The San Mateo, California, Youth Commission was created to facilitate youth leadership and capacity building and to inform policy. As the Youth Commission funder, San Mateo County Health System leveraged their contracting process to explicitly include equity metrics and requirements in the youth facilitator contract.
Who Took This On
Health Policy and Planning Program, San Mateo County Health System, CA
Ways You Can Get Started
- Explore leadership development and capacity-building opportunities around policy development and advocacy
- Explore opportunities to include equity in city and county contracting processes — for example, by ensuring that vendors/contractors have a track record of working with communities, include explicit plans for community engagement, and identify how they will build community power
See Advice for Local Health Departments below for more ways to take action.
What Sparked This?
County creates Youth Commission to provide youth voice in government
In 1993, the San Mateo County Board of Supervisors created a Youth Commission to address youth needs in the county and provide youth voice in local government. The Commission consists of 18–25 members between the ages of 13 and 21 who reside or attend school in San Mateo County and are approved by the County Supervisors, as for any other county commission. The Health Policy and Planning Program (HPPP) of the San Mateo County Health System funds the Commission, and it is co-facilitated by Youth Leadership Institute, the Health Planning and Policy Program (HPPP), and the County Board of Supervisors.
Data-driven reports highlight path forward for Youth Commission
In 1999–2000, reports and data illustrated that many San Mateo County youth were at high risk for unsafe sexual behaviors, drug use, and violence. One report, the San Mateo Community Needs Assessment, concluded that community-level strategies to reduce these risk factors had not been adequately explored or implemented. In response, the San Mateo County Board of Supervisors called for a strategic plan to support San Mateo County youth.
This led to the development of the 2001 San Mateo County Adolescent Report, which presented national and local data, model programs, and best practices, and made 3 recommendations:
(1) Increase the amount and number of sustained adult/child interactions, with the specific goal of having 2 to 3 non-teacher, non-parent adults associated with and regularly in every classroom.
(2) Youth should be treated as equals and involved as joint decision makers in activities and programs that affect them.
(3) Establish a structure that can help accomplish the first 2 recommendations.
Following its publication, the county made progress in these areas by enhancing Youth Commission interaction with community bodies and organizations, developing and strengthening school-based programs, and incorporating youth asset development principles in county initiatives.
A second Adolescent Report described youth development activities in the county including youth mentorship programs, youth leadership in school-based programs, and research on youth experiences with behavioral risk factors. The report also shared local and national data and included a call to action for organizations and people in San Mateo County to take shared responsibility for improving the lives of young people. The call to action provided policy recommendations and ways to continuously work to build youth assets.
Youth Commission improves internal policies to increase participation and focus on specific issues
After publishing the second Adolescent Report, the Youth Commission diversified itself to better reflect San Mateo County as a whole — for example, to better represent schools and high school districts. They also reformed their structure to have committees focusing on specific issue areas (e.g., immigrant youth, environmental protection, adolescent needs, mental health, and legislation).
The Commission has a 3-pronged approach: 1) the Commission as a whole sets a youth agenda, 2) individual youth develop leadership skills through participation as Commissioners, and 3) Commissioners sit on other boards and commissions to bring their perspective into those decision-making processes.
Through this last approach, the youth proactively introduce ideas into other policy and decision-making circles and also react to conversations and ideas brought to them. In 2015, there were 23 youth liaisons on 12 boards, commissions, and initiatives. Youth Commission staff provided trainings and support for the Youth Commissioners and the adult allies who mentored them.
Health Department supports Youth Commission awareness raising about social determinants of health
Since its creation, the San Mateo County Health System has funded the Youth Commission and managed the contract with an external facilitator to support Youth Commission activities and capacity building. HPPP manages the contract, works closely with the facilitator to conduct periodic adolescent needs assessments, supports the facilitator and the Youth Commission to analyze assessment findings, and helps develop a policy agenda. HPPP staff also incorporated trainings on the social determinants of health and policy advocacy in the Youth Commission leadership development process.
