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Case Study: Learning From New York City Read the case study “Case 4: Learning From New York City: A Case Study of Public Health Policy Practice in the Bloomberg Administration” in your supplemental textbook, JPHMP’s 21 Public Health Case Studies on Policy & Administration. In a 5-6 page paper, answer the questions below: What are the unintended consequences of a top-down approach to public health reform such as that undertaken in NYC? What are the implications for historically underrepresented and marginalized populations? How can mayors (or other executive decision makers) be encouraged to make an impact in public health? How exportable and sustainable are large-scale data infrastructure initiatives for health monitoring and surveillance? Do these systems improve public health decision making, and in what ways? What capabilities are necessary to harness the potential benefits of a data infrastructure? What is the appropriate scope and authority for a board of health? What reforms can small health departments feasibly accomplish with a more limited organizational capacity than NYC? This week, we discussed Dror’s four sets of “variables” for thinking about political feasibility (see the chapter in your textbook, Health Policy Analysis: An Interdisciplinary Approach, titled “The Policy Analysis Process: Evaluation of Political Feasibility”). The main actors—who they are and what they intend. Other inputs into the policy arena—the political climate, the state of the economy, public opinion, technological capabilities, and so forth. The interplay of the first two—how actors come together and interact, taking the other inputs into account. Some actors may ally to form a required coalition with enough combined political leverage to move a policy forward. The threshold for adoption. In the House of Representatives, for example, the threshold for passage is a simple majority, but overriding a presidential veto requires a two-thirds majority. An actor or a coalition may have considerable leverage, but whether it has enough will depend on the threshold that must be met. Consider these variables in the NYC approach to adoption of the public health policy in the case study. Who were the main actors? What was the political climate, state of the economy and public opinion? How did they work together?
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