To date, SFHIP has done policy advocacy and provided endorsements and letters of support on issues that impact the identified health priorities. These include:
Alcohol Policy Initiative
SFHIP created an Alcohol Policy Partnership Working Group (APPWG) in order to reduce disparities in alcohol-related harm. APPWG developed a diverse multisector partnership, including community members burdened by high rates of alcohol-related health and safety problems, SFDPH, and SF Police Department. With the help of technology industry nonprofit organizations, the group developed data tools and conducted applied research to inform community organizing and policymaking.
Achievements of the group included the following:
- San Francisco Board of Supervisors issued a policy statement recommending a state ban on the sale of powdered alcohol; the California State Legislature subsequently enacted a ban (2015–2016).
- San Francisco Board of Supervisors passed a resolution calling on the California State Alcoholic Beverage Commission not to issue alcohol licenses to formula retail businesses (Starbucks, Taco Bell) in San Francisco; as a result, the businesses subsequently withdrew their license applications (2015–2016).
- San Francisco Health Improvement Partnership (SFHIP) Alcohol Policy Partnership Working Group established and supported community alcohol policy promotoras to build community capacity to engage in policy implementation, monitoring, and enforcement (2015–2017).
A full description of this initiatives and subsequent initiatives (Children’s Oral Health Initiative and the SSB Initiative) can be found in a published case study by Grumbach et al.
Creating and maintaining partnerships is a vital component of SFHIP’s strategy to enact city-wide changes. As individual organizations, we’re limited in the scope of influence and impact we can have in our communities and city. Developing mutually-reinforcing partnerships and collaborations with organizations who seek to address health equity is required for system-level changes.
Children’s Oral Health Initiative
In order to address the disparities in prevalence of childhood caries, SFHIP developed the Children’s Oral Health Working Group (COHWG). The group partnered with organizations and leaders from various diverse sectors to address this issue, making sure along the way that the strategic plan and direction was community-driven.
Key stakeholders included:
- SFDPH’s oral health division and primary care clinics
- UCSF CTSI and School of Dentistry
- University of the Pacific School of Dentistry
- San Francisco Community Clinic Consortium and its Federally Qualified Community Health Centers
- Health equity coalitions
- San Francisco Dental Society
- Head Start.
The goal of the partnership was to develop and implement a city-wide strategic plan to reduce disparities in children’s oral health.
Achievements of the partnership included:
- Developed a citywide strategic plan written by SFHIP partnership working group and adopted by the San Francisco Health Commission (2013–2015).
- Created a new SFDPH position, Children’s Oral Health Coordinator, with city funding (2016).
- Launched the community-driven Chinatown Children’s Oral Health Task Force, acquiring $250,000 in new city funding for several neighborhood task forces (2016).
- Trained more than 70 primary care medical providers to apply fluoride varnish to children’s teeth (2013–2016).
- Increased the number of clinics providing fluoride varnish at routine well-child visits from 3 to 14 (2013–2017).
- Acquired a waiver from the California Department of Education to allow dental clinics to be paid for dental services delivered in schools, paving the way for local community dental clinics to begin providing sealants and other preventive dental services in San Francisco schools (2016).
Sugar-Sweetened Beverages (SSB) Initiative
At the time in San Francisco, 34% of Black/African American and 24% of Latinx children and adolescents consumed 2 or more sugary beverages per day, compared with 4% of whites. In order to address this disparity, a sugar-sweetened beverages (SSB) initiative was created, led by a working group. The goal of the SSB initiative was to implement public and private policies to reduce consumption of sugary beverages.
This was accomplished by briefing San Francisco policymakers on the science demonstrating adverse health outcomes of SSB consumption and the evidence of effectiveness of regulatory and pricing policies in reducing consumption. In addition, a community participatory research project was conducted in order to identify the attitudes and views towards SSB regulatory and tax policies among low-income neighborhoods, which are the communities most affected by SSB intake and heavily targeted by SSB companies’ marketing.
Achievements of the initiative included:
- Most San Francisco hospitals implemented healthy beverage policies prohibiting serving or sale of SSBs (2015–2017).
- 2 new local SSB ordinances were enacted banning use of San Francisco government funds to purchase SSBs and requiring health warnings on advertisements for SSBs (2015).
- Sugar tax ballot measures were qualified for June 2014 and November 2016 elections; June 2014 ballot measure was defeated by voters but voters passed the November 2016 ballot measure.
- 19 new neighborhood tap water filling stations installed in low-income neighborhoods (2016–2017).
- SFUSD wellness policy was adopted prohibiting sale or serving of SSBs (2016)
- 9 community health workers were trained on SSBs for education campaign in low income and minority neighborhoods (2016).