Health Department supports building power and capacity of youth to become leaders
HPPP stresses the importance of having a diverse set of Commissioners to effectively and authentically represent San Mateo’s diverse communities. HPPP also works with the facilitator, the Youth Leadership Institute, to build the capacity of Commissioners in policy and systems change. To activate the full power of the Commission, HPPP believes it is important for youth to learn and exercise their role, and to develop leaders who represent diverse communities. Since the turn of the century, the majority of county residents have been people of color and the Youth Commission can be a powerful mechanism to build a pipeline of diverse, engaged, and caring leaders for the county.
As the Youth Commission funder and manager, HPPP has had the opportunity to leverage their contracting process and the commission selection process to advance equity.
HPPP hired an outside facilitator with a youth development background and knowledge to build Commissioner capacity and skills, and to conduct a needs assessment to understand health issues facing San Mateo youth. In 2016, HPPP revised their request for proposals (RFP) for the Youth Commission facilitator to more proactively advance diversity, equity, and policy development.
Finding the Right Contractors
The Department explicitly sought contractors to support youth in understanding and advancing a policy agenda, maximize their power on the Commission, and advance a sustainable effort to improve health equity.
Equity-oriented language in the RFP included:
Recruitment: “Specific effort will be made to recruit Youth Commission members who can serve more than one year and represent geographic, ethnic, cultural, racial, and socio-economic diversity. Engage with San Mateo County school staff and other organizations to identify and nominate qualified youth from low-income families and youth of color to participate in the Youth Commission.”
Mentorship: “Special efforts will be made to support the leadership of youth commissioners from disadvantaged backgrounds in order to ensure their full participation on the commission and their ability to maximize learning and development opportunities.”
Trainings: “Contractor will provide leadership trainings or bring in speakers or trainers on leadership development, with a particular focus to leadership development of disadvantaged youth such as youth of color, low-income youth, girls and women, LGBTQ, and those with disabilities.”
Evaluation: “Key indicators may include advancement of Youth Commission’s policy priorities, indications of leadership development, number of youth of color, low-income youth and other diversity factors on the commission, and number of youth serving on commissions and boards, among other measures.”
Key Partnerships: “Youth Commissioners will work with youth-based organizing groups and other youth-based organizations to engage diverse youth in their policy agenda, learn from their perspective and build a partnership in the advancement of health, equity, and youth development in San Mateo County.”
Vendors were required to answer questions about how they would support Youth Commission implementation, youth trainings and leadership development, health policy and planning, community partnerships, and evaluation. They were also asked to answer questions about cultural humility, which was defined as the “ability to maintain an interpersonal stance that is other-oriented (or open to the other) in relation to aspects of cultural identity that are most important to the [person].” The facilitator RFP is available here.
Outcomes and Impacts
Youth Commission builds social capital, self-efficacy, and power
As noted by the HPPP Senior Manager, the Youth Commission is an exciting opportunity to address equity because participating youth are empowered to be part of decision-making processes, and not only as advocates from the outside. She notes, “These early experiences as decision makers help create a pipeline of civically minded and engaged youth and young adults who feel empowered and are more likely to seek out and hold leadership positions moving forward. Particularly for the youth coming from lower-income, historically marginalized neighborhoods, this opportunity helps build the youth’s social capital, social networks, and self-efficacy, and by extension is helping address imbalances in power.”
Youth contractor advancing equity
With the new RFP, the contractor selected to facilitate the commission must have a deep commitment to equity and justice, and bring extensive experience engaging diverse communities across San Mateo County. The current contractor has worked closely with HPPP to recruit more diverse Youth Commissioners and train the youth on the social determinants of health and policy advocacy. The facilitator also supported the youth committees, each of which aim to complete a year-long policy project working closely with 1 or more governmental agencies.
Youth educate and advocate for others
Youth Commissioners wrote a research paper on the changing state of sanctuary cities and counties and what it could mean for San Mateo County. They also wrote letters asking County Supervisors to 1) ensure protections for all community college students; 2) consider the impacts of proposed state legislation on the digital privacy of San Mateo students and administrators; and 3) support a local youth council’s efforts to reduce the amount of alcohol signage in storefronts. They also created infographics on the 2016 US presidential candidates and the cabinet selections of President Trump and on how to apply for FAFSA student aid, and created a video on the dangers of marijuana edibles and driving under the influence of drugs.
