Community Context 

Spanning more than 9,000 square miles, Maricopa County is home to dozens of cities, including Phoenix. The county sits on the ancestral land of several American Indian tribes, but an influx of European settlers to the region was precipitated by economic growth in the “Five Cs” (copper, cotton, climate, citrus, and cattle). 

Today, the education, healthcare, and social services sectors make up about 20 percent of the economy, followed by professional and administrative services and retail trade. With rising housing costs, Phoenix is now one of the most of expensive places for rent in the country, and Maricopa County has thousands of people who face homelessness nightly. 

The dry climate has historically been a draw for residents and businesses, but the area is facing an increase in extreme heat, breaking records in 2020, and resulting in an increase in heat-related deaths. Current health priorities for the county include increasing access to care and to healthy food and early childhood development—a shift from the focus on chronic diseases in years past. 

The pandemic has taken a toll on residents’ physical and mental health, with severe cases of COVID-19 more common among American Indian populations. 

The county has high rates of opioid-related overdose and deaths, and overdose deaths increased by 160% between 2019 and 2020.

In 2019, Phoenix elected a Democratic mayor, only the second elected female mayor in the city’s history. However, there remains a political divide in the county, extending to state policies.

Maricopa County’s Journey to Promote Health, Well-Being, and Equity

Over the past five years, there has been a shift in mindset and narrative toward a greater recognition of the importance of social determinants of health and equity, and the importance of cross-sector collaborations in improving health and well-being.

Investments in the staffing and operating budgets of the Maricopa County Department of Public Health as well as grants to address social determinants of health over the next two years hold promise for improving health and well-being, but it is not clear yet whether those investments will have the intended impacts. With a diverse population and ongoing concerns around health disparities, there is still a need to focus on populations who are underserved; leverage cross-sector collaborations to build trust; and lift up, empower, and engage communities in decision-making efforts. As Maricopa County expands its focus on health equity, there is room for additional thought leaders to contribute to meaningful change.


Baseline research started in 2016 to track community programs and initiatives. The most recent report, from 2022, provides more in-depth insights and analysis into the community's efforts to build a Culture of Health.

Lessons Learned: Where is Maricopa County Five Years Later?

Evidence suggests that Maricopa County has shifted its focus more toward health and well-being. The county acknowledges of the importance of social determinants of health and other systemic and structural factors that contribute to health equity. 

Although the change is happening slowly, on-going investments by dedicated organizations continue to lead the way. Other communities can learn from Maricopa County’s approaches to make these changes, as well as the challenges the county encountered, to inform their own journeys. And as COVID-19 recovery continues, with historic funding flowing to local communities, future research could consider the ways in which momentum around health, equity, and well-being influences community health narratives and decisions moving forward.

Maricopa County has leveraged investments by foundations and local government, cross-sector collaboration, and expanded inputs in decisionmaking to make progress towards health. However, the size of the county, siloed sectors, and lingering mistrust of government remain as critical barriers.

Facilitators:

  • Investments in health and infrastructure

  • Severe weather impacts led to the adoption of climate action plan

  • Foundational messaging on connection of a healthy community and healthy economy

  • Increased opportunity for community voice

  • Enhanced efforts to collect data from diverse populations

Barriers:

  • County size inhibits meaningful collaboration

  • City and county divisions focused on health are siloed in efforts

  • Lack of political will to model inclusivity drives lack of trust in government