actively address the health of their community. This group accepted an
invitation to be part of the MAPP initiative. The MAPP committee helped facilitate
their proceedings and provided the necessary statistical information for them to
understand some of the health conditions facing their residents and themselves. The
MAPP committee’s first proposal was that their focus be broadened from air quality to
quality of life. MAPP partners would assist them in addressing issues that arose from
the various assessments. The MAPP Quality of Life tool was modified to reflect the
culture of the neighborhood and to include environmental factors- there were
questions about air, water, land, and infrastructure. Residents were recruited to
complete the survey with a student from a local university. The neighborhood was
divided into 10 areas, and each area was sampled. Health issues identified matched
statistical data: chronic diseases, smoking, and lack of exercise. This neighborhood
moved to an action plan very quickly and wrote for two grants to address heart health
and exercise. Both proposals were funded.
Vignette: Columbus, OH
Residents of North Central participated in a heart health project conducted under the
direction of the American Heart Association and in an exercise program held at
elementary schools and recreation centers. These programs reached over 300
residents. Most participants succeeded in lowering their cholesterol, increasing
exercise times, and eating healthier. Some of the programs have proved sustainable
because aerobics instructors were trained from the neighborhood and they continue
to provide this opportunity after grant completion.
The Local Public Health System Assessment
The MAPP committee decided to approach this phase as a community-wide
assessment. The committee was not able to bring all stakeholders together at one
time to review each standard and indicators. With the involvement of a graduate
student from the Ohio State School of Public Health, the MAPP committee
interviewed 41 stakeholders representing public health professionals, immigrant
community members, business persons, health care providers, educators, insurers,
government leaders, foundations, advocacy groups, faith community leaders,
evaluators, community based organizations, and agencies. The interviews were
designed around the model standards for each indicator. For analysis the
interviewees were divided into three groups: providers, funders, and general public.
Next, the 10 Essential Public Health Services were categorized as Assessment
(monitor, diagnose),Assurance (enforce, link, competent workforce, and evaluate), or
Policy Development (mobilize, inform, develop policy).
Using these broad categories the committee concluded that as a system, Columbus
was doing fairly well in the areas related to Assessment; achieving 60 percent to 80
percent of what is needed and public health is contributing 63 percent to 75 percent of
the investment. The system was not doing as well in the area of Assurance. Sixty
percent of this function was being accomplished and public health contributes 50
percent of the effort. In Policy Development Columbus was at 59 percent of where it
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