Health Department leverages funds for youth leadership and development work
Building on the experiences of youth becoming transformative leaders, HPPP leveraged more Department resources to support youth leadership development work in other areas. Examples include:
- Community Implementation Funding: As described in the other San Mateo County case study, HPPP offers small grants to support community implementation of Get Healthy San Mateo County (GHSMC) strategic priorities. In 2016 and 2017, HPPP awarded funding to the Youth Leadership Institute and Urban Habitat to “build youth leadership and research the needs of transit-dependent populations to help support healthy and affordable public transportation opportunities in rural Half Moon Bay and urban South San Francisco.”
- Engaging youth in research: Working with HPPP staff and San Mateo County epidemiologists, the Youth Commissioners helped develop a unique survey for students in grades 7–12; analyze the data; develop policy recommendations to address issues identified; and distribute the 2015 San Mateo County Adolescent Report,” which included their data analysis and policy recommendations, through presentations to community members and other stakeholders across the county.
- Hosting the annual San Mateo County Youth Conference: The Youth Commission hosts an annual conference that attracts 200–300 youth participants and features speakers and workshops on topics such as teen mental health, youth development, alcohol and drug prevention, sexual health education, and juvenile justice.
- Organizing community events: The Commission has also organized other community forums for youth including “Forms of Abuse,” on sexual assault, human trafficking, and rape culture in San Mateo County, and “Bee the Change,” on how youth and adults can support honey bee conservation; and hosted a community ceremony to award 2 youth with the county Passion, Dedication and Determination: Immigrant Youth Scholarship.
- Serving on other San Mateo County boards and commissions: Over the years, youth involved in the Youth Commission have served on the First 5 Commission, HIV Board, Commission on the Status of Women, Commission on Disabilities, Parks Commission, and the Pride Initiative, among others. Their representation on these commissions ensures the youth perspective is represented in the decision-making process in each of these areas.
Over the next 3 years, the Youth Commission facilitator will continue to work toward the goals established in the RFP, with a clear vision of engaging youth who are most impacted by health and social inequities to develop policy recommendations. The facilitator will also begin planning for the next Adolescent Report, which will involve extensive community engagement with youth, schools, social service providers, parents, and others to capture current needs and opportunities for San Mateo youth.
HPPP will continue to support Youth Commission operations and Adolescent Report data collection and analysis, and will work with the Commission to interpret findings and identify policy solutions. They will also continue to leverage their funding capacities to support youth leadership development and engagement. HPPP is committed to ensuring the success of the Commission in representing the diverse voices of San Mateo County communities.
Advice for Local Health Departments
Do as much as possible to support diverse leadership
Representative government is critical to advancing health equity. By including those impacted by decisions in the decision-making process, you ensure that those communities’ needs and aspirations are considered front and center. Work to create a clear pathway for people who are not typically represented in decision-making roles to be positioned to authentically represent their communities. Supporting pathways for people of color, low-income people, youth from diverse backgrounds, those with disabilities, and others to build their capacity and fill decision-making and advisory positions on boards and commissions is a key strategy to advance health equity.
Engaging youth is important for local governments. Many decisions impact youth’s current and future well-being, yet they are rarely engaged in decision making. Building their capacity creates lifelong civic engagement and valuable leadership development that can impact future individual and community trajectories. At the same time, youth bring energy, fresh perspectives and ideas, and new ways to engage community that complement otherwise bureaucratic approaches.
Be creative and flexible and don’t give up
Advancing health equity can be challenging and exhausting. Working in government, even in a progressive municipality, means working within a bureaucracy. It’s important to be creative, flexible, and persistent.
Connect to like-minded peers
Champions for health equity often don’t have much internal support, which can make them feel isolated. If possible, connect to a broader network of people who are not directly in your jurisdiction to provide guidance and share ideas.