By: Paige Clayton , Derek Jett, Mary Shoemaker
Fulton County’s overall health status is higher than many other counties in Georgia (RWJF, 2013). Unfortunately Fulton’s ranking masks health inequities and disparities within the County, creating problems for policymakers attempting to address health issues in a county consisting of 14 cities and unincorporated areas. Our task was to answer the question: What policy initiative(s) will improve the health of residents in the cities of Georgia’s Fulton County?
Qualitative Comparative Analysis (QCA) was used in order to discern health programs that would have the highest return on investment in each city of Fulton County. This approach utilizes case study and quantitative methods. Profiles of cities comparable to those in Fulton County provided a basis for our case study research. QCA allowed us to determine the types of health programs in the case cities that were associated with overall death rates and heart disease death rates in each city that were lower than the national rates.
With these results we were able to make significant, focused recommendations for the types of programs the cities in each region of Fulton County should pursue to improve their citizens’ health. We recommend that each city of Fulton County establish a volunteer community advisory committee to create a structure for health programs and policies in each city. The committee should work with and use county resources to advance the specific health needs of each city’s constituency. Furthermore we recommend that each city establish regular health assessments so that officials will have accurate information when setting health agendas.
We also recommend more specific program focuses for the cities in each region of Fulton County. The City of Atlanta should focus on programs related to behavioral health issues. The cities of North Fulton should foster and promote partnerships for health that will encourage active living, healthy lifestyles, and an overall culture of health in each city. Finally, the cities of South Fulton should focus on preventive health and mitigating the underlying socioeconomic factors that are associated with poor health outcomes.
These results pointed to three overarching themes important to the health of citizens in each Fulton County city: geographically targeting health issues with the potential for positive spillover, collaboration among community organizations and individuals, and structurally institutionalizing responsibility for city health programs.