Public Health Citizen Advisory Boards
by
Ned E. Baker, Marie Fallon
  • LAST REVIEWED: 15 June 2015
  • LAST MODIFIED: 23 February 2011
  • DOI: 10.1093/obo/9780199756797-0016

Introduction

From the earliest colonial days, the citizens of North American colonies banded together to protect their health from the ravages of epidemics. As the colonies became a nation, many local governments called upon their citizens to help them control the spread of disease and improve sanitation. These same governments in the late 18th century began to appoint citizen boards of health to advise them on issues of public health. In the mid-19th century, one of the most notable and extraordinary early documents on public health was published: “Report of the Sanitary Commission of Massachusetts” (Shattuck, et al. 1850, cited under Introductory Works), authored by Lemuel Shattuck, Nathaniel Banks, and Jehiel Abbot. Shattuck, the principal author, was a layman and a legislator appointed to chair a legislative committee to study the health and sanitary problems of the Commonwealth. One of the primary recommendations in this report was to establish a state board of health and to create local citizen boards of health in every community in Massachusetts. In 1876, this report was presented to the International Medical Congress, which endorsed it as a model and guide for the development of modern public health services in the country. Today, public health relies on the strength and involvement of the citizen constituency it serves. In nearly every state, boards of health, public health councils, or similar bodies provide governance for local health departments, establish public health policies, or advise public health policy makers. Most boards of health are governing and/or policy making bodies. Those boards of health that are only advisory still have the vital role of providing input and advice to policy makers and health officials. All types of boards of health can appoint citizen advisory committees to further address public health needs and actions. Citizen advisory boards and committees provide the community engagement needed to translate science into practice that results in desired public health outcomes. While more than 20,000 US citizens serve on official boards of health, many other community citizens are involved on sub-boards or committees providing advice to the boards of health, other governing bodies, or public health officials. Most boards of health and health officials utilize advisory groups of citizens on either a permanent or ad hoc basis to assist in conducting community health assessments and developing programs to deal with health concerns related to such issues as tobacco use, second-hand smoke, and obesity. Many program directors, such as directors of public health nursing and environmental health, utilize citizen advisory groups to advise them on their specific programs. Public health is a community affair involving citizens and stakeholders from the community to enhance the effectiveness of public health programs by establishing partnerships.

Introductory Works

Citizen advisory boards of health provide guidance and input for governmental public health departments and agencies. Early health departments were established in colonial North America before the end of the Revolutionary War. Paul Revere assembled several interested and influential citizens of Boston who formed one the first local boards of health. The board provided input to the Boston Health Department. Other cities and municipalities followed Boston’s example, believing that involving the citizens in solving the community’s problems was critical to successful public health outcomes. Recognizing the effectiveness of local boards, similar boards were organized at the state level. The legal authorities and responsibilities for boards of health are defined in each state’s statutes, ranging from advisory to policy and governing roles. Because state constitutions differ, the roles and responsibilities of public health boards vary from state to state. Baker 2001 provides an overview of citizen advisory boards of health. Citrin 2001 addresses relationships between health boards and communities. Shattuck 1850 provides an assessment of the population and living conditions in Boston in the mid-19th century. It is, in many ways, a forerunner to these other works.

  • Baker, N. E. 2001 Boards of health. In Encyclopedia of public health.

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    Definition and description of citizen advisory boards of health.

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    • Citrin, Toby. 2001. Enhancing public health research and learning through community-academic partnerships. Public Health Reports 116.1: 74–78.

      DOI: 10.1093/phr/116.1.74Save Citation »Export Citation »E-mail Citation »

      This article is written by an expert in health board composition and activities. The author describes the importance of partnerships and how they contribute to the success of health boards and public health outcomes.

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      • Fallon, L. Fleming, and Eric Zgodzinski. 2009. Essentials of public health management, 2d ed. Sudbury, MA: Jones and Bartlett.

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        Chapter 17 provides an introduction to boards of health. Their roles are delineated and the various types of boards are described. The author has served on a local health board for several years.

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        • Shattuck, Lemuel, Nathaniel Banks, and Jehiel Abbot. 1850. Report of a general plan for the promotion of public and personal health.

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          This work is a comprehensive census assessment of the city of Boston in the mid-19th century, a landmark in statistical census data and its contribution to public health. It includes twenty-two sections on various features of Boston’s population and living conditions, including birthplace, water supply, education, health, occupation, wealth, marriages, and deaths.

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          Roles and Responsibilities

          The roles and responsibilities of public health advisory boards are defined in state constitutions, and no two states have identical definitions. Nicola 2005 urges board of health members to take their duties and responsibilities seriously, whether these are advisory, governing, or policymaking. O’Conner and Gates 2000 focuses on the contributions that boards of health make to their communities.

          • Nicola, Ray M. 2005. Boards of health give citizens a voice. Transformations in Public Health 5.3: 1–4.

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            Editorial provides the perspective of a member of a large metropolitan board of health. The author urges board of health members to take their responsibilities seriously and to strive to continually update and improve their knowledge of local public health needs.

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            • O’Connor, Drew, and Christopher T. Gates. 2000. Toward a healthy democracy. Public Health Reports 115.2–3: 157–160.

              DOI: 10.1093/phr/115.2.157Save Citation »Export Citation »E-mail Citation »

              Discusses the Healthy Communities movement as a collaborative, citizen-based effort of civic renewal. Building communities and relationships is a critical component. Quality-of-life outcomes are a challenge to track and measure, but nonetheless a central theme of their work.

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              Statutory Authority

                The responsibilities of public health advisory boards are defined in state constitutions. Depending on the date of the most recent revision, the responsibilities of the board may be current or may be in need of revisions to serve public health in the 21st century. National Association of Local Boards of Health 2008 provides a comprehensive list of relevant statutes for public health governance state by state.

