Strategic Plan

December 2021



Healthy, more equitable communities through big city innovation and leadership 


Advancing equity and health for present and future generations, through sharing of best practices, leadership, and advocacy 

Guiding Principles

As members respond to the COVID-19 pandemic, work toward an equitable recovery for all, and aim to address long standing structural barriers to achieving health and equity in our communities, it is critically important in this moment to harness the power of collective voice, increase organizational capacity and putting in place a strong and well-resourced infrastructure for the future.  

Coalition members and staff work together to: 

  • Elevate the visibility, understanding, and value of governmental public health that is anchored in science and, at its core, focused on prevention; 
  • Foster strong collaboration between big city health departments; 
  • Provide leadership and expertise on complex, shared challenges, in particular social determinants – education, income, access to care, housing, and others – to work toward a comprehensive definition of “good health;” and 
  • Provide a unified voice on policy matters and takes advantage of advocacy opportunities primarily at the national level.  

Purpose Statement

The Big Cities Health Coalition (BCHC) is a forum for the leaders of America’s largest metropolitan health departments in the country’s most urban areas. Cities are critically important – both here and abroad – and have a unique ability to impact the health of large numbers of people. Local government agencies are also more likely to be able to move nimbly and are home to many of today’s innovative practices and achievements. BCHC members exchange strategies and jointly promote and protect the nation’s health and safety to help foster a healthier America. 


The overarching goals of the Coalition are to: 

  1. Create, promote, and disseminate innovative best/promising policies and practices for member health departments and others addressing shared urban health challenges. 
  1. Provide shared value to BCHC membership to improve local health department infrastructure, build a strong organization that is a resource to members, and foster leadership development. 
  1. Advocate, primarily at the national level, for policies and funding to protect and improve the health of urban America. 

Background & History

BCHC was founded in 2002 by Dr. Thomas Frieden, as Commissioner of the New York City Department of Health and Mental Hygiene, and Dr. Jonathan Fielding, Director of Public Health and the Health Officer at the Los Angeles County Department of Public Health. The Coalition was created to provide leaders of big city health departments with a core network of peers facing similar challenges and experiences.   

In 2021, BCHC is funded by de Beaumont Foundation, CDC Foundation, Kellogg Foundation, Kresge Foundation, and Robert Wood Johnson Foundation, which accounts for approximately two-thirds of its operating budget. BCHC also has project-based funding from the CDC, and members pay dues to supplement foundation and federal government funding, which provides for “unrestricted” revenue.

Members & Staff

BCHC membership is comprised of the lead health official, generally either the health department director or jurisdiction’s health officer. To be eligible for membership in BCHC, a health department must serve a city with a (city) population of at least 500,000 and be locally controlled, not a state agency. These criteria were adopted by consensus in January 2015 and subsequently amended in July 2017 and October 2021. Note all members that were in good standing (i.e. active participants and current on dues) each time eligibility was amended have been grandfathered in even if they did not fully meet updated criteria.   

The most up-to-date membership list can be found on our website


Elected leadership of the Coalition consists of a Chair, a Chair-Elect, and a Vice Chair, with each serving a one-year term in each position. At the conclusion of the Chair-Elect’s term, he or she will assume the position of Chair for one year. Similarly, the Vice Chair will assume the role of Chair-Elect for one year. Each member jurisdiction has one vote in each election. Elections for the Vice Chair are held in December of each calendar year with new leadership assuming office in January.  

The BCHC Executive Committee (EC) consists of the BCHC Chair, Chair-Elect, and Vice Chair, as well as the BCHC Executive Director. The EC has the authority to make decisions on behalf of the Coalition when time is of the essence. 

Objectives by Strategic Goal

Goal 1: Create, promote, and disseminate innovative best and/or promising policies and practices for member health departments and others addressing shared urban health challenges 

  • Objective 1: Develop and promote an Urban Health Agenda meant to advance a shared, actionable vision for transforming urban health 
  • Objective 2: Work to build more Safer, Empower, and ultimately, More Resilient Communities through big city thought leadership and collective action in this space 
  • Objective 3: Work to fill gaps on Substance Use Disorder (SUD) policy and practice in big city health departments 
  • Objective 4: Continue to monitor Tobacco Regulation at the national (and local) level(s) to prevent additional use/initiation 
  • Objective 5: Continue to support members in COVID-19 response/recovery efforts through information sharing, TA, and liaising with federal/state/other partners 
  • Objective 6: Ensure Big Cities Health Inventory Data Platform is a resource to members and the field at large in pursuit of quality, timely, and actionable data at the city level 
  • Objective 7: Facilitate fielding of PH WINS with all BCHC HDs to gather data about the public health workforce, understand strengths and gaps, and informs future development efforts. 
  • Objective 8: Facilitate gathering of BCHC member data for CSTE’s Epidemiology Capacity Assessment to describe and support the epi landscape in big cities 

Goal 2: Provide shared value to BCHC membership to improve local health department infrastructure, build a strong organization that is a resource to members, and foster leadership development. 

  • Objective 1: Facilitate routine, but necessary communication(s) among and between membership through: Monthly Calls, In-person/Virtual Meetings, YourMembership (YM) On-line Interface, Friday Email, and On Boarding of New Members 
  • Objective 2: Manage and develop routine and emerging relationships with: Partners, Funders, and Members 
  • Objective 3: Help to build the workforce pipeline through Convening a Senior Deputies Cohort, Leveraging Recent BCHC Alumni, and Other Opportunities As they Arise/Are Needed 

Goal 3: Advocate, primarily at the national level, for policies and funding to protect and improve the health of urban America. 

  • Objective 1: Engage in advocacy on behalf of members and the field at large through strategic engagement with the: Legislative Branch (U.S. Congress), Executive Branch (Biden Administration), and Judicial Branch (Federal Courts) 
  • Objective 2: Engage in robust strategic communications activities to position BCHC members (and the organization as a whole) as accessible, trustworthy sources of information on urban health and to highlight the importance of a strong, well-resourced public health system