              • National Association of Local Boards of Health. 2008. State statutory authority for local boards of health. Bowling Green, OH: National Association of Local Boards of Health.

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                Provides an executive summary and a state-by-state review of public health governance statutes for local boards of health. Each state statute is unique. Topics covered include board jurisdiction, appointing authority, terms of office, composition, role, powers, duties, compensation, budget oversight, and limitation of powers.

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                Partnerships and Community Engagement

                  Partnerships between health departments and communities are a critical component in the success of agency programs. Public health advisory boards provide input from the community to the health department and from the health department to the community. Blackwell and Colemenar 2000 discusses how to create partnerships. Boyle 1997 comments on how partnerships influence the communities in which they operate. Conway, et al. 1997 reminds readers of the importance of establishing priorities for partnerships. Frankish, et al. 2002 addresses citizen participation in large regional organizations. Hatcher and Nicola 2000 discusses how to build partnerships. Ramiro, et al. 2001 reviews community participation patterns in the Philippines. Scutchfield, et al. 2006 reviews reasons why organizations form links with members of communities. Sherer 1998 comments on board membership. Weech-Maldonado and Merrill 2000 discusses how to build community partnerships. Williams, et al. 2005 discusses obesity and how deliberation can be used as a tool to affect outcomes.

                • Blackwell, A. G., and Raymond Colemenar. 2000. Community-building: From local wisdom to public policy. Public Health Reports 115.2–3: 161–166.

                  DOI: 10.1093/phr/115.2.161Save Citation »Export Citation »E-mail Citation »

                  Article oriented to building communities. Authors provide suggestions and arguments for integrating efforts to build communities and establish policies to support improved outcomes.

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                  • Boyle, Phillip. 1997. Participation in neighborhood governance and its influence on sense of community, capacity, and legitimacy. PhD diss., Univ. of Colorado at Denver.

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                    A doctoral dissertation examining the effect of participation in neighborhood associations and how it affects citizens’ sense of capacity, community, and legitimacy. A conceptual framework based on participatory democracy and democratic governance theory is used. Findings suggest that the process of governance in governmental and nongovernmental settings should be a concern of public administration.

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                    • Conway, Terrence, Tzyy-Chyn Hu, and Terrill Harrington. 1997. Setting health priorities: Community boards accurately reflect the preferences of the community’s residents. Journal of Community Health 22.1: 57–68.

                      DOI: 10.1023/A:1025198924501Save Citation »Export Citation »E-mail Citation »

                      Authors address the importance of establishing priorities that are relevant to the people who will be affected by them. As board priorities are more closely aligned with the needs of community members, the probability for success of the programs increases.

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                      • Frankish, C. J., Brenda Kwan, Pamela A. Ratner, Joan Wharf Higgins, and Craig Larsen. 2002. Challenges of citizen participation in regional health authorities. Social Science & Medicine 54.10: 1471–1480.

                        DOI: 10.1016/S0277-9536(01)00135-6Save Citation »Export Citation »E-mail Citation »

                        Explores issues related to citizen participation in large, regional organizations. Potential problems include board membership by a representative sample of people; integrating a large number of organizations, each having a number of programs; reconciling differences in organizational backgrounds and policies; and evaluating the results of new regional programs.

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                        • Hatcher, M. T., and Ray M. Nicola. 2000. Building constituencies for public health. Journal of Public Health Management and Practice 6.2: 510–520.

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                          Discusses establishing effective relationships with those involved in or affected by public health issues. Constituency-building activities are linked to community health improvement using various processes and strategies.

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                          • Ramiro, L. S., Fatima A. Castillo, Tessa Tan-Torres, Christina E. Torres, Josefina G. Tayag, Rolando G. Talampas, and Laura Hawken. 2001. Community participation in local health boards in a decentralized setting: Cases from Philippines. Health Policy and Planning 16.2: 61–69.

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                            Discusses the benefits associated with community participation in local boards of health in the Philippines, which have duties remarkably similar to those of American boards of health.

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                            • Scutchfield, F. D., L. Hall, and C. L. Ireson. 2006. The public and public health organizations: Issues for community engagement in public health. Health Policy 77.1: 76–85.

                              DOI: 10.1016/j.healthpol.2005.07.021Save Citation »Export Citation »E-mail Citation »

                              Discusses the critical role that public health organizations have in promoting community deliberation. Several assessment programs are mentioned as models for community health improvement. CEOs of eight national public health constituent organizations were interviewed to gauge their understanding and awareness of public deliberation.

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                              • Sherer, Jill L. 1998. Preventing board-community disconnect. Healthcare Executive 13.5: 6–11.

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                                Discusses issues related to board members and the communities served by their organization’s programs. The author provides a number of warning signs of problems and gives suggestions for addressing them proactively.

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                                • Weech-Maldonado, Robert, and Sonya B. Merrill. 2000. Building partnerships with the community: Lessons from the Camden Health Improvement Learning Collaborative. Journal of Healthcare Management 45.3: 189–205.

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                                  A case study on the subject of building community partnerships. Authors provide a methodology and then use it as the framework for the discussion. Conclusion includes lessons learned.

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                                  • Williams, S., Bonnie Braun, Jan Hartough, Stephanie Grutzmacher, and Sarah Kaye. 2005. Infusing deliberation into a professional association’s culture: Naming and framing obesity as a public issue. Washington, DC: American Association of Family & Consumer Sciences.

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                                    A monograph presented to the Kettering Foundation summarizes historic and contemporary work and work group findings related to naming and framing obesity. Community engagement and public policy are discussed.

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